Jan 29, 2015
Bulletin Board

Stepping Up Helmet Standards

With the attention paid to concussion assessment, treatment, and prevention reaching new highs, the National Operating Committee on Standards in Athletic Equipment (NOCSAE) is looking to update its standards for football helmets. For almost four decades, NOCSAE has used just one drop-test test, which has been criticized for not being rigorous enough. Critics say the test has changed little since it was introduced in 1973 and is only based on protecting against force levels that would fracture skulls.

According to Robert Cantu, MD, Vice President of NOCSAE and a Clinical Professor of Neurosurgery at Boston University, updates to the group’s standards could include using lower force standards and testing for the more complex rotational forces that cause concussions. Regulations similar to those currently used for lacrosse helmets will be considered.

In statements published after NOCSAE’s annual meeting in January, Cantu indicated the group would investigate devising a separate safety standard for helmets worn by youth players. In the meantime, NOCSAE has said it will work with the Centers for Disease Control and Prevention to better communicate the limits of the current safety standards to parents of young athletes.

With an eye toward addressing the unknowns, NOCSAE announced it has created the Scientific Advisory Panel. An extension of the group’s Multidisciplinary Concussion Task Force, the panel is chaired by Cantu and charged with directing and conducting scientific research related to concussions and helmet standards. The Scientific Advisory Panel will evaluate future multi-year concussion-related grant proposals. At the January meeting, NOCSAE awarded over $600,000 in grants for concussion-related research.

AED Attention Needed

Athletic trainers may want to take a closer look at the Automated External Defibrillators (AEDs) in their schools and athletic facilities–including testing them to make sure they work. A January report from the Food and Drug Administration (FDA) revealed that in the five-year period from 2005 to 2010, there were 68 recalls and more than 28,000 reported incidents of malfunctioning AEDs, including some cases in which a person died.

However, a report published in the February issue of the Archives of Internal Medicine says the FDA may have to shoulder some of the blame for the problem. The report found that 80 percent of 113 recalled medical devices–which includes but is not limited to AEDs–since 2005 were initially approved by the FDA through an abbreviated review process called 510(k) in which the manufacturer is required to provide minimal data on safety and effectiveness. The remaining 20 percent of recalled devices were approved through the agency’s more rigorous premarket approval (PMA) process.

As a result of the recent reports, the FDA may require all AEDs go through the stricter PMA process and exclude such devices from being approved through the 510(k) process. The FDA is also working with the University of Colorado’s Department of Emergency Medicine to develop a defibrillator registry, which will include the names of companies that have issued recalls. In November, the FDA sent a letter to manufacturers warning that companies could face stricter regulation of AEDs if they do not take action to address the recurring problems.

Nitrates For Efficient Muscles

It looks like Popeye may have had it right all along. Eating spinach and other leafy green vegetables containing nitrates can make your muscles work more efficiently. In a study published in the February issue of Cell Metabolism, subjects who took a small dose of inorganic nitrate for three days were shown to consume less oxygen while riding an exercise bike than they did before the nitrate supplementation.

Researchers say that the subjects’ improved performance was due to the nitrate increasing efficiency of the mitochondria that power the growth and activity of muscle cells. While they aren’t encouraging athletes to take inorganic nitrate, they do recommend including leafy green vegetables in their diets.

“We’re talking about an amount of nitrate equivalent to what is found in two or three red beets or a plate of spinach,” lead researcher Eddie Weitzberg, PhD, Professor of Anesthesiology and Critical Care at Sweden’s Karolinska Institute, said in the study’s summary. “We know that diets rich in fruits and vegetables can help prevent cardiovascular disease and diabetes but the active nutrients haven’t been clear. This shows inorganic nitrate as a candidate to explain those benefits.”

To read the full text of the study, go to: www.cell.com/cell-metabolism and type “Dietary Inorganic Nitrate Improves Mitochondrial Efficiency in Humans” into the search window.

More Innings, Bigger Risk

A study published in the February issue of the American Journal of Sports Medicine followed nearly 500 youth baseball pitchers for 10 years, and offers some of the longest-running data on overuse injuries available. Researchers found that players–boys between nine and 14 years old at the start of the study–who pitched more than 100 innings in a year were 3.5 times more likely to be injured than their counterparts who pitched fewer than 100 innings in a year.

In addition to innings pitched, researchers considered factors such as other positions the subjects played and the type of pitches each threw. The study followed up with each player annually and recorded any medical issues they reported such as pain while pitching, the number of practices or games missed due to pain, or surgery that resulted from pain.

Over the course of the 10 years researchers followed the 481 pitchers, five percent threw more than 100 innings and sustained an injury that led to surgery or quitting the sport. Specifically, seven players underwent shoulder surgery, and three had elbow surgery.

“It is a tough balancing act for adults to give their young athletes as much opportunity as possible to develop skills and strength without exposing them to increased risk of overuse injury,” Glenn Fleisig, PhD, Research Director at the American Sports Medicine Institute and the study’s lead researcher, said in a news release. “Based on this study, we recommend that pitchers in high school and younger pitch no more than 100 innings in competition in any calendar year. Some pitchers need to be limited even more, as no pitcher should continue to pitch when fatigued.”

To read the full text of the study, go to: ajs.sagepub.com and type “Risk of Serious Injury for Young Baseball Pitchers: A 10-Year Prospective Study” into the search window.

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