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Biomedical subjects

James G Garrick

Publications and source records attributed to James G Garrick.

7 recordsLinked to original sources
PubMed2005

Structured exercises to prevent lower limb injuries in young handball players.

OBJECTIVE: To investigate the effect of a structured warm-up program in reducing the occurrence of knee and ankle injuries in teenage handball players. DESIGN: Block randomized controlled trial with a sample size designed to achieve 90% power with [alpha] = 5% to detect a relative risk (RR) reduction of 50%. Clubs within the randomization blocks were matched by region, playing level, and number and sex of players. SETTING: Norwegian Handball Federation clubs in the 16-year and 17-year divisions during the 2002 to 2003 season. PARTICIPANTS: Clubs in the division were invited to participate in the study before the season (n = 123 clubs recruited; 85% of the 145 invited clubs). After 3 clubs were excluded or dropped out, 1837 eligible players (uninjured at baseline) aged 15 to 17 years (86% young women) were included in the analysis. INTERVENTION: Coaches of the intervention group clubs (958 players) were instructed in exercises to improve awareness and control of knees and ankles during standing, running, cutting, jumping, and landing. The program comprised exercises with the ball, including the use of the wobble board and balance mat, for warm-up, technique, balance, and strength. Players were to spend 4 to 5 minutes on each group of exercises for a total of 15 to 20 minutes at the first 15 training sessions and thereafter once per week. Coaches recorded attendance and details of the sessions on standard forms. Coaches of the control group clubs (879 players) were asked to continue with their usual training methods and to record types and volume of exercises used. MAIN OUTCOME MEASURES: The primary outcome measure was an acute injury to the knee or ankle during a match or training session that required the player to have medical attention or miss part of the next session. Secondary outcomes were any injury to the lower limbs, injuries overall, and injuries to the upper limb. Injuries were recorded by physiotherapists blinded to group assignment who were in contact with the coaches at least every month. The physiotherapists interviewed injured players in person or by telephone as soon as possible (range, 1 day to 4 months). MAIN RESULTS: During the season 262 players (14%) were injured at least once (241 acute and 57 overuse injuries). In intention-to-treat analysis, the intervention group had lower risks than the control group of acute knee or ankle injuries (RR, 0.53; 95% CI, 0.35-0.81), lower limb injuries (RR, 0.51; CI, 0.36-0.73), any injury (RR, 0.49; CI, 0.36-0.68), and upper limb injuries (RR, 0.37; CI, 0.20-0.69). Rate ratios for moderate and major injuries (absence from play for 8 to > or =21 days) were lower for the intervention group for all injuries (P < 0.001) and for acute knee or ankle injuries (P < or = 0.03). Fewer players in the intervention group had > or =2 injuries. Risk of injury did not differ for young men and women. Crossovers to the other intervention occurred in 13% of the intervention clubs (noncompliance with the training program) and 22% of the control clubs (use of similar preventive exercises to the intervention group). CONCLUSIONS: The rate of acute knee and ankle injuries and all injuries to young handball players was reduced by half by a structured program designed to improve knee and ankle control during play.

Journal Article↗
PubMed2004

Preparticipation orthopedic screening evaluation.

OBJECTIVE: To review evidence-based support for the preparticipation orthopedic evaluation. DATA SOURCES/METHODS: Articles were reviewed that dealt with the sensitivity, specificity, and predictive value of the components of the standardized preparticipation orthopedic evaluation. In addition, studies describing musculoskeletal conditions/findings predictive of future injuries were sought through a PubMed search. RESULTS: The sensitivity of the evaluation questionnaire appears to be adequate, exceeding 90% in some studies. There is little or no published information documenting that the physical examination (1) approaches the questionnaire in either sensitivity or specificity or (2) identifies elements of value based on their association with future injuries or reinjuries. There are no readily discernible elements even in an expanded examination that are documented as being predictive of future problems. CONCLUSIONS: The current questionnaire and examination appear to fulfill adequately both legal and institutional requirements. Practitioners should be aware of the absence of data linking virtually any of the findings on the examination to either an increase or a decrease in the likelihood of future injuries. There is no evidence that increasing the scope of the examination would enhance its predictive value.

Evidence-Based Medicine↗
PubMedDate not supplied

Sports and fitness activities: the negative consequences.

Participation in sports and fitness activities offers potential health benefits for individuals of all ages, such as combating obesity and osteoporosis, as well as enhancing cardiovascular fitness. Negative consequences of musculoskeletal injuries sustained during sports participation in childhood and adolescence may compromise function in later life, limiting the ability to experience pain-free mobility and engage in fitness-enhancing activity. Increasingly successful management of sports-related injuries has allowed more athletes to return to participation. However, even effective early management of meniscal or anterior cruciate ligament injury does not minimize or preclude the increased likelihood of developing subsequent osteoarthritis. In addition, even in the absence of injury, vigorous participation in sports and fitness activities during childhood and adolescence increases the likelihood of developing osteoarthritis. It is ironic that return to vigorous sports participation has been adopted as an important measure of success of treatment, yet few efforts have been made to document long-term consequences of continued participation. Awareness of the long-term consequences of intensive sport and fitness activities allows the physician to help patients make informed decisions about the types and levels of activity they choose.

Athletic Injuries↗