2023 CASEM Poster Presentations

The Differences in Pain and Cardiovascular Responses Between Male and Female Athletes During a Cold Pressor Test Geoffrey Dover, PhD, CAT(C), ATC, Tristan Castonguay, MSc, CAT(C), Matylda Lentini, BSc, CAT(C), and Ilana Patlan, BSc Affiliation: Concordia University, Montreal, Quebec, Canada. Objective: In the general population, there is evidence that women experience more pain than men, but this has not been fully evaluated in athletes. Therefore, the purpose of our study was to measure the differences in pain and cardiovascular variables between male and female athletes during a painful cold pressor task. Study Design: Two groups, pre–post test design. Subjects: Sixty healthy male university athletes (age = 22.9 ± 2.2 years, height = 179.3 ± 9.6 cm, weight = 89.1 ± 12.2 kg) and 60 healthy female university athletes (age = 22.5 ± 2.5 years, height = 164.8 ± 6.7 cm, weight = 64.9 ± 9.2 kg) participated in the study. Intervention: We used the cold pressor task, which requires the participant to immerse their hand in cold water for 3 minutes to induce pain and to increase blood pressure. Outcome measures: We measured pressure pain thresholds (PPT) at the upper extremity and lower extremity before and after the cold pressor task. We used the numeric pain rating scale to assess pain, and we measured heart rate, systolic blood pressure, and diastolic blood pressure before, during, and after the cold pressor task. Results: All participants experienced a significant amount of pain during the cold pressor task. There was no difference in pain during the cold pressor task between the male and female athletes (male = 5.56 ± 2.36, female = 5.7 ± 1.69, P = 0.723). Female athletes had significantly lower upper extremity PPT scores compared with male athletes (females = 70.2 ± 24.7 N and 74.7 ± 24.3 N and males = 97.9 ± 31.6 N and 107.9 ± 35.5 N; all P < 0.001). A similar result was observed for the PPT at the lower extremity. Although there were no significant differences in heart rate before and during the cold pressor task between male athletes (68.6 ± 10.2 bpm and 70.9 ± 10.2 bpm) and female athletes (70.2 ± 8.8 bpm and 72.8 ± 9.8 bpm, P = 0.361 and P = 0.299), there were significant differences in systolic blood pressure before and during the cold pressor task (males = 129.0 ± 11.8 and 143.5 ± 11.6, females = 111.9 ± 9.4 and 129.3 ± 12.4, P < 0.001 for both). Conclusions: Although male and female athletes experienced a similar amount of pain during the cold pressor task, pain thresholds were significantly lower in female athletes compared with male athletes, which is a separate pain construct. The differences in PPT and systolic blood pressure could indicate that female athletes have a different conditioned pain modulation compared with male athletes. Acknowledgements: This study was partially funded by the Canadian Athletic Therapists Association. Follow-up After ACL Reconstruction: How Long is Long Enough? Alexander J. Hoffer, MD,* and Jordan M. Leith, MD† Affiliations: *Department of Surgery, Faculty of Medicine, University of Western Ontario; and †Department of Orthopaedics, Faculty of Medicine, University of British Columbia. Objective: To assess the differences in patient-reported outcome measures (PROMs) at 1 year and 2 years after anterior cruciate ligament reconstruction (ACLR) and evaluate the need for follow-up 1 year after the surgery. Study Design: A retrospective comparison of prospectively collected PROMs. Subjects: All patients who underwent an ACLR by a single surgeon between 2016 and 2020. Intervention: Primary ACLR with or without associated meniscal surgery by a single surgeon between 2016 and 2020. Demographics include age, sex, side, and ethnicity. Outcome Measures: Six externally validated PROMs were collected preoperatively and at 6, standardized, postoperative times. A repeated-measures analysis of PROMs at 1 year and 2-years after the surgery and subgroup analyses based on sex, age, and associated meniscal injury were completed. Differences in PROMs were compared with previously published or calculated minimal clinically important differences for each score. Results: One-hundred forty-five participants were included in the final analysis. All PROMs except the Veteran's Rand-12 Mental Component showed a statistical improvement at 2 years compared with 1 year after ACLR. However, only the Quality of Life and Sport and Recreation domains of the Knee Injury and Osteoarthritis Outcome Score showed a clinically significant difference at 2 years postoperatively. No major differences were found in the subgroup analyses compared with the entire included sample. Conclusion: Overall, PROMs exhibit little to no clinically meaningful difference at 2 years compared with 1 year after ACLR. As reinjury generally triggers rereferral, a 2-year follow-up visit has low clinical utility and increases financial and opportunity costs for the patient, physician, and health care system. Acknowledgements: None. The impact of 2-hour exertional heat stress on exercise-induced gastrointestinal syndrome and exercise-associated gastrointestinal symptoms in masters versus young adult endurance athletes Pascale Young, MDiet,* Ricardo J. S. Costa, PhD,* Rhiannon M. J. Snipe, PhD,† Stephanie K. Gaskell, BHon,* Rebekah Alcock, PhD,‡ Alice Mika, MDiet,* Christopher Rauch, BHon,* and Kayla Henningsen, MDiet* Affiliation: *Monash University, Melbourne, Victoria, Australia; †Deakin University, Melbourne, Victoria, Australia; and ‡La Trobe University, Bundoora, Victoria, Australia. Objective: To determine if the impact of exertional heat stress on the gastrointestinal tract varies between masters (≥40 years) and young adult (<30 years) endurance athletes. Study Design: Cross sectional. Subjects: Sixteen (male n = 12 and female n = 4) masters [mean (SD): age 43.9 (3.2) years, height 176 (8) cm, body mass (BM) 74.2 (11.6) kg, fat mass 19.2 (6.3)%, V̇O2max 56.3 (6.9) mL/kgBM/min, and weekly training volume 291 (287) min], and 21 (male n = 14 and female n = 7) young adult [age 25.9 (2.3) years, height 177 (7) cm, BM 69.5 (8.4) kg, fat mass 14.6 (4.9)%, V̇O2max 61.0 (7.8) mL/kgBM/min, and weekly training volume 230 (294) min] recreationally trained, nonacclimatized, endurance athletes volunteered to participate. Intervention: Two hours running at 60% V̇O2max in 35°C ambient conditions and 29% relative humidity. Outcome Measures: Whole-blood samples were collected before, immediately after, 1 hour after, and 2 hours after exercise and analyzed for markers of exercise-induced gastrointestinal syndrome (EIGS) (plasma concentrations of I-FABP, sCD14, LBP, IgM, and systemic inflammatory cytokines). Thermoregulatory measures (rectal temperature and thermal comfort rating), heart rate (HR), rating of perceived exertion (RPE), and gastrointestinal symptoms (GIS) were recorded every 10 to 20 minutes during exertional heat stress. Results: Preexercise to postexercise peak magnitude of change in intestinal epithelial integrity markers did not significantly differ (P > 0.05) between masters [mean (95% CI): I-FABP 1632 (959-2304) pg/mL, sCD14 −0.17 (−1.75 to 1.42) µg/mL, LBP −0.68 (−3.54 to 2.19) µg/mL, and IgM −3.71 (−31.1 to 23.7) MMU/mL] and young adult [I-FABP 1378 (815-1940) pg/mL, sCD14 0.59 (0.05-1.13) µg/mL, LBP 1.17 (0.02-2.31) µg/mL, and IgM 38.9 (−2.31 to 80) MMU/mL] endurance athletes. postexercise concentrations of was in young adult pg/mL, P = masters to endurance athletes. No difference between systemic inflammatory was observed (P > of during exercise was not different between masters and young adult endurance athletes (P > were measures of adult endurance athletes significantly (P = and (P = bpm and compared with masters bpm and endurance athletes the stress. Conclusions: of in to 2 hours of exertional heat stress is not different in with masters endurance athletes to young adult endurance athletes. a significant difference in of and of no clinical A for the of Tristan Castonguay, MSc, and Geoffrey Dover, PhD, CAT(C), Affiliations: *Department of and Concordia University, Montreal, and Montreal, Canada. Objective: This the evidence for the change in temperature during the of The of the evidence was evaluated with the purpose of for We 3 of and for and during the follow-up of in the the and 2 the of the Results: We 3 that our that was was a follow-up of and of In all 3 used to the temperature of the with the A of participants with or were The of all 3 that during the a temperature is and clinically As the during the and a in temperature was observed in all training or was the temperature of the was to the all were to the temperature to the of the Conclusions: to the used to evaluate the the body of evidence the of a was with a by used to the of a stress The of could to determine the of and for a to is a and that more is and that Acknowledgements: This was partially funded by the Canadian Athletic Therapists of MD,* MD,* CAT(C), and Affiliations: *Department of and Medicine, University of and Canada. Objective: To the of and health care to to after a Study Design: The of a on the to after a were a in a Subjects: and the Intervention: and were by the were for on to to after the of a health the the which was by the and their in The was by the to to each and to to and Outcome Measures: were and on the and of the Results: of the included a of and and and the was and was by all of the of this to a for and This was and in and is Conclusions: and by in the health care by in the of similar the of in Injury MSc, PhD,† PhD,‡ S. PhD,* and Affiliations: *Department of and University, Montreal, for and of the University Montreal, of and University, Montreal, and for University, Montreal, Canada. Objective: injury is by and to injury and or injury by with is the and relative of in to The of this study to determine the relative of in in injury on in the in and the which is for injury Study Design: study with weekly follow-up for Subjects: to on the of their participated in and experienced pain each with pain were by a who Outcome Measures: The outcome was to were for the between the of weekly and to injury in each on in the were different and the was the We for measures by Results: The included 20 of of recorded in the 2 to were of of However, the more than Conclusions: between and Although of injury by and who during this to on to of Acknowledgements: by The of on in to Ricardo J. S. Costa, PhD,* Kayla Henningsen, MDiet,* Stephanie K. Gaskell, BHon,* Rebekah Alcock, PhD,† Alice Mika, MDiet,* Christopher Rauch, BHon,* and Affiliation: *Monash University, Melbourne, Victoria, Australia; Trobe University, Victoria, Australia; and Objective: To determine the of 2 on of gastrointestinal in to exertional heat stress. Study Design: Subjects: After and endurance or male participants [mean (SD): age (8) years, height body mass kg, fat mass and V̇O2max volunteered to participate. Intervention: after the participants were to 2 exertional heat stress with at included a water and 1 of the 2 and participants were to a with and for before the exertional heat stress and every 20 minutes to during 2 hours running at 60% V̇O2max in 35°C ambient water volume Outcome Measures: Whole-blood samples were collected before, immediately after, 1 hour after, and 2 hours after exercise and analyzed for of exercise-induced gastrointestinal syndrome concentrations of I-FABP, sCD14, LBP, IgM by and systemic inflammatory by and markers and gastrointestinal symptoms (GIS) were recorded every 20 minutes during Results: Overall, [mean (95% CI): did not differ between the (P > Preexercise concentrations of gastrointestinal did not significantly differ between the (P > to peak postexercise I-FABP pg/mL, pg/mL, sCD14 to 12 to IgM to to 8.8 and systemic inflammatory but not LBP µg/mL, 9.2 9.8 were observed on and compared with (P < did not significantly differ between the and [mean at at at Conclusions: The of to for before and during exertional heat stress the gastrointestinal integrity and systemic inflammatory associated with but without of the of the to J. MSc, S. and M. MSc, MD,* and M. CAT(C), Affiliations: Faculty of University of for and of Medicine, University of Injury Faculty of University of University of University of for University of of University of of of Medicine, and of Canada. Objective: To the and to a for the of the ligament of the Study Design: A study by and Subjects: Sixteen patients male and 10 age years) a clinical the of 2 different The patients were a of the were a to the experience of the Outcome Measures: was used to an of the and to The final was with 2 the Results: were to the and to clinical injury and The the between the to the were to a to experience with similar a of the purpose of the of age, and of were clinical with and of and to were low and and low Conclusions: the impact of on clinical and patient-reported requires a of This study a of the of to for include and follow-up with patients with injury and and patients in and of in K. PhD,* PhD,* J. J. PhD,* and Affiliations: Faculty of University of and †Department of Surgery, for Objective: To the of single with to Study Design: study. Subjects: with Intervention: were with = 6, years) who underwent surgery. were for 3 hours on = were and a and The of the was at to were was to to stress. to the of samples the stress of with was compared with that by age of and adult which to similar to by Outcome Measures: The outcome measures were the of with and the stress of with and and Results: We observed a in the of the with compared with a that peak stress at a on the of the the stress of the with was (P < 0.05) compared with young and adult ± ± ± and ± Conclusions: We that the of with is is to the of this and could on we that the in is to a in in with and on the of than on and Affiliations: *Department of and University of the of of the of University, Faculty of and of and Medicine, and the years, a of young have that and weight to the of However, there no the of age, and on and Six male between 12 and years were has been by the of the and on with was in a and included of height and body with and and and To determine the of the of by the was The of of all the who in the study were Results: In the study to years age ± years, height ± cm, weight ± and body mass ± the between age in years and of of and analyzed significant and were found between and height = P < weight = P < = P < and = P < = P < and = P < and this for was than that with Conclusion: The of has a more significant on the and of young than Sport Injury the Between and Injury in ATC, and PhD, Affiliation: of and Athletic University, Objective: This study to the between and injury rate Athletic 1 athletes. Study Design: Subjects: athletes age = years, = Athletes rate of perceived exertion to 10 minutes of the of each and the of 1 of 14 were by to in our measure of Outcome Measures: The study outcome was and injury the and were collected a of the Results: The for all female athletes was 21 the in the weekly a a in 1 to 2 and during and the 2 of the A of and and during the The injury was hours of to athletes Athletes who experienced an injury had a of 21 20 the compared with in athletes. Conclusions: of this study a between and injury athletes. and could and lower injury Acknowledgements: This study was funded by a the at the University and the The of a or on and and Ricardo J. S. Costa, PhD,‡ PhD,* Alice Mika, Christopher Rauch, and Pascale Young, Affiliations: of the Australia; of and University, Melbourne, Victoria, Australia. Objective: To determine the of a and or on gastrointestinal and symptoms in to endurance and exercise Study Design: Subjects: = 10 male and n = 2 recreationally endurance [mean (SD): age years, height body mass kg, fat mass 20 and V̇O2max with exercise-associated gastrointestinal symptoms (GIS) volunteered to participate. Intervention: were to a and a with a between the After the participants 2-hour running at 60% by a in ambient conditions at was every 20 minutes during water during the entire 3 A 20 of was minutes the test to determine Outcome Measures: Preexercise and postexercise samples were and and temperature were minutes during and were During the the was recorded every and every samples were collected every minutes during the samples were analyzed for to determine Results: did not significantly differ between minutes and minutes (P = were (P = and during = on were at the to 2-hour on (P = There was no difference in measured or between the was and on and (P = Conclusions: A before endurance running to before and during this not impact exercise gastrointestinal or exercise in the to 2-hour with the requires Acknowledgements: has an for for Female Sport to Stephanie BSc, BSc, and S. Affiliation: of Western University, Canada. To which female endurance athletes or have previously and perceived to have their health and To the for female endurance athletes, with and Study Design: study on The study was to and to university and and endurance Subjects: participants the a female endurance years used or that with a health care could impact Results: the participants = the an and the of with their than experienced a impact on and that had a training impact and In the and were not with their of experience and more which was a major impact on of on the body and In of the athletes who their = did not that was the Conclusion: that the is perceived to the the impact on endurance female endurance athletes the This is important a significant of female endurance athletes were and not by their during of and on the of in to A and S. and Affiliations: of Medicine, University of and of and University of Canada. Objective: To determine the of and on the of A was in the and of included were Results: Two were with an the or with of injury or with of clinical of and 3 and in to were associated with or to and symptoms years after injury were associated with and with were associated with of a No or Conclusions: The on the of and on in patients with is and for were We a change to of athletes to more the this Acknowledgements: The for on a that the for this study. The University of and for their of the of Medicine, who of the of in and BSc, PhD, and Affiliation: Canada. Objective: To the of in a of and Study Design: Subjects: and and and by and in of Outcome Measures: The of the of in and of in of of Results: of in was and in of in and was = = and = = Conclusion: There was a significant difference in the of between and the differences in the of between the 2 and in this the of in athletes after The scores in that there in to that impact the of athletes after The of Injury to on A Study MD,* Stephanie K. PhD,‡ and Affiliations: of Surgery, of Surgery, Faculty of and University of Surgery, of and University of Faculty of and University of and University of Canada. Objective: To assess the between injury to surgery on in a of patients with Study Design: study. Subjects: patients females and with to an surgeon and surgery between and 2020. Outcome Measures: The outcome was the impact of injury to surgery on meniscal or at the of surgery. were analyzed was at = Results: age was years = patients with anterior cruciate ligament to surgery was 21 = patients underwent a The a significantly to surgery compared with the = = P = with a to surgery of than 21 had a increase in the of (95% P = age, sex, and anterior cruciate ligament were not found to a was Conclusions: with who underwent 21 the of injury a significantly for compared with a to surgery. follow-up is to determine the of the need for in this this in As meniscal in study the of and and surgeon to the of at the of surgery. used to for of in the Canadian to for After on to to a J. M. CAT(C), and Affiliations: Injury Faculty of University of University of University of for University of of University of of and University of University of of and Faculty of Medicine, Montreal, for in Montreal, Faculty of University of Sport and and of and of Medicine, University of Canada. The was to the of to a The was to to to a Study Design: design. Subjects: Canadian to 12 and and by Outcome Measures: were used to the of to in to 12 and of to to 12 to a analysis was used to the Results: = and = who to 12 participated in the and participants = n = an on the of of participants that have to a that were more to of or of than to only of or in the of and that and to the of to a Conclusions: and the of to a that the for and to that with the the of and of the that more for to to a Acknowledgements: The Sport Injury is of the for of Injury and of by the The the of and the of the of the and the participants for their in this study. is by the and in funded by the a in N a in for Long of the BSc, BSc, BSc, PhD, BSc, and Affiliation: University of of Medicine, Canada. To which the based on and To in and of of the of the Study Design: by Subjects: and who underwent 1 of or 1 of 3 for the of Intervention: include and with and with and of include with with with in with Outcome Measures: The outcome measure was the for the surgery or by The outcome measures were the with the and the in the surgery a single with Results: who underwent with were significantly more to than who underwent 1 P = who that were to could before their had to = P = who underwent and that the surgery was and that have the surgery scores were in = = and = = Conclusions: that is to with in the rate of and and to of and on in Athletes and Affiliations: Injury Faculty of University of of University of University, for University of University of University of and of British Canada. Objective: is a that and of and in the and a for the and of This study to the between in healthy athletes age, sex, and Study Design: study. Subjects: athletes = age ± female = the in to the of and their study. samples were collected athletes before their Outcome Measures: was measured in the between and sex, age, and Results: in male athletes was significantly compared with female = P = in = P = and = P = had significantly compared with in No was found between and age = P = or = P = by sex, we found that age was associated with female = P = but not with male = = Conclusions: in healthy athletes is by and but not by of In female athletes, was with a in athletes. Acknowledgements: for the study by the for and of Injury and and Affiliation: *Department of and Athletic of University, and †Department of and for University, Objective: To determine is associated with and in and determine is associated with in Study Design: A study a study. Subjects: 1 and a and we and and a at a to injury and for were by body Outcome Measures: we collected a rating of perceived exertion to measure the scale of a and and a of a previously validated was on a scale and 10 and for we and analyses to 1 and for each included sex, and of Results: on a final had a significant with and injury the there was a significant between and this was on Conclusions: A measure of injury in A measure of is a that to and in and in a This study was funded by the at the Injury and in Canadian and Affiliations: Injury Faculty of University of of University of for and Injury in for University of University of of and and Sport of Faculty of University of University of for and University of of of Medicine, University of of of Medicine, University of and of Sport Faculty of Canada. Objective: To the injury and at a in Study Design: analysis. Subjects: Male and female years) in a in male and 14 were were recorded and analyzed Outcome Measures: and were evaluated based on previously validated injury and injury rate female rate were compared between male and female Results: (male = female = were recorded (male = female = and did not differ by = (male = female = were (male = female = for a of (male = female = with no significant difference by = The was the to injury male = female = Conclusions: in with no significant differences for or The for a of an for injury Acknowledgements: The Sport Injury is of the for the of Injury and of This study is a of a in to and study and in This study was with the and Canada. the in injury a study in the British of by in of the A MSc, and BSc Affiliation: of Medicine, University of Canada. Study Design: Subjects: adult patients with Objective: To determine immediately after a symptoms of pain, and more compared with care after Intervention: with of the were to or by care in the In groups, the was by 1 who was to the The was an of a volume of and the In the patients immediately to

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