A Review of Implementation Concepts and Strategies Surrounding Traumatic Brain Injury Clinical Care Guidelines.

Despite considerable efforts to advance the science surrounding traumatic brain injury (TBI), formal efforts supporting the current and future implementation of scientific findings within clinical practice and healthcare policy are limited. While many and varied guidelines inform the clinical management of TBI across the spectrum, clinicians and healthcare systems are not broadly adopting, implementing, and/or adhering to them. As part of the Brain Trauma Blueprint TBI State of the Science, an expert workgroup was assembled to guide this review article, which describes: (1) possible etiologies of inadequate adoption and implementation; (2) enablers to successful implementation strategies; and (3) strategies to mitigate the barriers to adoption and implementation of future research.

Unique Features of the US Department of Defense Multidisciplinary Concussion Clinics.

The US Department of Defense (DoD) and the Department of Veterans Affairs (VA) actively address care needs for a subset of service members (SMs) who experience prolonged symptoms and adverse sequelae interfering with their usual level of function after sustaining mild traumatic brain injury. The development of multidisciplinary concussion clinics and implementation of several reinforcing policies within the DoD and the VA address this unique patient population. A network known as the National Intrepid Center of Excellence and Intrepid Spirit Centers and the VA, primarily support these patients through intensive outpatient programs.

Consortium for health and military performance and American College of Sports Medicine Summit: utility of functional movement assessment in identifying musculoskeletal injury risk.

Prevention of musculoskeletal injuries (MSKI) is critical in both civilian and military populations to enhance physical performance, optimize health, and minimize health care expenses. Developing a more unified approach through addressing identified movement impairments could result in improved dynamic balance, trunk stability, and functional movement quality while potentially minimizing the risk of incurring such injuries. Although the evidence supporting the utility of injury prediction and return-to-activity readiness screening tools is encouraging, considerable additional research is needed regarding improving sensitivity, specificity, and outcomes, and especially the implementation challenges and barriers in a military setting.

Training in ACSM black flag heat stress conditions: how U.S. marines do it.

Exertional heat injuries have gained public attention over the past several years, as have the means to prevent and treat them. One of the simplest preventive measures is to refrain from physical training and competition during times of increased environmental heat stress. Unfortunately, this often is not possible or desirable in certain populations.

A prospective investigation of biomechanical risk factors for patellofemoral pain syndrome: the Joint Undertaking to Monitor and Prevent ACL Injury (JUMP-ACL) cohort.

Background: Patellofemoral pain syndrome is one of the most common chronic knee injuries; however, little research has been done to determine the risk factors for this injury.

Hypothesis: Altered lower extremity kinematics and kinetics, decreased strength, and altered postural measurements will be risk factors.

Study Design: Cohort study (prognosis); Level of evidence, 2.

American College of Sports Medicine position stand. Exertional heat illness during training and competition.

Exertional heat illness can affect athletes during high-intensity or long-duration exercise and result in withdrawal from activity or collapse during or soon after activity. These maladies include exercise associated muscle cramping, heat exhaustion, or exertional heatstroke. While certain individuals are more prone to collapse from exhaustion in the heat (i.

Intravenous fluids post marathon : when and why?

The medical management of marathon casualties involves several potential treatment pathways. It is helpful to develop defined treatment protocols for commonly experienced conditions addressing intervention selection criteria and monitoring response to therapy. Providing intravenous (IV) fluids for runners post marathon should be scrutinised based upon the effectiveness and safety of the intervention.

Diagnosis and current treatment options of shoulder impingement.

A comprehensive review of shoulder impingement reveals numerous causes, contributing factors, and therapeutic options for the resolution of symptoms and return to optimal shoulder function. The clinical diagnosis of shoulder impingement is rather straightforward, but the challenge arises in identifying causative factors and directing treatment options to alleviate symptoms and restore normal function. Shoulder impingement occurs when the space between the proximal humerus and the coracoacromial arch is narrowed such that the transversing tendons, primarily the supraspinatus and to a lesser degree, the infraspinatus, are injured.

Current progress in meniscal repair and postoperative rehabilitation.

The understanding and treatment of meniscal injury has evolved at a rapid pace over the past 20 years. With the realization of the meniscus as a vital structure to proper knee integrity, function, and longevity, the sports medicine and orthopedic communities have shifted the focus of conservative and surgical treatment to that of meniscal conservation. Hand-in-hand with this increased understanding, advances in surgical procedures, techniques, and equipment have followed.