Archive for March, 2014

Training Program Reduces ACL Injuries in Young Athletes

A good friend of mine’s son is backing playing Ultimate frisbee, having torn up his knee last spring playing Freshman football in high school.

Reconstructive surgery repaired Sam’s two torn knee ligaments, including the anterior cruciate ligament (ACL), a critical ligament that stabilizes the knee joint.

ACL injuries are quite common among young athletes and have become more prevalent over the past decade as more youngsters participate in sports such as football, soccer, volleyball, and basketball, which are hard on the football concussions

Recent research has found that screening tools, such as “hop” or isokinetic (computer/video) tests to identify neuromuscular deficits, may identify athletes more likely to suffer ACL injuries.

Biomechanical studies have led to the development of neuromuscular training programs to improve neuromuscular control and reduce ACL injury rates.

Now research led by doctors from New York-Presbyterian/Columbia University Medical Center has found that universal neuromuscular training — which focuses on the optimal way to bend, jump, land, and pivot the knee — is an effective and inexpensive way for young athletes to avoid ACL sprains and tears.

The researchers reported their results at the American Academy of Orthopedic Surgeons annual meeting on March 14, 2014.

The research team evaluated 3 strategies for young athletes: no training or screening, universal neuromuscular training, and universal screening with neuromuscular training only for identified high-risk athletes.

Risk of injury, risk reduction from training, and sensitivity and specificity of screening were based on published data from clinical trials.

Costs of training and screening programs were estimated based on existing literature.

Using a model based on data from recent clinical trials, the researchers evaluated a hypothetical group of student athletes ages 14 to 22.

They found that universal training reduced the incidence of ACL injury on average by 63% while the screening program reduced the incidence rate on average by 40%.

Of 10,000 athletes, the model predicted 300 ACL injuries in the no-screening group, 110 in the universal training group, and 180 in the universal training/screening for “at risk” group.

What’s more, by reducing the risk of ACL injury universal training would save an average of $275 per player per season.

“While we were not surprised that training was more cost effective than no intervention, we were impressed by the magnitude of the benefit,” said lead researcher Dr. Eric Swart, an orthopedic resident at New York-Presbyterian/Columbia University Medical Center.

“According to our model, training was so much less expensive and so much more effective than we anticipated.

In addition, fewer players injured means fewer surgical reconstruction procedures, which also saves money.”

He believes that widely implementing a universal training strategy could actually pay for itself in terms of injuries prevented and surgeries avoided.

And that’s doesn’t include saving youngsters from the pain and anguish of recovering from major surgery.

Neuromuscular training may be too late for Sam, who continues to do physical therapy to strengthen his leg muscles to support his rebuilt knee.

But thousands of other young athletes could certainly benefit from better training to avoid devastating knee injuries.

Take Advantage of National Day of Unplugging

National Day of Unplugging starts tonight, offering us a chance to disconnect from technology and reconnect with family and friends.

Today’s guest blog comes from occupational therapist Robbie Levy, a highly respected authority in her field who has been successfully working with children since 1981.

Robbie was ahead of her time when she recognized the importance of early intervention and the need for therapeutic resources dedicated to children.

She founded Dynamic Kids, one of the leading pediatric occupational therapy practices in the New York region.Dynamic Kids logo

Below, she presents some cogent thoughts on why kids need to unplug, and how you can help them go about it.

National Unplugging Day

There is no denying the media, the Internet, video games, and computers are all part of our daily lives.

We use these electronic devices for a variety of reasons: for work, to assist us in our everyday routines, to keep up with friends, and for play and recreation.

For the most part, technological advancements have improved society.

But what effects do these gadgets really have on young children’s’ development as they grow?

According to the American Academy of Pediatrics, children spend an average of 7 hours a day on entertainment media.

Limit Kids Screen Time

As a parent, it is crucial to limit children’s screen time and offer only educational media and non-electronic formats, such as books, board games, and sensory motor activities.

If your young child does use media, watch together and then talk about what you saw.

Or sing the songs together.

This will help guide your children to a better media experience.

In a child’s first 5 years of life, the brain grows rapidly.

Young children learn best by interacting with other people and directly from sensory and motor play with their bodies utilizing all their senses.

National Day of Unplugging from sundown on Friday, March 7th to sundown on Saturday, March 8th allows us 24 hours to reconnect with our children, family, and friends (and self) without the interference of technology.

As an Occupational Therapist and child development specialist for 33 years, I assure you this is a wonderful opportunity to unwind, de-stress, try new activities, or pick up an old one that you have forgotten.

Unplugged Activities

Here are some suggestions of activities that parents CAN do with their children on this day that will have the most powerful impact on a child’s sensory and motor properties.

You don’t have to limit these suggestions to a National Day of Unplugging, so feel free to do them frequently.

You will be providing your kids with the ingredients they need to strengthen their bodies and minds.

1. Go out in nature!

Even if the weather is cold, take a walk, play in the snow, ice skate, or go sledding.

Do something physical but also talk about what you see and feel in the world, that is, the colors, textures, temperature, clouds, and animals.

2. Start a garden indoors or outdoors!

Dig, plant, hoe, spread dirt, and plant seeds.

Work with your hands and have your child get his or her hands dirty.

3. Cook together!

Especially focus on the gooey stuff, such as mixing, stirring, spreading, and pouring.

For older children, allow them to cut and chop with supervision.

4. Read together!

Tell each other stories.

Ask questions about what you are reading.

Ask your children to anticipate what they think will happen.

Ask them to make up a different ending.

Or simply tell stories to each other.

5. Play with manipulatives together!

Try various types but especially ones that require pushing and pulling.

Try pop-beads for younger hands and Zoobs for older hands.

Don’t tell your children what to make.

See what they come up with and then talk about it.

6. Make an obstacle course indoors or outdoors!

Use furniture, toys, and pillows, and then go over, under, through, and around objects.

Change directions and go the other way.

Then try crawling backwards.

Unplug and enjoy!!!!!

Exercise More, Sit Less to Prevent Heart Failure

Be more active and sit less and you’ll improve your chances of preventing heart failure.

That’s the message of the first study to provide evidence that high levels of sedentary time, even among physically active men, places them at risk for heart failure.

“The evidence of the effects of physical activity on heart failure is developing.

Our study adds to this by examining the associations in a large racially and ethnically diverse population.

We provide even more evidence that moving more and sitting less can lead to better health,” says lead author Deborah Rohm Young, PhD, research scientist at the Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA.

Dr. Young and colleagues examined the electronic health records of nearly 83,000 men aged 45 years and older who were part of the California Men’s Health Study and had enrolled in Kaiser Permanente health plans in the Northern and Southern California regions.

The researchers published their results in the January 21, 2014 issue of the journal Circulation: Heart.

After monitoring these men for more than 10 years, they found that the risk of heart failure in those who reported high levels of sedentary time and low levels of physical activity was twice that in men who reported high physical activity and low sedentary time.

Although the researchers were not able to identify the types of exercise that the men did in the study, Dr. Young suggested that “brisk walking is a great form of physical activity.

It can be done almost anywhere, it does not require equipment, and most people of all ages can do it.”

She says that a brisk walk is “as if you’re in a hurry, and is defined as a 3- to 4-mile per hour pace or a 15- to 20-minute mile.”

To prevent heart disease, Dr. Young encourages men to meet the National Physical Activity Guideline—150 minutes per week of moderate intensity physical activity.

“We are still learning about the detrimental effects of high daily sedentary time,” she says.

“At this point, there is no consensus on how much sedentary time is too much.

Plus, our study only asked about sitting time outside of work.

But given the number of health benefits from being physically active, people should find ways to put physical activity into their lives and spend less time sitting.”

At Kaiser Permanente, clinicians have initiated an “Exercise Vital Sign” program in which all members are asked about their physical activity at every outpatient visit.

“The information is recorded in their electronic health record and is available for the health care providers when they see the patient.

It provides an opportunity for the provider to counsel the patient on physical activity levels,” Dr. Young says.

She suggests that primary care physicians ask their patients about their regular physical activity.

“When it’s insufficient, patients need to hear that regular physical activity is important for their health.

Physicians can be powerful advocates in helping to promote this message.”