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Sports Medicine Team from Scottish Rite for Children Had Strong Presence at PRiSM 2023

Sports Medicine Team from Scottish Rite for Children Had Strong Presence at PRiSM 2023

by | Feb 15, 2023 | Research & Innovation

The sports medicine team from the Scottish Rite for Children Center for Excellence in Sports Medicine recently attended the 10th Annual Pediatric Research in Sports Medicine (PRiSM) society meeting in Denver, Colorado. Several of our team are founding members in this group leading the way in pediatric sports medicine research.

Medical director of clinical research Henry B. Ellis, M.D., says, “Most conferences are designed to gather one discipline, but this one is inclusive. Scottish Rite had an impressive presence not only in attendance, but also with most of the 23 staff who attended actively contributing.” The Scottish Rite team included sports medicine physicians, pediatric orthopedic surgeons, a radiologist, advanced practice providers, physical therapists, researchers, psychologists and more. Many of them presented and led discussions about important care and treatment techniques for young athletes.

The three-day meeting included a variety of formats for collaboration and learning. Our team presented results from studies at the podium and during poster sessions where authors held conversations with attendees about the projects. The program also included a variety of didactic sessions designed to inform the participants of available evidence on a topic while stimulating discussion for future research.

Some of the noteworthy accomplishments of our team include:

  • Our director of Movement Science Sophia Ulman, Ph.D., had an active role in multiple aspects of the meeting. Ulman hosted a program with other movement science experts teaching best practices on applying motion capture in return to sports decision making. Bioengineer Alex Loewen, M.S., and Ben Johnson, P.A.-C., presented a study on measuring changes in pelvic tilt before and after hip surgery. Ulman and Loewen shared another study designed to improve accuracy of trunk testing across movement science labs. Additionally, biomechanist Ashley Erdman, B.S., M.B.A., presented results of a ballerina survey on pointe readiness.
  • Perfectly aligned with her passion, Ulman officially assumed responsibility as chair of the Injury Prevention Research Interest Group and provided her peers with the latest research updates on using movement science to facilitate sports injury prevention protocols.
  • Musculoskeletal ultrasound expert and sports medicine physician Jacob C. Jones, M.D., RMSK, gave a report on the state of pediatric musculoskeletal ultrasound to the society attending the conference. His specialty in this methodology solidified him as the top choice to address the group with the latest and greatest in the use of musculoskeletal ultrasound for pediatric sports medicine patients. Additionally, Jones presented a poster addressing the use of diagnostic musculoskeletal ultrasound in gymnasts.
  • Shane M. Miller, M.D., concluded his two-year term as chair of the PRiSM Concussion Research Interest Group. This means he led collaborative efforts with others from around the country to improve the identification and treatment of concussions in young athletes and to create a better understanding of the condition. In addition to this national collaboration, our team worked on other concussion projects. Jones shared results of a study on concussions in young athletes, comparing injuries by position in soccer players.
  • Elbow and shoulder injuries in throwing athletes continue to be a concern for pediatric sports medicine experts across the country. Sports surgery pair Philip L. Wilson, M.D., and Chuck Wyatt, M.S., CPNP, RNFA, shared results from several projects aimed at improving all aspects of care in two upper extremity scientific sessions. In addition to sharing results of Scottish Rite studies on elbow injuries in young athletes, Wilson shared results from a multi-center group focused on clavicle fractures called FACTS.
  • Three of our physical therapists, Jessica Dabis, P.T., D.P.T., O.C.S., Katie Holehouse, P.T., D.P.T., CSCS, and Jacob Landers, P.T., D.P.T., O.C.S., CSCS, presented projects at the meeting.
  • Our sports psychologists Emily Stapleton, Psy.D., and Emily Gale, Ph.D., presented on mental health screening tools and the presentation of suicidality in young athletes.
  • One of our student interns Sarp Sahin was one of five students awarded a grant from PRiSM to attend and present at the conference. As an undergrad at Washington and Lee University, Sarp was proud to present a novel project that he has been working on since high school. His efforts were recognized by sports medicine clinicians and appreciated by many.

The sports medicine staff’s expertise was shared with other sports medicine clinicians around the country to improve care for young athletes near and far. In return, our team learned valuable information that will impact how we care for young athletes at Scottish Rite. With 23 staff members from the Scottish Rite Sports Medicine team attending, we had a well-rounded, multi-disciplinary representation, and the team returned inspired to continue to contribute to the future of the field of pediatric sports medicine.

Learn more about our Sports Medicine team.

Moment of Impact: Keeping Young Athletes SAFE

Moment of Impact: Keeping Young Athletes SAFE

by | Nov 28, 2022 | Sports Medicine

Article previously published in Rite Up, 2022 – Issue 3.

What if you could prevent a sports injury before it happens? That is exactly what the experts in the Center for Excellence in Sports Medicine at Scottish Rite for Children aim to achieve. Led by Sophia Ulman, Ph.D., the SAFE (Sports-specific Assessment and Functional Evaluation) program uses 3D motion capture technology — the same technology used to create special effects in movies and video games — to assess injury risk by studying the movements of young athletes.

The goal of the SAFE program is to develop injury prevention tools that will reduce sport-related injuries in young athletes here and beyond, creating a new standard of care. “Current injury prevention methods are falling short, as sports injuries in young athletes are skyrocketing,” Ulman says. “We are the first to use machine learning techniques to assess a young athlete’s risk for injury by considering risk factors such as movement characteristics, demographics, sports participation characteristics, psychological measures, nutrition, and sleep patterns.”

Uninjured athletes are invited to the Scottish Rite’s Movement Science Laboratory, where they are fitted with reflective markers. The markers are used to collect the athlete’s movement patterns to evaluate their mobility, speed, agility, and power in 3D. Participants are asked to jump, squat, run, pivot, and perform sport specific movements like penalty kicks, layups, or back handsprings. “The data is analyzed to learn more about how young athletes move and to determine if certain movement patterns lead to future sports injuries that would require treatment,” Ulman says.

The SAFE program has tested the movements of approximately 340 athletes across sports, such as baseball, basketball, gymnastics, softball, track, and more. “After initial testing, we follow athletes for one year and note if any athlete experiences an injury,” Ulman says. “This data is helping us compare the movements of athletes who remained healthy versus athletes who were subsequently injured to determine what may have led to the injury.”

Researchers at Scottish Rite have already identified findings that might help predict injury risk in young athletes. “We have found that current tools for assessing injuries of the knee may be unreliable in some instances,” Ulman says. “Current methods commonly rely on 2D video to assess injury risk, but our research using 3D modeling is identifying potential risk factors that the 2D assessment cannot.” Through this innovative program, Scottish Rite researchers collaborate with medical professionals and sports medicine experts across the field to advance the treatment of young athletes throughout the country.

The SAFE program is poised to change the way health care professionals assess athletes for injury risk and, best of all, will help keep young athletes in the game.

To learn more about Movement Science, please call 469-515-7160 or email MSL.Frisco@tsrh.org.

Read the full issue.

Concussion Balance Study

Concussion Balance Study

by | Oct 10, 2022 | Sports Medicine

Learn how we use our Movement Science Lab to evaluate balance testing in sport-related concussion management.

Balance testing is commonly used to assess impairment and recovery after a sport-related concussion in the clinic setting. Measuring imbalances while going through various stances combined with both a firm and foam surface can provide valuable information in the evaluation of a concussion. Scottish Rite’s study, recently published in Brain Injury, was designed to look at how balance performance differed from diagnosis to return-to-play among athletes recovering from a concussion. A standardized test called the Balance Error Scoring System (BESS) is easy to perform in a clinic setting, but it may not provide the level of detail needed for a research study evaluating balance after sustaining a sport-related concussion. By conducting balance testing using the Movement Science Lab’s force plates, or special areas built into the flooring that are sensitive to the weight and force applied, researchers could correlate the BESS results with a highly objective center-of-pressure (COP) measure.

Principal investigator and director of movement science Sophia Ulman, Ph.D., explains the differences between these tests. “The BESS is a subjective test that requires clinical training and practice,” she says. “Alternatively, the force plate used to assess COP provides very specific, multidimensional measures that allow for discrimination of small differences in balance performance.”

It has been well established that there is an increased risk of prolonged symptoms as well as potential for compounding injuries if an athlete returns to play too soon after a sport-related concussion. Although balance is not the only measure used to determine readiness for sport, the proper assessment of balance is an important factor in this decision making. After reviewing data for these two tests in 40 patient-subjects, our team noted that the commonly used BESS test may not provide the information needed to assist with balance assessment as symptoms improved.

What does this mean for providers managing sport-related concussions?

Despite the volume of studies on the topic, the Sports Medicine team is continuing to learn about managing sport-related concussions in young and growing athletes. Pediatric sports medicine physician Shane M. Miller, M.D., says, “Until there is a better test to use in the clinical setting, we will continue to use tests like the BESS to do our best to assess balance improvement and identify the right time to return athletes to their sport. I suspect this will be a conversation for many years.”

The study, “Improvement in balance from diagnosis to return-to-play initiation following a sport-related concussion: BESS scores vs center-of-pressure measures,” was published in July 2022 in Brain Injury, the journal of the International Brain Injury Association.

SAFE Program

SAFE Program

by | Sep 9, 2020 | Sports Medicine

As experts in caring for young athletes, our Sports Medicine team at Scottish Rite for Children is focused on providing tips and tools for kids to stay healthy – before they might need us. Sometimes the best way to learn how injuries occur is to evaluate children and young athletes who are not injured. Towards this effort, the Movement Science Lab in Frisco is leading a research initiative called the SAFE Program. The Specialized Athlete Functional Evaluation is a project which invites sports teams of all skill levels and ages to perform a variety of sports-related and other tasks to assess balance, mobility, agility and strength.

The Purpose
Sports specialization occurs when an athlete focuses on only one sport, year-round. More than ever, young athletes are concentrating on a single sport, which has resulted in an increase of overuse injuries due to a lack of variation in their training and no real off-season. Data collected from the SAFE Program will be a great resource to help our team identify who might be at the greatest risk of injury. 

The Process
Through the SAFE Program, healthy athletes go through a series of performance tests that evaluate their strength, speed, agility and flexibility. In addition, the Movement Science team uses high-speed motion capture to analyze each athlete’s motion during dynamic movements, such as running and jumping, and sport-specific tasks based on their primary sport, like penalty kicks, layups or back handsprings. Small reflective markers are placed on the athlete’s body during this motion analysis testing help our team accurately measure how each joint moves in 3D. 

One of the most important aspects of the SAFE program is injury surveillance. Each athlete receives a monthly survey asking if they have sustained an injury in the previous month. If so, they are asked follow-up questions regarding details about where and how the injury occurred. Athletes who are interested may come back for a second round of testing after six months or a year. This will provide our team the opportunity to analyze changes in performance due to growth, improvement or an injury.

The Goal
The SAFE program will allow the Movement Science team to create a database of assessments in hundreds of athletes across all ages, sports and skill level. Then, injury surveillance after SAFE testing will provide our experts with additional information to see if any of the movement or performance measures could potentially point to a future injury. Ultimately, the goal is to create an injury prevention program, using these same SAFE tests, that can provide athletes with an individualized, comprehensive performance report which includes an injury risk assessment.  

Leader of the project and assistant director of the Movement Science Lab in Frisco, Sophia Ulman, Ph.D., is excited to see this initiative come to life. “I have a passion for sports and the SAFE Program is a project that can really make an impact in the lives of young athletes,” says Ulman. “Although we are still in the data collection phase, once we have enough information, we hope to be a resource for our highly athletic community. We want to be a go-to center for young athletes – before, during and after an injury. This program will eventually allow us to provide injury prevention assessments, help determine injury risk and interpret prevention strategies – helping athletes stay safe and in the game.”

To learn more about Movement Science, please call 469-515-7160 or email MSL.Frisco@tsrh.org.

Get to Know our Staff: Sophia Ulman, Movement Science Lab

Get to Know our Staff: Sophia Ulman, Movement Science Lab

by | Jan 27, 2020 | Sports Medicine

What is your role at the hospital? What do you do on a daily basis? 
I am the assistant director of the Movement Science Lab (MSL) at the Frisco campus. In our lab, we use motion capture technology to analyze movement patterns of patients and/or athletes. Similar technology is used to create video games and special effects in movies. I love working in the MSL because every day looks different. Some days we get concussion patients who come into the lab the day they are diagnosed to participate in research, or we might see a patellofemoral instability patient who has recently been cleared to return to sport. Other days, I spend my time processing data or writing a research paper. Recently, I have loved mentoring our high school and college interns while they were on winter break. We stay on our toes down in the lab.  
What do you enjoy most about Scottish Rite for Children?
I absolutely love sharing what we do in the lab. We get quite a few tours that come through including students, medical staff and/or community partners. I enjoy describing what motion capture is, how we use it to help our patients and what we are working on in regard to injury prevention for youth athletes.  

What was your first job? What path did you take to get here? How long have you worked here?
My first job was working at a local basketball gym – cleaning the floors, running the concession stand and working the clock/book for games. I worked numerous jobs throughout high school and undergrad, and my favorite job while at Duke University was working for the Sports Information Office, writing stat sheets and transcribing press conference interviews.

My path to Scottish Rite started the summer after my sophomore year when I shadowed one of Dr. Ellis’ surgeries. He was a fantastic resource for me. After sharing my interests in biomedical engineering and biomechanics, he referred me to Dr. Tulchin-Francis. The following summer I had the opportunity to intern in the Movement Science Lab in Dallas, which led to a student position in the K-Lab at Duke Medical Center (Coach K’s Human Performance Lab). In this lab, I helped with biomechanical assessments of professional athletes and sport-specific patient populations. I had the opportunity to work with an extremely experienced and successful medical staff.

These two internships prepared me for my graduate program at Virginia Tech where I completed my Ph.D. in collaboration with the Army Research Lab. My dissertation investigated performance prediction and injury prevention in the military domain using biomechanics. This work was directly related to current sports research and led me back to Scottish Rite for Children. I have been working here since June, and I am super excited for what we have already accomplished and what we have in the works for future research.
 
What’s the coolest or most interesting thing you’re working on right now?
In the Movement Science Lab, we recently started the SAFE Program (Specialized Athletes Functional Evaluation). We are excited to analyze elite athletes’ movements pre-injury to see if there are any movement discrepancies or deficiencies in specialized athletes compared to a multi-sport or non-elite athlete. Additionally, all participants will be participating in injury surveillance for a year after testing, which will be extremely interesting to observe.
 
What are you currently watching on Netflix?
Killer Inside: The Mind of Aaron Hernandez.

Who would you most like to swap places with for a day?
I would love to switch places with one of Coach K’s (Duke University basketball coach, Mike Krzyzewski) assistant coaches for a day. In my opinion, he is one of the best coaches in basketball history (or all sports) and an obvious leader in his field. I would love the opportunity to learn from him and pick his brain for a day.

What is a fun or interesting fact about your hometown?
My hometown is Argyle, TX, like the sweater/sock pattern.

What is your favorite thing to do when you’re not working? 
Spending time with family and friends, attending sporting events in the community and running.