Reviews of published studies on current topics in sports
medicine. The full articles can be obtained from hospital
and medical school libraries. To order complete Sports Reports
online for these topics and more complete
our online form.
ASTHMA AND EXERCISE-INDUCED BRONCHOSPASM
Diagnosing Exercise-Induced Asthma and Related Symptoms:
Studies indicate that using a sole screening method (patient
survey, physical exam, positive bronchial provocation)
may not be sufficient to diagnose all athletes who experience
exercise-induced bronchospasms or related asthmatic symptoms
[2, 3]. In future investigations, researchers recommend
testing methods be carefully standardized, as a difference
in exercise intensity of as little as 10% has been shown
to affect the presence of bronchoconstrictive symptoms
in diagnosed asthmatic patients .
1. Carlsen K-H, Engh G, Mork M. Exercise-induced bronchoconstriction
depends on exercise load. Respiratory Medicine 2002:94:750-755.
A study with 20 asthmatic children (9-17 years old) sought
to determine the effect of exercise load on exercise-induced
bronchoconstriction. Subjects performed two treadmill tests
at 85% and 95% of maximum heart rate (calculated based
on age). Lung functions were measured prior to test and
a fifteen-minute recovery period afterwards, and children
also completed a self-evaluation of perceived exertion.
Results showed that although all subjects showed a decrease
expiratory volume (FEV1) of equal to or greater than 10%
of baseline after 95% exercise load, only 9 subjects (40%)
showed a similar decrease after 85% exercise load. This
indicates that testing at a greater exercise load induces
symptoms in asthmatic subjects with greater regularity
than at reduced exercise loads. Authors suggest that exercise
tests used to interpret exercise-induced bronchoconstriction
should be strictly standardized to avoid misdiagnosis.
ACUPUNCTURE AS THERAPY FOR CHRONIC PAIN
Numerous studies of acupuncture have revealed it to be
a viable and efficacious therapy for the treatment
of chronic pain. Subjects with chronic conditions such
as low back
neck pain, and tennis elbow have used acupuncture to
relieve pain intensity, improve sleep, and increase functionality
[1, 2, 3]. Some authors have demonstrated that the
of acupuncture may be due to patient expectations 
or a more general placebo effect . Others have shown
needling is important to the treatment, although the
effects of choosing specific points remain unclear .
all the studies reviewed below conclude that, for whatever
reason, acupuncture can be an effective and safe supplemental
therapy for chronic pain management.
1. Carlsson CPO,
Sjslund BH. Acupuncture for chronic low pack pain: a
randomized placebo-controlled study with long-term
follow-up. The Clinical Journal of Pain 2001:17:4:296-305.
subjects with chronic low-back pain were treated with acupuncture
therapy or active placebo
week for a period
of eight weeks. During a follow-up period of
six months, subjects received two additional
also assessed by an independent observer. Subjects
individual pain diaries that recorded analgesic
intake, pain intensity,
quality of sleep, and activity level. Results
showed that fourteen out of thirty-four subjects
reported improvement that lasted during the
entire six months, while only two out of fourteen control
similar improvement. Specifically, acupuncture
patients reported significant decreases in
as well as improvements
in sleep, analgesic intake, and ability to
work by one to three months into the follow-up period.
that needle acupuncture appears to provide
long-term pain relief to some patients with chronic low
TREATMENT ISSUES FOR ANTERIOR CRUCIATE
LIGAMENT (ACL) INJURIES
When a tear of the ACL has been
diagnosed in an athlete, several decisions need to be
addressed. The first
decision is whether to proceed with surgery
or attempt rehabilitation
without surgery. If the decision is made
to have surgical treatment, questions arise as
type of surgery
for that individual, the long-term outlook
after surgery, and types of rehabilitation
are the author’s summaries of recently
published medical studies that address
these questions. The complete articles
can be found at most hospital, medical
school, or university libraries. The summaries
presented for educational purposes
only and are not in any way a substitute
for medical evaluation and treatment.
TENDON vs. HAMSTRING : The two most
common graft choices for ACL reconstruction
are to use the patient’s own hamstring
tendon or part of the patellar tendon to
replace the ACL. Here are
the two methods.
1. Mark D. Shaieb, Darryl M.
Kan, Spencer K. Chang, Jay
M. Marumoto, Allen B. Richardson.
of patellar tendon versus semitendinosus
gracilis tendon autografts for anterior
reconstruction . The American Journal
of Sports Medicine, March-April
2002 v30 i2 p214(7).
A comparison of patellar
tendon versus hamstring tendon for ACL reconstruction.
on 70 patients, all
surgery performed by the same surgeon.
At two year follow-up, 97% of patients
tendon grafts and 100% of
patients with hamstring tendon grafts
rated the results as
good or excellent. No significant
differences between groups in terms of activity level
or physical findings. Patellar tendon
of patellar-femoral pain at six months
and longer follow-up (42% versus 20% in the hamstring
group). There were two graft failures
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