Unlike patients with PFPS seeking medical care, early PFPS does not appear to be significantly associated with hip abduction strength asymmetry.

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Background Aerobic exercise at a sub-symptom heart rate has been recommended as therapy for Post-Concussion Syndrome (PCS). Assessing adherence with an accurate heart rate monitoring instrument is difficult limiting the proliferation of large-scale randomized controlled trials. Objective To evaluate the validity of the Fitbit Charge HR against electrocardiogram (EKG) to monitor heart rate during a treadmill-based exercise protocol. Design A methods comparison study. Setting Sports medicine research center within a tertiary care institution. Participants A convenience sample of 22 healthy participants (12 female) aged 18–26 years (mean age: 22 ± 2 years). Methods Fitbit Charge HR heart rate measurements were compared to EKG data concurrently collected while participants completed the Buffalo Concussion Treadmill Test (BCTT). Main Outcome Measures Agreement between Fitbit Charge HR and EKG was assessed by intraclass correlation coefficients (ICC3,1), Bland-Altman limits of agreement, and percent error. Results We observed a strong single-measure absolute agreement between Fitbit Charge HR and EKG (ICC3,1 = 0.83; 95% CI: 0.67 – 0.90). Fitbit Charge HR underestimated heart rate compared to EKG (mean difference = −6.04 beats per min (bpm); SD = 10.40 bpm; Bland-Altman 95% limits of agreement = −26.42 to 14.35 bpm). 69.9% of Fitbit heart rate measurements were within 10% error compared to EKG, and 91.5% of all heart rate measurements were within 20% error. Conclusions While the mean bias in measuring heart rate was relatively small, the limits of agreement between the Fitbit Charge HR and EKG were broad. Thus, the Fitbit Charge HR would not be a suitable option for monitoring heart rate within a narrow range. For the purposes of post-concussion exercise therapy, the relatively inexpensive cost, easy implementation, and low maintenance make Fitbit Charge HR a viable option for assessing adherence to an exercise program when expensive clinical equipment is unavailable.

Brain injuries in sports drew more and more public attentions in recent years. Brain injuries vary by name, type, and severity in the athletic setting. It should be noted, however, that these injuries are not isolated to only the athletic arena, as non-athletic mechanisms (e.g., motor vehicle accidents) are more common causes of traumatic brain injuries (TBI) among teenagers. Notwithstanding, as many as 1.6 to 3.8 million TBI result from sports and recreation each year in the United States alone. These injuries are extremely costly to the global health care system, and make TBI among the most expensive conditions to treat in children. This article serves to define common brain injuries in sport; describe their prevalence, what happens to the brain following injury, how to recognize and manage these injuries, and what you can expect as the athlete recovers. Some return-to-activity considerations for the brain-injured athlete will also be discussed.