The UK is currently facing an inactivity crises, with 1 in 5 children currently meeting physical activity guidelines (Health Survey for England, Children’s Health, 2016). To combat this growing problem there has been increased interest in promoting exercise and healthy lifestyle advise to patients as a method for improving public health. In line with this, the specialty of Sports and Exercise Medicine (SEM) has been gaining momentum and is now a recognised specialty with a higher specialist training programme. This postgraduate speciality aims to produce doctors who are experts in exercise and musculoskeletal medicine. Increasing numbers of NHS departments are employing SEM doctors to better manage musculoskeletal (MSK) issues and prescribe exercise (Morrissey et. al, Muscles Ligaments Tendons J 3:190–195, 2013). In keeping with this increased opportunity for SEM in postgraduate training, we believe that we should not forget that SEM should not be exclusive to postgraduates and there is increasing interest and need for teaching to medical students (Cullen et al, Br J Sports Med 34:244-245, 2000). This article provides an overview to students and clinicians into the current state of undergraduate SEM education in the UK, and highlights the importance of incorporating SEM into the medical curricula.
Background:Knee osteoarthritis (OA) affects an estimated 1 in 5 individuals older than 45 years of age in the United Kingdom. Previous studies have suggested that germanium-infused garments may provide improved clinical outcomes in OA. Germanium-embedded (GE) knee sleeves embrace this fabric technology.Purpose:To assess the outcomes of GE knee sleeves for patients with knee OA.Study Design:Cohort study; Level of evidence, 2.Methods:This study was undertaken at a hospital in the United Kingdom. Patients who had radiographic features of OA, experienced knee pain for at least 6 months, and opted for nonsurgical intervention were included. Patients were recruited over 3 months. The University of California, Los Angeles activity score, Lysholm score, visual analog scale (VAS) score, and Oxford Knee Score (OKS) were collected at monthly intervals for 6 months. Patients were followed to determine their compliance with wearing the knee sleeves at all times, as advised, and whether any adverse effects had occurred.Results:A total of 50 participants were recruited for the study; 4 participants were excluded due to pain and were converted to surgical management. Therefore, 46 patients were analyzed and placed into 2 groups according to severity of OA, as classified by the Kellgren-Lawrence system: group A had grade 1 or 2 OA, and group B had grade 3 or 4 OA. There were 25 patients in group A and 21 in group B. Improvements were seen in OKS, VAS, and Lysholm scores in both groups. Clinically significant improvements were seen in group A only for OKS (mean increase, 14), VAS (mean decrease, 4.1), and Lysholm (mean increase, 17.2) scores. These results were also statistically significant (OKS, P = 5.8 × 10-7; VAS, P = 7.7 × 10-12; Lysholm, P = 4.2 × 10-11). The data from this study demonstrated that GE knee sleeves gave better outcomes for patients with grades 1 and 2 OA compared with patients with more advanced disease, which is consistent with previous studies. A total of 3 patients reported skin irritation, which resolved with simple skin ointment application. No patients reported infection, deep vein thrombosis, or circulation problems.Conclusion:GE knee sleeves could play an important role in optimizing nonsurgical management of patients with knee OA, especially patients with grades 1 and 2 OA, as demonstrated by the clinically significant improvements.
The United Kingdom is currently facing crisis due to a shortage of radiology consultants despite ever‐increasing demand for medical imaging. The specifics of how best to teach radiology has generated increasing interest. This study aims to determine whether musculoskeletal (MSK) radiology teaching at the University of Nottingham (UoN) Medical School is perceived to be satisfactory by medical students, Foundation‐Year doctors, and senior medical professionals in preparing students for the demands working as Foundation‐Year doctors. Questionnaires were distributed to all medical students and Foundation‐Year doctors that graduated from UoN (n = 307). Semi‐structured interviews were conducted with consultants and teaching staff (n = 13). Forty‐nine percent of preclinical medical students, 43% of clinical students and 27% of Foundation‐Year doctors thought MSK radiology teaching was not sufficient in preparing them for the radiology challenges Foundation‐Year doctors' face. This difference was statistically significant (P < 0.001). The consensus from senior medical professionals was that MSK Radiology teaching is currently adequate and producing competent students. Interestingly, only 5% of students were considering a career in radiology compared to 34% of Foundation‐Year doctors. Overall, there seems to be concern among students regarding MSK radiology teaching and students have a lack of confidence with MSK radiology. Foundation‐Year doctors and senior medical professionals do not share this view. This may be due to medical students' lack of clarity on what is required of them. Formal documentation of set learning objectives for MSK radiology throughout the curriculum may address this.
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