4th International Conference on Sports Medicine and Fitness 2018-05-31 Edinburgh, Scotland

Chair

Juan Castellano

Life Pilates, Spain

Co-Chair

Ahmad Alkhatib

Dasman Diabetes Institute, Kuwait

Session Introduction

Beatriz Minghelli

Piaget Institute, Portugal

Title: Injuries and time-motion analysis in surfers: Development of preventive strategies

Time : 11:15-11:40

Biography:

Beatriz Minghelli has completed her PhD in Public Health at National School of Public Health, Lisbon, Portugal; Master of Science in Physiotherapy in School of Human Kinetics at University of Lisbon, Portugal and Physiotherapist training in Education School Helena Antipoff-Rio de Janeiro, Brazil. She is an Adjunct Professor in the School of Health Jean Piaget/Algarve at Piaget Institute, since 2006; Coordinator of the Physiotherapy Course of School of Health Jean Piaget/Algarve at Piaget Institute. She is the Member of Research in Education and Community Intervention (RECI). She has published more than 30 papers in national and international journals and has been serving as a Reviewer of reputed journals. She is the Editorial Board Member of Journal Austin Spine, EC Orthopaedics Journal, Research and Reviews and Research & Investigations in Sports Medicine (RISM).

Abstract:

Surfing practice has increased in popularity and the numbers of surfers in competitions. Surfers are subjected to external factors (ocean currents, wind orientation, wave size, contact with the board and other surfers) that require quick and efficient adaptations, increasing the risk of injury while riding waves. In a surfing session, it is necessary to perform repetitive paddling movements that require high muscular endurance, moderate-high cardio-respiratory endurance, and anaerobic power of the upper torso. During paddling movements, the surfer performed a hyperextension of the trunk and realized repetitive arm stroke action, and this repeated movement can be considered to be factors associated with chronic overuse injuries. Surfing has become an increasingly acrobatic and dynamic sport, increasing the number of acute injuries acquired while riding waves. Materials used for surfing are becoming lighter and shorter, providing greater speed and improved hydrodynamics and also float lower in the water, causing more instability for the athlete, increasing the injury risk. Thus, it is necessary to develop epidemiological studies, in order to identify the injury prevalence and risk factors, as well as evaluate surfers’ activities times in order to account for the time spent in each surfing activity to enable the development of appropriate preventative strategies. This presentation will approach the prevalence of injuries in this modality, indicating the most frequent types and anatomical sites, the injury mechanism, the associated risk factors and the physiological metabolism used for this practice.

Fahad Nasser Al-Khalaf

Al Razi Orthopedic Hospital, Kuwait

Title: Ramp lesion - menisco-capsular tears

Time : 11:40-12:05

Biography:

Fahad Nasser Al-Khalaf has completed his Medical Bachelor’s degree at the Royal College of Surgeon in Ireland-Dublin, in 2006. In 2014, he completed his Orthopedic Training and Saudi Board of Orthopedic Surgery at King Faisal Specialist Hospital and Research Center-Riyadh, Kingdom of Saudi Arabia. In 2017, he completed his Sport Medicine Surgery Fellowship at Queens University-Kingston, Ontario Canada. Currently, he is an Orthopedic and Sport Medicine Surgery Specialist practicing at Al Razi Hospital-Ministry of Health in Kuwait.

Abstract:

Meniscal tears are seen frequently with ACL injuries. Literature shows about 40% meniscal injuries are associated with ACL rupture. Since the late 1980’s medial meniscus posterior horn injuries has been described. Recent literature has shown more detailed classifications of the posterior horn injuries and its meniscocapsular separation which is now known as ramp lesions. Ramp lesions are difficult to diagnose. Images such as MRI have low sensitivity for diagnosing meniscocapsular tears. The gold standard diagnostic tool is arthroscopy. Since ramp lesion are at the “blind spot” of the posterior knee compartment, it became a standard step in the diagnostic arthroscopy to visualize the postro-medial compartment to roll out ramp lesion in the setting of ACL rupture which its incidence can be up to 17%. Unrecognized large ramp lesions can be responsible for failed reconstructed ACL. Biomechanical and laboratory studies shown that un-repaired RAMP lesions can be responsible for increased tibio-femral joint laxity and increased tibial external/internal rotation which increases the stress over the reconstructed ACL and might be a direct cause of graft failure. Surgical repair of ramp lesion can be technically demanding with increased risk of saphenous nerve injury. Different approaches have been proposed for repair, and each repair can carry its own advantages and disadvantages. Out side-in technique carries the highest risk and should be done with caution. All-inside and inside-out techniques demonstrated higher success and it’s more supported by literature. There is no specific rehab protocol for ramp lesion repair. Currently ACL rehab protocol is used for isolated ramp or concomitant ramp and ACL reconstruction with similar result as isolated ACL rehab.

Hana Válková

Masarykova University, Czech Republic

Title: Healthy community-education and health promotion in athletes of Special Olympics

Biography:

Dr. Hana Válková is a member of Doctoral Board and Scientific Board of the Faculty of Sports Studies in the Masarykova University, Czech Republic. Currently she is working as a Professor in the Division of History, Philosophy, Sociology and Psychology of Sport. She has over 100 publications in top scientific journals, including books, most recently publication is Leaving Competitive Sport in the Czech Republic.

Abstract:

The health of Special Olympics athletes is a key component of Special Olympics 2016-20 Strategic Plan. During sport activities inclusion of persons with mental disability can be developed and overall well-being is promoted. Until nowadays persons with mental disability are more restricted in their participation in sport comparing with inactive population in the Czech Republic. Generally lower level of fitness, higher overweight and obesity of persons with mental disability guide to the strategy of healthy communities. Healthy athletes programs are oriented on screening of fitness variables, life style habits including nutrition, the perception of health care and personal well-being perception. The Czech Special Olympics with partner universities is focused on composition of healthy communities in six territories of Czech Republic. To create realistic model of healthy community which will be friendly and pleasant for persons with mental disability is the main goal of presented project. The basic principles of the project are described: management, methods of screening, feedback and follow-up care, fitness level in relation of gender and social environment.

Warren Collins

Penningtons Manches LLP, UK

Title: Legal claims for the sports person injuries

Biography:

Warren Collins has been a Solicitor of the Senior Courts of England and Wales for 27 years. He practices exclusively in Claimant/Plaintiff personal injury claims with an emphasis on neurological injuries. His practice is truly international but with an emphasis on UK/US Claims. He is currently the Chief Assessor for the Personal Injury Accreditation Scheme of the Law Society of England and Wales and also Member of (and Assessor for) the Spinal Cord Injury and Brain Injury Specialist Accreditation Panels of APIL (the Association of Personal Injury Lawyers). In the USA, he is the current co-chair of the Spinal Cord Injury Litigation Group of AAJ (American Association for Justice) and the Secretary of AAJ’s International Practice Section. He is the only UK Solicitor member of the Melvin Belli Society (pre-eminent personal injury lawyers of America) as well as the National Crime Victims Bar Association of America. Warren is listed in the Lawyers’ Hall of Fame in the Legal 500 (a leading peer review directory of lawyers) and has won numerous awards including Personal Injury Lawyer of the Year in 2013.

Abstract:

Whenever one engages in sports, there is always an inherent risk of injury. Most athletes accept this risk as part of the game. Most injuries are accidental and relatively minor, like sprains, twists, and the occasional bone break. But what happens if an injury occurs as a result of a deliberate hit or someone acts so recklessly that injury is almost certain to occur? As we all know that coaches play a major role in the development of athletes. In other words, since a coach is placed in a position of power and trust, the duty of care will always be placed on him. If certain requirements are not met, the coach may be held financially, or even criminally, liable. It is a discussion on legal liability for sporting injuries, quantification of damages for pain, suffering of past and future financial losses. We will discuss the analysis of the law of consent to injury and contributory negligence/comparative fault. It is a review of the importance of medical records in the legal arena and an exploration of the law relating to medical causation. The claims process explained with particular emphasis on the role of the expert witness.

Chair

Kirill Micallef Stafrace

Maltese Olympic Committee, Malta

Co-Chair

Juan Castellano

Life Pilates, Spain

Session Introduction

Michiel Frederik Vande Kerckhove

St. Trudo Hospital, Belgium

Title: Lumbar disc herniation in the athlete: Considerations for management and surgical treatment

Biography:

Michiel Frederik Vande Kerckhove has completed his Medical studies at the University of Ghent, Belgium. He is in his fifth year of medical training at the University Hospital of Aachen, Germany. He is working as a Resident in the Orthopedic Surgery Department of Prof. Dr. Lauweryns. He has special interest in Spine Surgery.

Abstract:

A lumbar disc herniation in an athlete can cause significant morbidity and loss of playing time. It can also lead to financial loss, loss of status, psychological problems or even the end of a sports career. Lumbar disc herniation is a mechanical failure of the intervertebral disc to contain the disc material in the intervertebral disc space. This can possibly lead to a mechanical conflict and/or chemical irritation of the neurological structures in the lumbar spinal column. As such it can lead to irradiating pain in one or two legs, back pain, sensory and/or motor disturbances. The practice recommendations endorse an algorithmic approach to management that begins with observation, physical therapy and possibly epidural injections as the initial steps for treatment. Surgery is reserved for those who do not respond well to conservative care. In the general population, surgical treatment for lumbar disc herniation in the form of microdiscectomy has been shown to have excellent outcomes across several randomized controlled trials, with high success rates, return to work, and cost-effectiveness. This paradigm is also true in the athlete population. Studies suggest that a high level of return to sport is possible following lumbar disc surgery. This presentation depicts why it is important to give extra consideration regarding the management, the timing of surgery and the surgical options in lumbar disc herniation in the athlete.

Punchividanelage Nilu Jayashika Fernando

Sri Lanka Anti-Doping Agency, Sri Lanka

Title: Dietary supplement usage of athletes in a South Asian regional country; Sri Lanka

Time : 14:20-14:45

Biography:

Punchividanelage Nilu Jayashika Fernando has completed her BSc in Chemistry at University of Sri Jayewardenepura and Postgraduate Diploma in Analytical Chemistry at the University Of Colombo, Sri Lanka. She is a Research Officer at Sri Lanka Anti-Doping Agency. Her research interests include anti-doping science research in the field of sports.

Abstract:

Objective: Identification of dietary habits and dietary supplement usage pattern among Sri Lankan athletes.
Methods: Sri Lankan elite athletes (386) above 18 years old, who belong to 14 sports, were randomly selected for survey study. Data was collected through self-administered structured questionnaire.
Results: Dietary supplements are being used by 90% of them, mainly including multivitamins (62.5%), protein (47.4%), creatine (19.0%), rehydration fluids (54.5%) being weight gainers (1.1%) the lowest. Players in all 14 sports showed more than 75% dietary supplement usage while badminton, shooting, wrestling, netball and rugby showed significantly higher usage than karate which has the lowest usage. Supplement usage pattern was observed within geographical variation where six provinces showed more than 90% usage compared to all nine. A significant increase in supplement usage was observed in athletes between 21-35 ages. No significant difference was observed in the supplement usage pattern respect to marital status, gender, occupation of the athletes or highest level of participation. All the participants take carbohydrate rich diet for lunch and 13% cereal for breakfast and 4.2% vegetable and meat rich diet for both breakfast and dinner. Among them 10.9% consumes junk food for dinner. From these players 81.9% using fruits, 54.9% using porridge, 43% using soup and 22.8% using drinks made from medicinal plants show similar tendency in using dietary supplements (more than 90%). Among vegetarians (3.6%) the supplement usage is 85.7% which includes 57.1% protein supplements.
Conclusion: While dietary supplement usage is high among Sri Lankan athletes irrespective of sport, dietary habits and social status, their dietary practice needs a change.

Tossaphon Jaysrichai

Srinakharinwirot University, Thailand

Title: A new machine for evaluating the precision and response time of punches

Biography:

Tossaphon Jaysrichai has completed his PhD in Biomedical Engineering at Chulalongkong University. He is a Lecturer of Physical Therapy.

Abstract:

Response time and precision of punches are an important skill for boxers, because the high precision and the fast moving response refer to an excellent skill. Our team developed the boxing trainer device that was called “Robo Boxing Trainer”. The objective is to develop and evaluate the device for precision (in percent) and response time (in seconds) of punches. Researchers cooperated with Sport Authority of Thailand and the Amateur Boxing Association of Thailand for development. Robo-Boxing Trainer consisted of four targets. Each punching target has eight sensors and eight LED lights. Operating software, which created by PLC-CX programmer and DOPSoft (delta), can set the punching series and alarm signals. It could record the response time since starting signal until touching target and to calculate for precision percentage. This software could be set and recorded maximal 40 series and maximal 100 punches in each punching series. Researchers compared the accuracy of counting time with digital oscilloscope and tested the efficiency of sensors’ cutting signal. This study found the counting time to be high accuracy (100% and 98.8%). The cutting sensors' signal test was efficient. Robo-Boxing Trainer, which is a high accuracy device, might help to test and improve boxer’s skills.

Kaydar Al-Chalabi

Al Moosa Clinics & Day Surgery Center, UAE

Title: The Role of Platelet Rich Plasma (PRP) in musculoskeletal problems & sports medicine

Biography:

Dr. Kaydar Al Chalabi is a Specialist in Rheumatology, Physical Medicine and Rehabilitation who brings more than 25 years of experience in medical practice. His areas of expertise include Rheumatologic Diseases, Local Pain Management, Neurological Injuries, Pre/Post Orthopedic Management and Rehabilitation, and Post Amputations. Dr. Kaydar holds Bachelor’s Degrees in Medicine and Surgery (MBChB) from the College of Medicine at the University of Mosul in Iraq. He also completed a Master’s Degree in Physical Medicine, Rheumatology and Rehabilitation from the Faculty of Medicine, Ains Shams University in Egypt.

Abstract:

Platelet-rich plasma (PRP) is one of many new developments within the expanding field of regenerative medicine. Specialists in areas such as orthopedics, sport medicine, physical medicine and rehabilitation, and rheumatology have been exploring the benefits of this novel therapy. The use of orthobiologics such as PRP continues to advance as patients seek nonsurgical approaches to acute and chronic musculoskeletal injury and disease. Advancements in this novel bioactive therapy have occurred during the past 2 decades. Recently, the body of literature has grown and we are learning a great deal about the potential for this regenerative therapy. Applications in physiatrist, orthopedics, and sports medicine are currently being developed, and regenerative biomedicine is rapidly becoming an exciting and promising treatment option in musculoskeletal medicine. However, much remains to be learned in this emerging field. In this article we will focus on PRP, a bioactive regenerative therapy that has garnered significant attention in recent years. Human clinical trials are emerging that demonstrate the promise of this innovative therapy, which likely will play a major role in shaping the landscape of sports medicine.

Valerio Pace

University of Perugia, Italy

Title: Superior labrum anterior posterior lesions (SLAPs) in athletes: An overview

Biography:

Valerio Pace has completed his MBBS at the University of Perugia. He worked as T&O SHO and Registrar at Royal National Orthopaedic Hospital (RNOH) NHS Trust between 2015 and 2017. He is currently a T&O Resident Doctor at the University of Perugia, Italy. He also has Honorary Research Contract at the Royal National Orthopaedic Hospital. He has published eight papers in reputed journals, presented at several conferences and carrying on plenty of on-going research projects.

Abstract:

A SLAP lesion is defined as an injury of the superior labrum that begins posteriorly and extends anteriorly including the ‘anchor’ (the biceps tendon to the labrum). It is a frequent injury in throwing athletes. It has 3 anatomical variants: normal, sublabral foramen, Buford complex. The biomechanics of this injury is related to GH translation and motion increment and strain on AIGHL with ABER. His etiology includes a single traumatic event or repetitive overhead activities (compression, traction, avulsion, internal impingement). His epidemiology is characterized by a low incidence, no side prevalence and these are frequently associated injuries. The most used classification systems are Snyder and Moffet. A wide range of symptoms are common, causing loss of velocity in throwing athletes. An appropriate examination should include observation, palpation, neurovascular exam, ROMs, assessment of coexisting pathologies. Typical findings are positivity to the following tests: O’Brien’s (sensitivity 100%), Jobe’s, Grind’s, Yergason’s, Speed’s, Mimori’s (sensitivity 100%), Kibler’s, Crank’s, Kim’s. The performance of an MRI arthrogram gives very accurate findings. Treatment options include conservative measures (capsular stretching, rotator cuff strengthening, scapular stabilizers) which are characterized by lack of studies able to report their efficacy. Surgical options depends on classification: debridement is appropriate for type 1, stabilization with biceps anchor for type 2, ; excision of bucket-handle tear for type 3, biceps tenodesis or excision for tyope 4, stabilization with biceps anchor and labral repair for type 5. Outcomes show relatively good surgical results, while frequent failure of conservative treatments is observed. The postop rehab program include a sling for 4 weeks, early PROMs and gentle AAROMs, FF 145 and ER 60 (45 in Abd) by 6 weeks, full ROMs by 10 weeks, 14 weeks of restricted sport activity (light swimming, half golf swings), interval throwing program by 10-20 weeks, RTP by 6-9 months. Conclusions: high index of suspicion of this diagnosis in throwers with shoulder pain while clinical exam usually provides the correct diagnosis. MRI is useful investigation to confirm the diagnosis. The recommended treatment for throwers is rest, NSAIDs and rehab program in first instance; surgical management should be considered when conservative measures fail. Suture anchor repair procedures are the preferred option for overhead activities or athletes.