Study shows significant benefit of PolarCap® in recovery from sports-related concussions

Press release:

PolarCool AB (publ), a Swedish medical device company focusing on treatment of sports-related traumatic brain injury (TBI) and whiplash, today announced that it has submitted a 510(k) pre-market notification to the U.S. Food and Drug Administration (FDA) for the PolarCap® System.

This submission follows publication of statistically significant clinical results in the scientific journal Concussion, showing clear benefit for use of the PolarCap® System in the treatment of concussions among players of 15 elite Swedish Ice-Hockey teams in the Swedish Hockey Leagues (SHL).

The incidence of sports-related concussions is a significant national health concern in Sweden, as it is here in the U.S., and there is growing evidence that repetitive traumatic brain injury can cause long-term changes in brain structure and function. This is of particular concern in the field of contact sports, such as ice hockey, where available treatment options are limited.

“With this important FDA submission, we are paving the way for the first-ever sports-related TBI treatment model,” said Martin Waleij, PolarCool Chairman of the Board. “Supported by robust clinical evidence enabling players to safely return to play much earlier, our 510(k) submission is the first step in the FDA review process. We look forward to this review and are confident that speedy clearance for the PolarCap® System is on the horizon.”

The study, led by investigators from Lund University at Skåne University Hospital in Lund, Sweden, Luleå University of Technology in Luleå, and BrainCool AB, represents the largest study population focused on sports-related concussion treatment in Sweden or the U.S., and shows statistical benefits of therapeutic cooling using the PolarCap® System head and neck cooling technology.

“Publication of these study results in the journal Concussion marks a significant milestone for sports medicine around the globe,” said Erik Andersson, Chief Executive Officer of PolarCool, maker of the PolarCap® System that was used in the Lund study. “We are eager to proceed with larger studies and to partner with academic medical centers and professional sports organizations to further validate the benefits of this medical cooling technology–with the ultimate goal of improving both short- and long-term safety for players of all contact sports.”

The Swedish Hockey League, the players organization SICO and PolarCool are actively collaborating to improve player safety. Two PolarCap® Systems are available at all games and the league is working to establish a standardized acute treatment method concussion injuries.

“It is very positive that we can constitute that the introduction of the Polar Cap has meant fewer long time absences among players that were treated by cooling directly after a concussion, with this treatment we have another tool to use (against head injuries),” said SHL Sports Director & Vice CEO Johan Hemlin in a recent SHL press release.

Fifteen teams from elite ice-hockey leagues for males in Sweden were given the option to participate in the intervention group (receiving selective head-neck cooling after a sports-related concussion) or the control group (standard sports-related concussion management). Selective head-neck cooling was initiated at a mean of 12.3 ± 9.2 min after the concussion in 29 players, and 52 SRC controls received standard management. Results showed significant benefits of cooling in treating concussions with a median time to return to play for the players who underwent cooling of 7 days, versus 12 days for those who did not. The study also shows promising reduction in the proportion of long-term absence, which can be as long as three weeks or more, among treated players.

Sever’s Disease of the Heel in Child Athletes

The commonest reason for pain in the heel in adults is a condition called plantar fasciitis that make up to 90% of the cases. In regards to children, plantar fasciitis is actually very rare and the most frequent reason for pain in the heel in kids being a condition often called Sever’s Disease. This really is bad vocabulary becasue it is not a disease and the use of that phrase can certainly have pretty undesirable consequences. There’s also a trend away from the using terminology of disorders from getting named after individuals, typically the doctor which first described the problem. The better appropriate name for the problem is calcaneal apophysitis. It is a problem of the growing cartilage area at the back of the heel bone or calcaneus.

When we are born, many of the bones continue to be a delicate and flexible cartilage framework which the bone grows on. With the heel bone growth commences in the center and grows to take up the entire area of that cartilage material framework. Nevertheless, there exists still a cartilage growing region in the back of the calcaneus that development and growth continues to occur at. That small growth growth plate at the back of the calcaneus can be at risk from injury if strains on the heel bone tend to be excessive.

The principle risk factors are a higher bodyweight, those that are taller and having an even more lively lifestyle including playing more sporting activity. Many additionally suggest that tighter calf muscles are a factor, but that’s not absolutely a regular observation. The disorder is far more common in the ages of 8 through 12 years. The growing plate of the heel bone combines with the rest of the bone tissue about the middle of the age of puberty, which means that no matter what happens it’s not possible to have got this issue past that age.

The signs and symptoms of Sever’s disease will usually start off as a slight ache in the back of the heel bone which gets even worse as time passes and it is more painful with a lot more exercise. The condition frequently becomes worse with a lot more exercise levels with soreness amounts definitely not exactly the same every day and differs depending on physical activity or sports participation amounts. A characteristic indication of this problem is pain on the sides in the back of the calcaneus when you press it between your fingers. There aren’t any xrays or any other imaging that can be used to help determine this and the diagnosis is dependant on the clinical findings.

The key approach to treating Sever’s disease will be education of the child and parents about the characteristics of the condition and its self-limiting character. Way of life as well as sport activity levels are going to need to be decreased so the stress on the developing area is lessened to bearable amounts. Cold therapy can be used following sporting activity in cases where the discomfort levels are higher. When the calf muscles are tight, then a stretching program are useful to improve the range of flexibility. A shock absorbing heel pad is frequently also very effective. Usually it is a matter of doing these therapies as well as managing the activity amounts and then wait for the condition to take its natural course and finally recover.

Exercise can help support recovery of patients with lasting COVID symptoms, study finds

Press release:

Patients with lasting symptoms of COVID-19 who completed a six week, supervised rehabilitation programme demonstrated significant improvements in exercise capacity, respiratory symptoms, fatigue and cognition, according to researchers at the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre – a partnership between Leicester’s Hospitals, the University of Leicester and Loughborough University.

The study, which is published in the journal Chronic Respiratory Disease today (Friday 7 May 2021), followed thirty patients who took part in face-to-face exercise rehabilitation classes twice a week over a period of six weeks. The programme included aerobic exercise, such as walking or using a treadmill, strength training of the arms and legs, and educational discussions to support symptom management based upon the information on the Your COVID Recovery platform.

Researchers found a statistically significant improvement in exercise capacity, as measured by scores of distance travelled and ability to keep going without a rest using incremental and endurance shuttle-walking tests. They also found that fatigue improved by 5 points on the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale over the six-week period. In addition, participants demonstrated improvement in their overall wellbeing and cognition, as measured by standardised clinical assessment tools.

Participants were referred through a hospital discharge follow-up telephone assessment, at a face-to-face COVID-19 clinic assessment, or via their GP. Individuals were offered the opportunity to take part if they displayed physical and/or psychological symptoms that were affecting their daily activities. Patients were excluded if they demonstrated acute symptoms, or were not medically stable (such as uncontrolled diabetes) or had only symptoms that were deemed unlikely to benefit from a pulmonary rehabilitation programme, such as loss of taste or smell.

Of the participants, there was an even split between men and women, with an average of 58 years. Eighty-seven per cent of participants were admitted to hospital with COVID-19, staying on average 10 days in hospital. Fourteen per cent required mechanical ventilation and were treated in an Intensive Care Unit. Four individuals had a pre-existing respiratory condition, such as asthma or chronic obstructive pulmonary disease (COPD).

Dr Enya Daynes, specialist pulmonary rehabilitation and research physiotherapist at Leicester’s Hospitals and lead author of the study, said: “We know that COVID-19 survivors present with a wide variety of symptoms and that a one-size-fits-all approach to managing these would not be appropriate. However, there are some overlap between the needs of COVID-19 survivors and patients who have accessed pulmonary rehabilitation [PR] for other conditions, such as COPD. So we modified our well-established PR course for COVID-19 survivors and measured their symptoms to assess whether the programme could be of potential benefit.

“We found there were significant improvements in clinical outcomes of walking capacity and symptoms of fatigue, cognition and respiratory symptoms – factors that patients tell us most affect their quality of life.”

Professor Sally Singh, head of cardiac and pulmonary rehabilitation at Leicester’s Hospitals, professor at the University of Leicester and senior author of the paper, said: “This adapted rehabilitation programme for individuals following COVID-19 has demonstrated promising improvements in clinical outcomes. There were no drop-outs due to worsening symptoms and the high completion rate suggests that patients found it to be an acceptable treatment.

“There has been concern that rehabilitation may worsen or trigger symptoms of post-viral fatigue and that exercise therapy may exacerbate fatigue. The exercise element of this programme is progressed by staff experienced in delivering pulmonary and cardiac rehabilitation programmes in line with patient’s symptoms throughout the programme. Our results did not show that fatigue worsened among the group of patients on the study, and that many of their symptoms improved. This suggests an adapted pulmonary rehabilitation courses can be part of a spectrum of patient-centred and holistic approaches to treating the many different presentations of lasting COVID symptoms.”

The research team acknowledges that as a cohort study there is no control group of people with similar symptoms who did not embark on the modified pulmonary rehabilitation course to offer a comparison and that further studies with a larger patient population are needed to confirm their preliminary findings.

The Richie Brace for a Progressive Flat Foot

A progressing deteriorating of a flat foot or fallen arch of the foot in an adult is oftentimes known as posterior tibial tendon dysfunction as well as adult acquired flatfoot and may have problematic consequences if not detected early and sorted out. This is often more frequent in older in addition to obese adults. The key issue is that the posterior tibial muscles which are the reason for supporting the arch of the feet are not very good at doing that, and so a gradual flattening of the foot occurs. In addition to a falling with the arch of the foot there is typically increasing pain and discomfort in the arch area of the foot and the rearfoot. As the adult acquired flat foot progresses, further walking gets increasingly tougher and it is extremely tireing.

There are actually commonly 4 stages involving posterior tibial tendon dysfunction that this problem progresses through with one being the initial phase and 4 being the final phase that only surgical treatment can deal with. There is certainly some difference of opinion with the classifications of this as their is variability between health professionals plus some reliability concerns. That being said, stage 1 is typically treated with foot supports along with exercises plus some medication for the pain and discomfort. Stage 2 usually needs a lot more aggressive and supportive foot orthoses, carrying on using the exercise routines as well as increasing levels of pain alleviation medicines may be required. Both stage one and two will benefit with high top supporting shoes. Long-term weight loss plans will also be going to be helpful. If this doesn’t stop the development and the foot is heading in the direction of a stage three, then there’s increasing probability that reconstructive foot surgery is likely to be needed. This is the reason it is so crucial that there be more intense conservative treatment of the foot when it’s still at stage 2 to halt the development.

An increasingly frequent treatment for posterior tibial tendon dysfunction while it progresses to stage two is the Richie Brace. This Richie Brace is now being commonly used and it has been demonstrated to be very effective at stopping the progress with this problem and avoiding the requirement for surgical treatment. Surgical interventions tend to be successful, but there is frequently a left over measure of impairment remaining as the surgery usually will require the fusing of some important joints and also the moving of muscles insertions to other parts of the foot. The Richie brace is a combination of an aggressively supportive bespoke foot orthotic plus an ankle foot orthoses with struts to support both sides of the joints at the ankle. The bespoke foot orthoses is made from a plaster cast or optical scan of the foot with the foot kept in a ideal position. The aim of the foot orthotic portion of the Richie Brace would be to try and support the foot in this corrected position. The struts which get included up the side of the ankle are hinged with the ankle joint to allow motion to happen at this joint. These struts are then held on by Velcro on the leg to help support and enhance the benefit of the foot orthotic. Generally if the progress of the problem can be ended making use of this, then surgery is commonly prevented.

Exercise for Restless Legs Syndrome

Restless legs syndrome is a miserable health issue that compel the legs to want to move at night. There is not a lot known if doing any sort exercises is beneficial for restless legs syndrome and helping those with the condition get some sleep. Also what is not known is if it is useful, just what sort and type of exercises should be used.

This clinical trial was recently registered in which the researchers are going to study exercise in restless legs syndrome.

Here is a summary of the study:

Restless leg syndrome (RLS) is a very common neurological condition characterized by an uncontrollable desire to move the legs. Due to the traumatic effect of RLS on morbidity, the patient is negatively affected in many different directions. The duration and quality of sleep of the patients decrease, and their cognitive functions change. The prevalence or risk of anxiety and depression increases in this population. At the same time, the quality of life of patients is significantly reduced. Among the different pharmacological agents used in RLS, dopamine agonists are the most widely used. However, the reporting of serious and common side effects related to this treatment has led to non-pharmacological approaches in the treatment of RLS and the effectiveness of many different approaches has been investigated. The exercise approach, which is determined to be effective in the treatment of the disease, is a subject that has been little studied. The type, duration and frequency of optimal exercise could not be standardized. In addition, the effect of exercise on RLS patients has been investigated in limited subjects. For this reason, the aim of our study is to examine the effect of different exercise programs on symptoms, sleep, cognitive functions, quality of life, psychological status and fatigue in patients with RLS.

The Use of Recovery Footwear

Athletes workout very hard to achieve their goals, usually by increasing the amount and intensity of their workout. On the other hand, what has become clearer lately is that relaxing and not training may perhaps be just as necessary as the specific working out that they perform. The rest or downtime is equally as significant with improving performance and is also an integral strategy to avoid injuries. Overuse injury deterrence is very necessary as if an exercise related injury develops then that affects the ability to exercise to improve overall performance. Every time a training load is applied by a hard workout, you will find some microdamage to the body. The tissues must recover from this damage. The tissues will return from a high intensity workout better if it’s allowed to rest. This microdamage must also recuperate. In case a additional exercising strain is carried out before that small trauma has recuperated, then the damage amasses and an overuse injury sooner or later occurs.

This is exactly why a great deal of research is considering the science of recuperation. Runners have to recover from games and training work outs ahead of the subsequent one. Generally this is as straightforward as only training hard one day and not training as hard the next day. What’s more, it ensures that pro athletes and scientists are looking for tips on how to speed up and facilitate recovery. For instance, costly but not entirely tested concepts such as ice bathing and hyperbaric oxygen chambers. It could imply something as simple as what is known as recovery footwear.

Following a exercise session, professional athletes love to take off their shoes and place on footwear which is comfy and frees the foot from the confines of those shoes. The favourite recovery shoes are frequently flip-flops or sandals which free the foot from the limitations of shoes. They are really commonly soft or well padded plus they typically have some foot support. The intention of these types of shoes are to help provide the feet and leg muscles some rest so that they don’t work as hard. The goal being that this will facilitate recuperation of those worn out feet as well as leg muscles so they are actually better ready for the following workout. A further benefit from those flip flops with an arch support constructed in, is they can be easily made use of by those athletes who are required to wear foot supports within their training shoes. The amount of arch support that may be built in these is usually is similar to that is available in over-the-counter supports that you can buy at retail.

There are many brands of these different kinds of recovery footwear. Among the most well-known in the United States is the Oofos brand name. Their shoes contain a lot of padding which is designed to really provide the foot a rest after having a high intensity exercise session. In Australia, a popular brand name are the Archies. The Archies are a flip flop with an above average amount of arch support and good padding. With these sorts of footwear, a reduced amount of energy is required to move, so that they improve recuperation which help the muscles and joints recuperation from those little discomfort that might come after a very hard workout. This means they are really much more ready for their subsequent workout.

Mueller-Weiss disease of the navicular bone

Mueller Weiss disease is a rare source of pain within the midfoot in adults that has been also known as Brailsford disease. It is a sudden onset osteonecrosis of the navicular bone in the foot. You will find there’s a a lot more well-known problem of the same bone in young childen known as Köhler disease, which is also an osteonecrosis in the tarsal navicular bone, but they are completely different conditions due to the nature with the developing bone tissues in youngsters. The condition was first described by Schmidt in1925. It was W Muller who afterwards proposed how the underlying mechanism of the disorder has been due to an excessive compression force upon the midfoot region. About the same period, K Weiss, noted which the appearances on x-ray were similar to those noticed in a condition known as Kienbock disease, and this is an osteonecrosis. The two of these reviews led to the most commonly used name for this problem, Mueller Weiss syndrome.

Mueller Weiss disease usually affects adults in between forty and sixty years of age (Köhler disease has a common starting point around 5 years of age). It is more prevalent in females. It might have an impact on just one foot, or it can affect both feet. The common symptoms include the gradual oncoming of pain in the mid-foot and hindfoot that may often be localized to the most agonizing area being over the navicular. A flat foot is in addition more common in those with this issue. The easiest way to diagnose Mueller Weiss disorder is via the use of radiology. On x-ray there will probably appear to be a failure of areas of the bone and sclerosis along with comma-shaped deformity on the lateral aspect. A CAT scan may also display similar issues and could be helpful to appraise the stage with the problem in far more detail. A magnetic resonance image can be more sensitive to aid in the diagnosis since it is capable of detect changes in the bone marrow.

Mueller Weiss disease is often progressive and may produce severe pain and become fairly disabling, so treatment should be commenced as early as possible to prevent it from becoming impaired too much. Initial treatment methods are to limit activities, perhaps some pain alleviation medicines and use supportive footwear. Usually foot orthotics are used to help further stabilise the area and support the mid-foot (arch) of the feet. This will keep a lot of stress from the navicular. If that is not really helping, then a even more limitation in weight bearing amounts is essential which means that there is much less pressure around the painful navicular. A moon boot or walking splint is the next phase to help protect and also immobilise the area if the signs and symptoms aren’t improving. If most of these conservative approaches do not help, there are also surgical options that can help with the soreness but can frequently result in some minimal disability, which can be a lot better in comparison to the continual pain of an active disease. The particular surgical treatment might be a decompression of the bone tissue using drilling. Another option in case there are regions of bone destruction would be a operative fusion of the important joints around the bone.

Golf as a contact sport?

Press release:

In the article “Golf: a contact sport. Repetitive traumatic discopathy may be the driver of early lumbar degeneration in modern-era golfers” published today in the Journal of Neurosurgery: Spine, Drs. Corey T. Walker, Juan S. Uribe, and Randall W. Porter from Barrow Neurological Institute describe the biomechanics of modern-era golf and its clinical consequences.

The authors point out that “among professional and amateur golfers, back disorders remain the most common injury, comprising 55% and 35% of injuries in these groups, respectively.” They also note that modern professional golfers are experiencing back problems at far younger ages than the general population. To explain this, they focus on how the golf swing of present-day professionals, such as Tiger Woods, differs from that employed by golf legends Jack Nicklaus and Ben Hogan.

As golf has evolved over the last two decades, the golf swing has become more powerful. To keep up, modern-era professional golf players participate in intensive strength-training sessions. And the techniques of the swing have also changed. During the downswing, greater compressive force is directed toward the spinal disc and facet joints, and this affects these structures asymmetrically. With more than 300 swings per golf-playing day, the golfer repeatedly experiences minor traumatic injuries to the spine, which over time can result in a pathogenic process that the authors have termed “repetitive traumatic discopathy” (RTD).

To illustrate how this can occur, the authors discuss Woods’ years of debilitating spine pain.

In this paper Walker and colleagues discuss modern-day golf swing biomechanics and how they relate to the development of RTD, earlier ages of players exhibiting RTD, and the possibility that golfer’s athletic strength training may contribute to RTD. They also address treatment of patients with this repetitive spinal injury.

When asked about the study, Dr. Walker said, “We believe Tiger Wood’s experience with spinal disease highlights a real and under-recognized issue amongst modern era golfers. Repetitive traumatic discopathy (RTD) results from years of degenerative ‘hits’ or strains on the spine resulting in early onset breakdown, instability, and pain. We hope medical practitioners, and surgeons in particular, will be able to diagnose and treat golfers with RTD in a specialized fashion going forward.”

Young athletes’ ACL injury risk increases with fatigue, new research shows

Press release:

ACL injuries are one of the most common sports injuries affecting adolescent athletes, leading to lost playing time and high healthcare costs. Research presented today at the American Orthopaedic Society for Sports Medicine’s Annual Meeting in San Diego shows athletes who experience fatigue – tested on a standardized assessment -¬ demonstrated increased risk of ACL injury. The study is the first to measure the direct impact of fatigue on injury risk in the adolescent population.

“We studied 85 athletes at an average age of 15.4 years, and found 44.7% showed an increased injury risk after high-intensity aerobic activity,” noted lead author Mohsin S. Fidai, MD, from Henry Ford Health System in Detroit. “Additionally, 68% of those studied were identified as having a medium- or high-risk for injury following the activity, as compared to 44% at baseline.”

The study utilized vertical and drop-jump assessments of each athlete, which were captured on video and reviewed by 11 professional health observers. Participants included track and field, basketball, volleyball, and soccer athletes. Injury risk was also associated with the level of fatigue, as 14 of 22 athletes demonstrating over 20% fatigue showed an increased ACL injury risk. Female athletes and those over age 15 were also more likely to demonstrate an increased injury risk.

“While ACL injury prevention programs are commonly used now, a decrease in injury numbers has not followed suit,” commented Fidai. “We hope this study helps advocate for ACL injury prevention training programs to incorporate fatigue resistance training and awareness by coaches, trainers and physical education teachers.”