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Almousa S, Mullen R, Williams K, Bourne M, Williams M. Identification of potential risk factors for lower limb injuries in female team-sport athletes: a prospective cohort study. SCI MED FOOTBALL 2024; 8:126-137. [PMID: 36803421 DOI: 10.1080/24733938.2023.2181386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVES The purpose of this prospective cohort study was to assess the associations between lower limb injuries in female team-sport athletes and a number of factors. The potential risk factors explored included (1) lower limb strength, (2) history of life-event stress, (3) family history of ACL injuries, (4) menstrual history, and (5) history of oral contraception use. METHODS One hundred and thirty-five female athletes aged between 14 and 31 years (mean: 18.8 ± 3.6 years) from rugby union (n = 47), soccer (n = 72), and netball (n = 16) volunteered to participate in this study. Demographics, history of life-event stress, injury history and baseline data were obtained prior to the competitive season. The following strength measures were collected: isometric hip adductor and abductor strength, eccentric knee flexor strength and single leg jumping kinetics. Athletes were then followed for 12 months, and all lower limb injuries sustained were recorded. RESULTS One hundred and nine athletes provided one-year follow-up injury data, of whom, 44 suffered at least one lower limb injury. All athletes who reported high scores for negative life-event stress sustained lower limb injuries. Non-contact lower limb injury was positively associated with weak hip adductor strength (OR: 0.88; 95%CI: 0.78-0.98; p = 0.017), and between-limb adductor (OR: 5.65; 95%CI: 1.61-19.7.; p = 0.007) and abductor (OR: 1.95; 95%CI: 1.03-3.71; p = 0.039) strength asymmetries. CONCLUSION History of life event stress, hip adductor strength, and between-limb adductor and abductor strength asymmetries offer potential novel avenues for investigating injury risk factors in female athletes.
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Affiliation(s)
- Sania Almousa
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Richard Mullen
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, London, UK
| | - Kate Williams
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Matthew Bourne
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Morgan Williams
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
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Hagino T, Ochiai S, Furuya N, Hagino T, Wako M, Taniguchi N, Haro H. Hereditary Anatomical Risk Factors for Anterior Cruciate Ligament Injuries. Cureus 2024; 16:e55129. [PMID: 38558731 PMCID: PMC10979650 DOI: 10.7759/cureus.55129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Genetic and anatomical factors have been reported as risk factors for anterior cruciate ligament (ACL) injuries. This study aimed to investigate anatomical characteristics in family members sustaining ACL injuries, compared with age- and sex-matched patients with simple meniscus injuries. MATERIALS AND METHODS Medical records of 1548 patients who underwent ACL reconstruction were reviewed. Cases of ACL injury occurring in first-degree relatives were selected. Forty-one patients from 20 families were included in the study (F-ACL group). Fifty patients with meniscus injuries were included as controls. Anatomical factors comprising posterior-inferior tibial slope (PITS), notch width index (NWI), notch angle (NA), and intercondylar notch roof inclination angle (RA) were compared between groups. The correlation of these anatomical factors between parent and child or siblings was also investigated. RESULTS The 41 patients (20 families) consisted of 12 parent-child pairs and 29 siblings (13 pairs and one trio). Injuries occurred during playing the same sport in 11 families (55%). PITS was significantly steeper in the F-ACL group (9.9 vs. 7.8 degrees). NWI and NA were significantly smaller in the F-ACL group (0.262 vs. 0.278 and 50.5 vs. 58.8 degrees). RA was significantly greater in the F-ACL group (130 vs. 126.9 degrees). A positive correlation in NA (r = 0.677) and a weak correlation in NWI and RA were observed between family members. CONCLUSIONS Common anatomical risk factors of ACL injury exist within families, including intercondylar notch stenosis and steep posterior tibial slope. The findings suggest the potential for developing effective ACL injury prevention programs targeting these risk factors.
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Affiliation(s)
- Tetsuo Hagino
- Department of Orthopedic Surgery, National Hospital Organization (NHO) Kofu National Hospital, Kofu, JPN
| | - Satoshi Ochiai
- Department of Orthopedic Surgery, National Hospital Organization (NHO) Kofu National Hospital, Kofu, JPN
| | - Naoto Furuya
- Department of Orthopedic Surgery, National Hospital Organization (NHO) Kofu National Hospital, Kofu, JPN
| | - Tetsuhiro Hagino
- Department of Orthopedic Surgery, University of Yamanashi, Chuo, JPN
| | - Masanori Wako
- Department of Orthopedic Surgery, University of Yamanashi, Chuo, JPN
| | - Naofumi Taniguchi
- Department of Orthopedic Surgery, University of Yamanashi, Chuo, JPN
| | - Hirotaka Haro
- Department of Orthopedic Surgery, University of Yamanashi, Chuo, JPN
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Dennis JD, Choe KH, Montgomery MM, Lynn SK, Crews BM, Pamukoff DN. Lower extremity and trunk sagittal plane coordination strategies and kinetic distribution during landing in males and females. J Sports Sci 2024; 42:169-178. [PMID: 38423997 DOI: 10.1080/02640414.2024.2323857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
Force attenuation during landing requires coordinated motion of the ankle, knee, hip, and trunk, and strategies may differ between sexes. Sagittal plane coordination of the ankle/knee, knee/hip, and knee/trunk, and lower extremity and trunk kinematics and kinetics was compared throughout landing between 28 males and 28 females. Coordination was assessed with a modified vector coding technique and binning analysis. Total support moments (TSM), each joint's percent contribution, and timing of the TSM were compared. Females landed with less isolated knee flexion in the ankle/knee, knee/hip, and knee/trunk couplings, but more simultaneous ankle/knee flexion, less simultaneous knee flexion/hip extension, and more simultaneous trunk/knee flexion. Females landed with larger plantarflexion angles from 0-16% and smaller trunk flexion angles from 0-78%. In females, absolute TSM were larger from 0-6% and smaller from 42-100%, and normalized TSM were larger from 0-8% and 26-42%. Females had greater ankle contribution to the TSM from 14-15% and 29-35%, smaller absolute peak TSM, and the peak TSM occurred earlier. Females compensated for less isolated knee flexion with greater simultaneous ankle/knee flexion early in landing and knee/trunk flexion later in landing. Coordination and TSM differences may influence force attenuation strategies and have implications for knee injury disparity between sexes.
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Affiliation(s)
- Justin D Dennis
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Kinesiology, California State University, Fullerton, CA, USA
| | - Kevin H Choe
- Department of Kinesiology, California State University, Fullerton, CA, USA
- Department of Kinesiology, Whittier College, Whittier, CA, USA
| | | | - Scott K Lynn
- Department of Kinesiology, California State University, Fullerton, CA, USA
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Sprouse B, Alty J, Kemp S, Cowie C, Mehta R, Tang A, Morris J, Cooper S, Varley I. The Football Association Injury and Illness Surveillance Study: The Incidence, Burden and Severity of Injuries and Illness in Men's and Women's International Football. Sports Med 2024; 54:213-232. [PMID: 33369724 PMCID: PMC7768595 DOI: 10.1007/s40279-020-01411-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To determine the incidence and characteristics of injury and illness in English men's and women's senior and youth international football. METHODS Time-loss injuries and illnesses, alongside match and training exposure, were collected across 8 seasons (2012-2020) in youth (U15, U16, U17, U18, U19) and senior (U20, U21, U23, senior) English men's and women's international teams. Analysis of incidence, burden, and severity of injury and illness was completed. Sex-specific comparisons were made between the senior and youth groups, and across the 8 seasons of data collection. RESULTS In men's international football, 535 injuries were recorded (216 senior; 319 youth) during 73,326 h of exposure. Overall, match injury incidence (31.1 ± 10.8 injuries/1000 h) and burden (454.0 ± 195.9 d absent/1000 h) were greater than training injury incidence (4.0 ± 1.0 injuries/1000 h) and burden (51.0 ± 21.8 d absent/1000 h) (both P < 0.001). In women's international football, 503 injuries were recorded (senior: 177; youth: 326) during 80,766 h of exposure and match injury incidence (27.6 ± 11.3 injuries/1000 h) and burden (506.7 ± 350.2 days absent/1000 h) were greater than training injury incidence (5.1 ± 1.8 injuries/1000 h) and burden (87.6 ± 32.8 days absent/1000 h) (both P < 0.001). In women's international football, a group × season interaction was observed for training injury incidence (P = 0.021), with the senior group recording a greater training injury incidence during the 2015-2016 season compared to the youth group (14.4 vs 5.7 injuries/1000 h; P = 0.022). There was no difference in injury severity between match and training for men's (P = 0.965) and women's (P = 0.064) international football. CONCLUSIONS The findings provide a comprehensive examination of injury and illness in English men's and women's senior and youth international football. Practitioners will be able to benchmark their team's injury and illness incidence and characteristics to the match-play and training information provided in the present study.
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Affiliation(s)
- Bradley Sprouse
- Sport Science Department, Nottingham Trent University, Nottingham, UK
| | - Jon Alty
- The Football Association, Burton-Upon-Trent, UK
| | - Steve Kemp
- The Football Association, Burton-Upon-Trent, UK
| | | | - Ritan Mehta
- The Football Association, Burton-Upon-Trent, UK
| | - Alicia Tang
- The Football Association, Burton-Upon-Trent, UK
| | - John Morris
- Sport Science Department, Nottingham Trent University, Nottingham, UK
| | - Simon Cooper
- Sport Science Department, Nottingham Trent University, Nottingham, UK
| | - Ian Varley
- Sport Science Department, Nottingham Trent University, Nottingham, UK.
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Abou Al Ardat B, Nyland J, Creath R, Murphy T, Narayanan R, Onks C. Micro-doppler radar to evaluate risk for musculoskeletal injury: Protocol for a case-control study with gold standard comparison. PLoS One 2023; 18:e0292675. [PMID: 37815998 PMCID: PMC10564143 DOI: 10.1371/journal.pone.0292675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/26/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Beyond causing significant morbidity and cost, musculoskeletal injuries (MSKI) are among the most common reasons for primary care visits. A validated injury risk assessment tool for MSKI is conspicuously absent from current care. While motion capture (MC) systems are the current gold standard for assessing human motion, their disadvantages include large size, non-portability, high cost, and limited spatial resolution. As an alternative we introduce the Micro Doppler Radar (MDR); in contrast with MC, it is small, portable, inexpensive, and has superior spatial resolution capabilities. While Phase 1 testing has confirmed that MDR can identify individuals at high risk for MSKI, Phase 2 testing is still needed. Our aims are to 1) Use MDR technology and MC to identify individuals at high-risk for MSKI 2) Evaluate whether MDR has diagnostic accuracy superior to MC 3) Develop MDR algorithms that enhance accuracy and enable automation. METHODS AND FINDINGS A case control study will compare the movement patterns of 125 ACL reconstruction patients to 125 healthy controls. This study was reviewed and approved by the Pennsylvania State University Human Research Protection Program (HRPP) on May 18, 2022, and the IRB approval number is STUDY00020118. The ACL group is used as a model for a "high risk" population as up to 24% will have a repeat surgery within 2 years. An 8-camera Motion Analysis MC system with Cortex 8 software to collect MC data. Components for the radar technology will be purchased, assembled, and packaged. A micro-doppler signature projection algorithm will determine correct classification of ACL versus healthy control. Our previously tested algorithm for processing the MDR data will be used to identify the two groups. Discrimination, sensitivity and specificity will be calculated to compare the accuracy of MDR to MC in identifying the two groups. CONCLUSIONS We describe the rationale and methodology of a case-control study using novel MDR technology to detect individuals at high-risk for MSKI. We expect this novel approach to exhibit superior accuracy than the current gold standard. Future translational studies will determine utility in the context of clinical primary care.
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Affiliation(s)
- Bilal Abou Al Ardat
- Pennsylvania State University College of Medicine, Hershey, PA, United States of America
| | - Jennifer Nyland
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, PA, United States of America
| | - Robert Creath
- Exercise Science Department, Lebanon Valley College, Annville, PA, United States of America
| | - Terrence Murphy
- Pennsylvania State University College of Medicine, Hershey, PA, United States of America
| | - Ram Narayanan
- Pennsylvania State University College of Engineering, The Pennsylvania State University, University Park, PA, United States of America
| | - Cayce Onks
- Pennsylvania State University College of Medicine, Hershey, PA, United States of America
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Sonesson S, Lindblom H, Hägglund M. Higher age and present injury at the start of the season are risk factors for in-season injury in amateur male and female football players-a prospective cohort study. Knee Surg Sports Traumatol Arthrosc 2023; 31:4618-4630. [PMID: 37542529 PMCID: PMC10471640 DOI: 10.1007/s00167-023-07517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/14/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE To describe the injury prevalence, injury pattern, and potential baseline risk factors for injuries in male and female adolescent and adult amateur football players. METHODS This prospective study followed adolescent and adult amateur football players over one season March-October 2020. The study was completed by 462 players (130 men, age 20.0 ± 5.7, 14-46 years) who answered a baseline survey and a weekly web survey during the season. A total of 1456 weekly surveys were registered from males and 5041 from females. Injuries were recorded with the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O2). Potential baseline risk factors (age, performance of strength/conditioning training, participation in other sports, perceived importance of sporting success, self-rated training and match load, perceived balance between training/match load and recovery, previous/present injury at start of season, and injury beliefs) and their association with injury were analysed with Poisson regressions within each sex. RESULTS Males reported 95 injuries (262 injury weeks, weekly prevalence 18.0% (95% CI 16.1-20.1)) and females 350 injuries (1206 injury weeks, weekly prevalence 23.9% (95% CI 22.8-25.1)). Gradual-onset injuries accounted for 57% of the injuries in males and 66% in females. For males, substantial injuries were most common in the hip/groin (weekly prevalence 3.8%), ankle (2.1%), posterior thigh (2.0%), and knee (2.0%); and for females, in the knee (4.3%), ankle (2.5%), and lower leg/Achilles tendon (2.0%). Significant risk factors for injury were higher age (rate ratio males 1.05 per year increase (95% CI 1.02-1.08), females 1.03 (95% CI 1.01-1.05)), and present injury at baseline (males 1.92 (95% CI 1.27-2.89), females 1.58 (95% CI 1.19-2.09)). CONCLUSION At any given week, almost one in five male and one in four female amateur football players reported new or ongoing injuries. Hip/groin injuries were more frequent in males, while female players had a higher prevalence of knee injuries. Older players and those with an existing injury at the start of the season were more prone to new injury during the season. Rehabilitation of pre-season injury and complaints are key to reduce the injury burden in amateur football. LEVEL OF EVIDENCE Level II. Trial registration number NCT04272047, Clinical trials.
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Affiliation(s)
- Sofi Sonesson
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Hanna Lindblom
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Martin Hägglund
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Spolaor F, Guiotto A, Ciniglio A, Cibin F, Sawacha Z. Effects of a proprioceptive focal stimulation (Equistasi®) on reducing the biomechanical risk factors associated with ACL injury in female footballers. Front Sports Act Living 2023; 5:1134702. [PMID: 37521101 PMCID: PMC10382620 DOI: 10.3389/fspor.2023.1134702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 06/20/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Football presents a high rate of lower limb injuries and high incidence of Anterior Cruciate Ligament (ACL) rupture, especially in women. Due to this there is the need to optimize current prevention programs. This study aims to verify the possibility to reduce the biomechanical risk factors associated with ACL injury, through the application of proprioceptive stimulation by means of the Equistasi® device. Methods Ten elite female footballers were enrolled and received the device for 4 weeks (5 days/week, 1h/day). Athletes were assessed directly on-field at four time points: T0 and T1 (evaluation without and with the device), T2 (after 2 weeks), T4 (after 4 weeks) while performing two different tasks: Romberg Test, and four sidestep cutting maneuvers bilaterally. Seven video cameras synchronized with a plantar pressure system were used, thirty double colored tapes were applied on anatomical landmarks, and three dimensional coordinates reconstructed. Vertical ground reaction forces and center of pressure data were extracted from the plantar pressure insoles. Hip, knee, and ankle flexion-extension angles and moments were computed as well as abd-adduction joint torques. From the Romberg Test both center of pressure descriptive variables and frequency analysis parameters were extracted. Each variable was compared among the different time frames, T1, T2 and T4, through Friedman Test for non-parametric repeated measures (p<0.05); Wilcoxon Signed Rank Test was used for comparing variables between T0 and T1 (p<0.05) and across the different time frames as follows: T1-T2, T2-T4 and T1-T4. Results Statistically significant differences in both posturographic and biomechanical variables between the assessment at T0 and T1 were detected. Reduced hip and knee abduction torques were revealed in association with reduced both ground reaction forces and ankle dorsiflexion torque from T1 up to T4. Discussion The proprioceptive stimuli showed to have the potential to improve cutting biomechanics mainly with respect to the ligament and quadriceps dominance theories. Results of the present study, even if preliminary and on a small sample size, could be considered promising towards the inclusion of proprioceptive training in injury prevention programs.
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Affiliation(s)
- Fabiola Spolaor
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Annamaria Guiotto
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Alfredo Ciniglio
- Department of Information Engineering, University of Padova, Padova, Italy
| | | | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Padova, Italy
- Department of Medicine, University of Padova, Padova, Italy
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Zeitlin J, Fontana MA, Parides MK, Nawabi DH, Wickiewicz TL, Pearle AD, Beynnon BD, Imhauser CW. Key Thresholds and Relative Contributions of Knee Geometry, Anteroposterior Laxity, and Body Weight as Risk Factors for Noncontact ACL Injury. Orthop J Sports Med 2023; 11:23259671231163627. [PMID: 37197036 PMCID: PMC10184233 DOI: 10.1177/23259671231163627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/27/2023] [Indexed: 05/19/2023] Open
Abstract
Background Limited data exist regarding the association of tibiofemoral bony and soft tissue geometry and knee laxity with risk of first-time noncontact anterior cruciate ligament (ACL) rupture. Purpose To determine associations of tibiofemoral geometry and anteroposterior (AP) knee laxity with risk of first-time noncontact ACL injury in high school and collegiate athletes. Study Design Cohort study; Level of evidence, 2. Methods Over a 4-year period, noncontact ACL injury events were identified as they occurred in 86 high school and collegiate athletes (59 female, 27 male). Sex- and age-matched control participants were selected from the same team. AP laxity of the uninjured knee was measured using a KT-2000 arthrometer. Magnetic resonance imaging was taken on ipsilateral and contralateral knees, and articular geometries were measured. Sex-specific general additive models were implemented to investigate associations between injury risk and 6 features: ACL volume, meniscus-bone wedge angle in the lateral compartment of the tibia, articular cartilage slope at the middle region of the lateral compartment of the tibia, femoral notch width at the anterior outlet, body weight, and AP displacement of the tibia relative to the femur. Importance scores (in percentages) were calculated to rank the relative contribution of each variable. Results In the female cohort, the 2 features with the highest importance scores were tibial cartilage slope (8.6%) and notch width (8.1%). In the male cohort, the 2 top-ranked features were AP laxity (5.6%) and tibial cartilage slope (4.8%). In female patients, injury risk increased by 25.5% with lateral middle cartilage slope becoming more posteroinferior from -6.2° to -2.0° and by 17.5% with lateral meniscus-bone wedge angle increasing from 27.3° to 28.2°. In males, an increase in AP displacement from 12.5 to 14.4 mm in response to a 133-N anterior-directed load was associated with a 16.7% increase in risk. Conclusion Of the 6 variables studied, there was no single dominant geometric or laxity risk factor for ACL injury in either the female or male cohort. In males, AP laxity >13 to 14 mm was associated with sharply increased risk of noncontact ACL injury. In females, lateral meniscus-bone wedge angle >28° was associated with a sharply decreased risk of noncontact ACL injury.
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Affiliation(s)
- Jacob Zeitlin
- Weill Cornell Medical College, New York, New York, USA
- Department of Biomechanics Research, Hospital for Special Surgery, New York, New York, USA
- Jacob Zeitlin, BA, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA ()
| | - Mark A. Fontana
- Weill Cornell Medical College, New York, New York, USA
- Center for Analytics, Modeling, and Performance, Hospital for Special Surgery, New York, New York, USA
| | - Michael K. Parides
- Biostatistics and Bioinformatics Program, Hospital for Special Surgery, New York, New York, USA
| | - Danyal H. Nawabi
- Department of Biomechanics Research, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Thomas L. Wickiewicz
- Department of Biomechanics Research, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Andrew D. Pearle
- Department of Biomechanics Research, Hospital for Special Surgery, New York, New York, USA
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA
| | - Bruce D. Beynnon
- Department of Orthopaedics and Rehabilitation, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Carl W. Imhauser
- Department of Biomechanics Research, Hospital for Special Surgery, New York, New York, USA
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Cronström A, Tengman E, Häger CK. Return to Sports: A Risky Business? A Systematic Review with Meta-Analysis of Risk Factors for Graft Rupture Following ACL Reconstruction. Sports Med 2023; 53:91-110. [PMID: 36001289 PMCID: PMC9807539 DOI: 10.1007/s40279-022-01747-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND The risk of sustaining a graft rupture after anterior cruciate ligament reconstruction (ACLR) is high. Contributing risk factors are, however, still not clearly identified. OBJECTIVE The aim of this systematic review was to identify and quantify risk factors for graft rupture after ACLR. METHODS A systematic review with meta-analysis (PROSPERO CRD42020140129) based on PRISMA guidelines was performed. MEDLINE, CINAHL and EMBASE were searched from inception to September 2021. Prospective and retrospective studies addressing risk factors for graft rupture after ACLR in males/females of all ages were considered. Meta-analyses using a random effect model (effect measure: odds ratio [OR] with 95% confidence interval [CI]) were performed. The GRADE tool was used to assess evidence quality. RESULTS Following full-text screening of 310 relevant papers, 117 were eventually included, incorporating up to 133,000 individuals in each meta-analysis. Higher Tegner activity level (≥ 7 vs < 7) at primary injury (OR 3.91, 95% CI 1.69-9.04), increased tibial slope (degrees) (OR 2.21, 95% CI 1.26-3.86), lower psychological readiness to return to sport (RTS) (OR 2.18, 95% CI 1.32-3.61), early surgery (< 12 vs ≥ 12 months) (OR 1.87, 95% CI 1.58-2.22), RTS (pre-injury level) (OR 1.87, 95% CI 1.21-2.91) and family history of ACL injury (OR 1.76, 95% CI 1.34-2.31) were all associated with increased odds of graft rupture. Higher age (OR 0.47, 95% CI 0.39-0.59), female sex (OR 0.88, 95% CI 0.79-0.98), fewer self-reported knee symptoms pre-reconstruction (OR 0.81, 95% CI 0.69-0.95) and concomitant cartilage injuries (OR 0.70, 95% CI 0.62-0.79) instead decreased the odds. Meta-analysis revealed no association between body mass index, smoking, joint laxity, RTS time, knee kinematics, muscle strength or hop performance and graft rupture. CONCLUSION Conspicuous risk factors for graft rupture were mainly sports and hereditary related. Few studies investigated function-related modifiable factors or included sports exposure data.
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Affiliation(s)
- Anna Cronström
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
- Department of Health Sciences, Lund University, Lund, Sweden.
| | - Eva Tengman
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Charlotte K Häger
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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Fältström A, Skillgate E, Weiss N, Källberg H, Lyberg V, Waldén M, Hägglund M, Asker M, Tranaeus U. Lifestyle characteristics in adolescent female football players: data from the Karolinska football Injury Cohort. BMC Sports Sci Med Rehabil 2022; 14:212. [PMID: 36517880 PMCID: PMC9753279 DOI: 10.1186/s13102-022-00603-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Normative values of lifestyle characteristics in adolescent female football players may be used by clinicians and coaches to take actions because the potential important for well-being, performance on the pitch, and risk of injury. The aim was to report descriptive characteristics of lifestyle factors in adolescent female football players and potential changes over 1 year. METHODS We included 419 adolescent competitive female football players from 12 clubs and 27 teams (age 14 ± 1 years, range 12-17 years) and 286 were followed over 1 year. The players completed an extensive questionnaire regarding demographics, football-related factors, and lifestyle factors including tobacco consumption, alcohol use, medicine intake, eating and sleeping habits, well-being, stress, coping, and passion. Baseline data are presented for the total cohort and separately for 4 age groups (12, 13, 14, and 15-17 years). RESULTS 12% skipped breakfast, 8% skipped lunch and 11% used protein supplements several days per week. 16% slept less than 8 h/night, 8% had impaired sleep with daytime consequences, and 22% stated that they were tired in daily activities several days per week. 32% experienced stress some or most days/week and 24% were classified as having psychological distress. Medicine intake (23% vs. 34%), skipping breakfast or lunch several days per week (10% vs. 47% and 20 vs. 33%), tiredness (20% vs. 27%), stress (26% vs. 40%), and psychological distress (27% vs. 37%) increased significantly (P = 0.031 to < 0.001) at the 1-year follow-up. CONCLUSION Many adolescent female football players skip breakfast and lunch, have insufficient sleep, experience stress and are classified as having psychological distress. These factors increased over 1 year.
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Affiliation(s)
- Anne Fältström
- grid.445308.e0000 0004 0460 3941Department of Health Promotion Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden ,grid.5640.70000 0001 2162 9922Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden ,grid.413253.2Region Jönköping County, Rehabilitation Centre, Ryhov County Hospital, Jönköping, Sweden
| | - Eva Skillgate
- grid.445308.e0000 0004 0460 3941Department of Health Promotion Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Unit of Intervention and Implementation for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nathan Weiss
- grid.445308.e0000 0004 0460 3941Department of Health Promotion Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Unit of Intervention and Implementation for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Källberg
- grid.445308.e0000 0004 0460 3941Department of Health Promotion Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden ,grid.419734.c0000 0000 9580 3113Unit of analysis, Department of Public Health, Analysis and Data Management, Public Health Agency of Sweden, Stockholm, Sweden
| | - Victor Lyberg
- grid.445308.e0000 0004 0460 3941Department of Health Promotion Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden
| | - Markus Waldén
- Unit of Public Health, Department of Health, Medicine and Caring Sciences, Linköping, Sweden ,GHP Ortho Center Skåne, Malmö, Sweden
| | - Martin Hägglund
- grid.5640.70000 0001 2162 9922Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden ,grid.5640.70000 0001 2162 9922Sport Without Injury ProgrammE (SWIPE), Linköping University, Linköping, Sweden
| | - Martin Asker
- grid.445308.e0000 0004 0460 3941Department of Health Promotion Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Unit of Intervention and Implementation for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden ,Naprapathögskolan, Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
| | - Ulrika Tranaeus
- grid.4714.60000 0004 1937 0626Unit of Intervention and Implementation for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden ,grid.416784.80000 0001 0694 3737Department of Physiology, Nutrition, Biomechanic, Sport Performance & Exercise Research & Innovation Center - Stockholm, SPERIC-S, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
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11
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Cardoso-Marinho B, Barbosa A, Bolling C, Marques JP, Figueiredo P, Brito J. The perception of injury risk and prevention among football players: A systematic review. Front Sports Act Living 2022; 4:1018752. [PMID: 36570494 PMCID: PMC9768495 DOI: 10.3389/fspor.2022.1018752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Football is associated with a certain risk of injury, leading to short- and long-term health consequences. However, the perception of football players about injury risk and prevention strategies is poorly documented. The present article reviewed the literature about perceptions, beliefs, attitudes and knowledge toward injury risk and prevention strategies in football players. An electronic search was performed in PubMed, Scopus, Web of Science, and APA PsychINFO until July 2022. Studies were eligible if they included the perceptions, beliefs, attitudes, and knowledge about injury risk and prevention in football players from any competitive level. The risk of bias was assessed in included studies using the Joanna Briggs Institute critical appraisal checklist. A total of 14 studies were included. Most football players agreed that their risk of injury is high and prevention strategies are important, however they do not intend to use some of these strategies. The most frequent perceived injury risk factors were low muscle strength, lack of physical fitness, fatigue, excessive training and type and condition of surfaces. The most frequent perceived injury prevention factors were warm-up, workload monitoring and strength and conditioning training. It is essential to acknowledge perceived injury risk factors, as well as a better understanding of how coaching and medical departments' perceptions match with players' perceptions, and a modification in the perceptions of the several stakeholders at different levels of action.
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Affiliation(s)
- Beatriz Cardoso-Marinho
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, Maia, Portugal,Portuguese Institute of Sports and Youth, IPDJ, Sports Medicine Center, Porto, Portugal,Armed Forces Hospital, Porto, Portugal,Correspondence: Beatriz Cardoso-Marinho
| | - Ana Barbosa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal,Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Caroline Bolling
- Amsterdam Collaboration on Health & Safety in Sports, Department of Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Science, Amsterdam UMC, Amsterdam, the Netherlands
| | - José Pedro Marques
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal,Hospital da Luz, Lisboa, Portugal
| | - Pedro Figueiredo
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal,Physical Education Department, College of Education, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Vila Real, Portugal
| | - João Brito
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
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12
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Xiao M, Lemos JL, Hwang CE, Sherman SL, Safran MR, Abrams GD. Increased Risk of ACL Injury for Female but Not Male Soccer Players on Artificial Turf Versus Natural Grass: A Systematic Review and Meta-Analysis. Orthop J Sports Med 2022; 10:23259671221114353. [PMID: 35990873 PMCID: PMC9382072 DOI: 10.1177/23259671221114353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Both natural grass (NG) and artificial turf (AT) are popular playing surfaces
for soccer. Biomechanical studies have found increased frictional forces on
AT that may lead to anterior cruciate ligament (ACL) injury. The increased
risk of ACL injury during soccer in female participants may amplify this
effect. Purpose: To systematically review the literature for studies comparing ACL injury risk
in soccer players on AT versus NG and to specifically determine whether
there were differences in injury risk in male versus female players when
considering the playing surface. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed using PRISMA (Preferred Reporting Items for
Systematic Reviews and Meta-Analyses) guidelines. Three databases were
searched for studies with evidence level 1 to 3 that compared the incidence
of ACL injuries on AT versus NG in soccer players. Data recorded included
study characteristics, sex, competition level, exposure setting (games or
practices), turf type, and ACL injury information. Study methodological
quality was analyzed using the methodological index for non-randomized
studies (MINORS) score, and incidence rate ratios (IRRs) were
calculated. Results: Included were 7 articles (3 studying professional soccer, 3 collegiate
soccer, 1 youth-level soccer; 4 male cohorts, 2 female cohorts, and 1 male
and female cohort; mean MINORS score, 20 ± 0.8). Pooled ACL injury IRRs
demonstrated no significant differences in overall ACL injury risk when
playing soccer on AT compared with NG (IRR = 0.57 [95% CI, 0.21-1.53];
P = .31). A significantly increased risk of ACL injury
in games played on AT compared with NG was detected for female (IRR = 1.18
[95% CI, 1.05-1.31]; P = .004) but not for male players
(IRR = 1.18 [95% CI, 0.97-1.42]; P = .09). Subgroup
analyses showed no significant differences in injury risk for games (IRR =
1.07 [95% CI, 0.97-1.18]; P = .20) or practices (IRR = 0.21
[95% CI, 0.04-1.23]; P = .09). Conclusion: Findings indicated that female soccer players had a significantly higher risk
of ACL injury when playing games on AT versus NG, whereas no significant
difference was seen in male players. No differences were found for the
combined male/female cohort or for soccer games or training sessions played
on AT compared with NG.
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Affiliation(s)
- Michelle Xiao
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Jacie L Lemos
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Calvin E Hwang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Seth L Sherman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Marc R Safran
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Geoffrey D Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
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13
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Nakahira Y, Taketomi S, Kawaguchi K, Mizutani Y, Hasegawa M, Ito C, Uchiyama E, Ikegami Y, Fujiwara S, Yamamoto K, Nakamura Y, Tanaka S, Ogata T. Kinematic Differences Between the Dominant and Nondominant Legs During a Single-Leg Drop Vertical Jump in Female Soccer Players. Am J Sports Med 2022; 50:2817-2823. [PMID: 35850117 DOI: 10.1177/03635465221107388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND In soccer, the roles of the dominant (kicking) and nondominant (supporting) legs are different. The kinematic differences between the actions of the dominant and nondominant legs in female soccer players are not clear. PURPOSE To clarify the kinematic differences between dominant and nondominant legs during a single-leg drop vertical jump (DVJ) in female soccer players. STUDY DESIGN Controlled laboratory study. METHODS A total of 64 female high school and college soccer players were included in this study. Participants performed a single-leg DVJ test utilizing video motion capture with artificial intelligence during the preseason period. This study assessed the knee flexion angles, knee valgus angles, hip flexion angles, and lower leg anterior inclination angle at 3 time points (initial contact, maximum flexion of the knee, and toe-off) and compared them between the dominant and nondominant legs. These angles were calculated from motion capture data and analyzed in 3 dimensions. A paired t test was used to analyze the differences between legs, and the significance level was set at P < .05. RESULTS The knee valgus angle at initial contact was greater in the nondominant leg (mean ± SD, 0.8°± 5.2°) than the dominant leg (-0.9°± 4.9°) (P < .01). There were no differences between legs for any other angles at any of the time points. CONCLUSION The kinematics of the dominant and nondominant legs of female soccer players in a single-leg DVJ differ in knee valgus angle. CLINICAL RELEVANCE Leg dominance is associated with the risk of sports injuries. Kinematic differences between the dominant and nondominant legs may be a noteworthy factor in elucidating the mechanisms and risk of sports injury associated with leg dominance.
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Affiliation(s)
- Yu Nakahira
- Department of Rehabilitation Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Taketomi
- Tokyo Sports Science Initiative, The University of Tokyo, Tokyo, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kohei Kawaguchi
- Tokyo Sports Science Initiative, The University of Tokyo, Tokyo, Japan; Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuri Mizutani
- Tokyo Sports Science Initiative, The University of Tokyo, Tokyo, Japan
| | - Masato Hasegawa
- Department of Rehabilitation Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chie Ito
- Department of Rehabilitation Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Emiko Uchiyama
- The Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Yosuke Ikegami
- The Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Sayaka Fujiwara
- Department of Rehabilitation Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ko Yamamoto
- Tokyo Sports Science Initiative, The University of Tokyo, Tokyo, Japan; The Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Yoshihiko Nakamura
- Tokyo Sports Science Initiative, The University of Tokyo, Tokyo, Japan; The Graduate School of Information Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toru Ogata
- Department of Rehabilitation Medicine, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Sports Science Initiative, The University of Tokyo, Tokyo, Japan.,Investigation performed at The University of Tokyo, Tokyo, Japan
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14
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Eustace SJ, Morris R, Tallis J, Page RM, Greig M. The influence of angle-specific torque of the knee flexors and extensors on the angle-specific dynamic control ratio in professional female soccer players. J Sports Sci 2022; 40:1235-1242. [PMID: 35389325 DOI: 10.1080/02640414.2022.2061251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this study was to assess whether dynamic torque ratios (DCR) from isokinetic strength assessments of eccentric knee flexors (eccKF) and concentric knee extensors (conKE) display differences when stratified into specific angle-specific DCR (DCRAST) groups. Fifty-two professional female soccer players (age 21.30 ± 4.44 years; height 166.56 ± 5.17 cm; mass 61.55 ± 5.73 kg) from the English Women's Super League completed strength assessments of both lower limbs on an isokinetic dynamometer at 60°∙s-1. Angle-specific torque (AST) were used to calculate DCRAST to create sub-groups using clustering algorithms. The results identified for the dominant side that the Medium DCRAST group elicited significantly higher conKE AST when compared to Low and High DCRAST groups at increased knee extension (P ≤ 0.05). For the non-dominant side, the High DCRAST group had significantly higher and lower eccKF and conKE AST compared to the Low DCRAST group at increased knee extension (P ≤ 0.05). This study highlights that the inclusion of AST data may subsequently help practitioners to prescribe exercise that promotes strength increases at targeted joint angles. In turn, these approaches can be used to help reduce injury risk, identify rehabilitation responses and help inform return to play.
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Affiliation(s)
- Steven James Eustace
- School of Life Sciences, Science & Health Building, Coventry University, Coventry, UK
| | - Rhys Morris
- School of Life Sciences, Science & Health Building, Coventry University, Coventry, UK
| | - Jason Tallis
- School of Life Sciences, Science & Health Building, Coventry University, Coventry, UK
| | - Richard Michael Page
- Sports Injuries Research Group, Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
| | - Matt Greig
- Sports Injuries Research Group, Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
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15
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Neuromuscular control and hop performance in youth and adult male and female football players. Phys Ther Sport 2022; 55:189-195. [DOI: 10.1016/j.ptsp.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
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16
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Anatomical and Neuromuscular Factors Associated to Non-Contact Anterior Cruciate Ligament Injury. J Clin Med 2022; 11:jcm11051402. [PMID: 35268493 PMCID: PMC8911271 DOI: 10.3390/jcm11051402] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/16/2022] [Accepted: 03/01/2022] [Indexed: 12/11/2022] Open
Abstract
The majority of anterior cruciate ligament (ACL) injuries occur during non-contact mechanisms. Knowledge of the risk factors would be relevant to help prevent athletes’ injuries. We aimed to study risk factors associated with non-contact ACL injuries in a population of athletes after ACL reconstruction. From a cohort of 307 athletes, two populations were compared according to the non-contact or contact mechanism of ACL injury. Gender, age and body mass index (BMI) were reported. Passive knee alignment (valgus and extension), knee laxity (KT-1000 test), and isokinetic knee strength were measured on the non-injured limb. The relationship between these factors and the non-contact sport mechanism was established with models using logistic regression analysis for the population and after selection of gender and cut-offs of age, BMI and knee laxity calculated from Receiver Operating Characteristics curve area and Youden index. Age, BMI, antero-posterior laxity, isokinetic knee strength, passive knee valgus and passive knee extension were associated with non-contact ACL injury. According to the multivariate model, a non-contact ACL injury was associated with non-modifiable factors, age (OR: 1.05; p = 0.001), passive knee extension (OR: 1.14; p = 0.001), and with one modifiable factor (Hamstring strength: OR: 0.27; p = 0.01). For women, only passive knee valgus was reported (OR: 1.27; p = 0.01). Age, passive knee extension and weak Hamstring strength were associated with a non-contact ACL injury. Hamstring strengthening could be proposed to prevent ACL injury in young male athletes or in case of knee laxity.
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17
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Screening Tests for Assessing Athletes at Risk of ACL Injury or Reinjury-A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052864. [PMID: 35270563 PMCID: PMC8910677 DOI: 10.3390/ijerph19052864] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 12/23/2022]
Abstract
Various tests are available to assess athletes for factors associated with their susceptibility and risk of anterior cruciate ligament (ACL) injury or reinjury; however, it is unclear which tests are clinically meaningful and what should be considered when using them. Therefore, the aim of this scoping review was to screen and summarize testing and to derive evidence-based recommendations for clinicians, practitioners and future research. Five databases were searched to identify studies addressing musculoskeletal morphology or functional-performance-related screening tests with a clear conceptual link or an evidence-based relationship to ACL (re)injury. A quality rating was carried out using the National Institutes of Health (NIH) Study-Quality Assessment Tool. Six different categories of common screening tests were identified: balance and postural control, gait- and running-related tests, joint laxity, joint morphology and anthropometrics, jump tests and strength tests. Predicting future injury in a complex, dynamic system based on a single screening test is methodologically challenging, which is also reflected in the highly controversial findings in the literature regarding potential associations between specific screening tests and the occurrence of ACL injuries and reinjuries. Nonetheless, various screening tests can provide clinically relevant information on ACL-(re)injury-related factors and help to provide tailored preventive measures. A selection of corresponding evidence-based recommendations is derived and presented in this scoping review.
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18
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Nishizawa K, Hashimoto T, Hakukawa S, Nagura T, Otani T, Harato K. Effects of foot progression angle on kinematics and kinetics of a cutting movement. J Exp Orthop 2022; 9:11. [PMID: 35041099 PMCID: PMC8766617 DOI: 10.1186/s40634-022-00447-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/07/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose Foot progression angle is a key factor for biomechanical knee load, which is associated with noncontact anterior cruciate ligament (ACL) injury during sports-specific tasks. The purpose of the present study was to assess the biomechanics of trunk, pelvis, and lower extremities during a cutting maneuver under different foot progression angles. Methods Nineteen male collegiate athletes (ages 18–24) participated in the present study. Cutting motion was analyzed using eight infrared cameras (250 Hz), two force plates (1250 Hz), and 44 reflective markers. Subjects performed 45-degree side cutting maneuvers under three foot progression angles, including 20 degrees (toe-out: TO), 0 degrees (neutral: TN), and − 20 degrees (toe-in: TI). Peak values of each biomechanical parameters in trunk, pelvis, hip, and knee within a first 40% stance phase and each parameter at the timing of the peak vertical ground reaction force were assessed. A statistical analysis was performed to compare data among the three-foot progression angles using the Friedman test. Results Peak angles of knee abduction, tibial internal rotation, hip internal rotation, and hip adduction were significantly greater for TI position than for TO position (p < 0.01). Peak moments of knee abduction and tibial internal rotation under TI position were also significantly larger than TO position (p < 0.01). Moreover, greater peak pelvis-trunk rotation was found for TI position than for TN and TO positions (p < 0.01). Conclusion From the present study, TI position could lead to an increased risk of ACL injury during a pre-planned cut maneuver, compared to TO position.
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Affiliation(s)
- Kohei Nishizawa
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanagawa, 252-0883, Japan.
| | - Takeshi Hashimoto
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanagawa, 252-0883, Japan.,Sports Medicine Research Center, Keio University, Yokohama, Kanagawa, Japan
| | - Satoshi Hakukawa
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Takeo Nagura
- Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Toshiro Otani
- International University of Health and Welfare Ichikawa Hospital, Ichikawa, Chiba, Japan
| | - Kengo Harato
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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19
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Tranaeus U, Weiss N, Lyberg V, Hagglund M, Waldén M, Johnson U, Asker M, Skillgate E. Study protocol for a prospective cohort study identifying risk factors for sport injury in adolescent female football players: the Karolinska football Injury Cohort (KIC). BMJ Open 2022; 12:e055063. [PMID: 35022175 PMCID: PMC8756291 DOI: 10.1136/bmjopen-2021-055063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Football is a popular sport among young females worldwide, but studies concerning injuries in female players are scarce compared with male players. The aim of this study is to identify risk factors for injury in adolescent female football players. METHODS AND ANALYSIS The Karolinska football Injury Cohort (KIC) is an ongoing longitudinal study that will include approximately 400 female football academy players 12-19 years old in Sweden. A detailed questionnaire regarding demographics, health status, lifestyle, stress, socioeconomic factors, psychosocial factors and various football-related factors are completed at baseline and after 1 year. Clinical tests measuring strength, mobility, neuromuscular control of the lower extremity, trunk and neck are carried out at baseline. Players are followed prospectively with weekly emails regarding exposure to football and other physical activity, health issues (such as stress, recovery, etc), pain, performance and injuries via the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O). Players who report a substantial injury in the OSTRC-O, that is, not being able to participate in football activities, or have reduced their training volume performance to a moderate or major degree, are contacted for full injury documentation. In addition to player data, academy coaches also complete a baseline questionnaire regarding coach experience and education. ETHICS AND DISSEMINATION The study was approved by the Regional Ethical Review Authority at Karolinska Institutet, Stockholm, Sweden (2016/1251-31/4). All participating players and their legal guardians give their written informed consent. The study will be reported in accordance with the Strengthening the Reporting of Observational studies in Epidemiology. The results will be published in peer-reviewed academic journals and disseminated to the Swedish football movement through stakeholders and media.
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Affiliation(s)
- Ulrika Tranaeus
- Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nathan Weiss
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
| | - Victor Lyberg
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
| | - Martin Hagglund
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Linköping University, Linkoping, Sweden
- Football Research Group, Linköping, Sweden
| | - Markus Waldén
- Sport Without Injury ProgrammE (SWIPE), Linköping University, Linkoping, Sweden
- Football Research Group, Linköping, Sweden
- Department of Orthopaedics, Hässleholm-Kristianstad Hospitals, Hässleholm, Sweden
- Unit of Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Martin Asker
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
| | - Eva Skillgate
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
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20
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Familial Predisposition to Anterior Cruciate Ligament Injury: A Systematic Review with Meta-analysis. Sports Med 2022; 52:2657-2668. [PMID: 35829993 PMCID: PMC9585006 DOI: 10.1007/s40279-022-01711-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Having a family history of anterior cruciate ligament (ACL) injury has been investigated in the literature but few studies have focused on this factor specifically or reported their outcomes by sex. OBJECTIVE We aimed to systematically review family history as a risk factor for sustaining a primary ACL injury and the impact it has on ACL graft rupture or contralateral ACL injury in male and female individuals. METHODS A literature search was completed in seven databases from inception until March 2021 to investigate primary and subsequent ACL injuries in those with a family history of ACL injury. Articles were screened by prespecified inclusion criteria, and the methodological quality of each study was determined. Study results were combined using an odds ratio (OR) meta-analysis. Subgroup analysis was also completed by sex for primary ACL injury, as well as by graft rupture and contralateral ACL injury for subsequent ACL injuries. RESULTS Twelve studies were acquired for systematic review and meta-analysis. Four studies that investigated primary ACL injury, seven that investigated ACL graft and/or contralateral ACL ruptures and one study that investigated both primary and subsequent ACL injury. Having a family history of ACL injury increased the odds of injury across all outcomes. Those with a family history had a 2.5 times greater odds for sustaining a primary ACL injury (OR 2.53 [95% confidence interval [CI] 1.96-3.28, p < 0.001)]. There was no significant difference of injury odds for primary ACL injury when analysed by sex. Family history of ACL injury was found to increase the odds of subsequent ACL injury by 2.38 (95% CI 1.64-3.46, p < 0.001) and was significant for both graft ruptures (OR 1.80 [95% CI 1.20-2.71, p = 0.005]) and contralateral ACL injuries (OR 2.28 [95% CI 1.28-4.04, p = 0.005]). When compared directly, the odds of sustaining a graft rupture versus a contralateral ACL injury were similar for those with a family history. Outcomes were not frequently reported by sex for subsequent ACL injuries. CONCLUSIONS Having a family history of ACL injury more than doubles the odds of sustaining a primary or subsequent ACL injury. However, if a family history of ACL injury is present, the sex of the athlete does not increase the risk for primary injury nor is there a difference in the risk for a subsequent graft rupture compared to a contralateral ACL injury. CLINICAL TRIAL REGISTRATION PROSPERO: CRD42020186472.
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Tranaeus U, Ivarsson A, Johnson U, Weiss N, Samuelsson M, Skillgate E. The Role of the Results of Functional Tests and Psychological Factors on Prediction of Injuries in Adolescent Female Football Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010143. [PMID: 35010400 PMCID: PMC8750218 DOI: 10.3390/ijerph19010143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/17/2021] [Indexed: 05/20/2023]
Abstract
Football is a popular sport among adolescent females. Given the rate of injuries in female footballers, identifying factors that can predict injuries are important. These injuries are often caused by complex reasons. The aim of this study was to investigate if the combination of demographic (age, number of training and match play hours/week), psychosocial (perceived stress, adaptive coping strategies) and physiological factors (functional performance) can predict a traumatic injury in adolescent female footballers. A cohort consisting of 419 female football players aged 13-16 years was established. Baseline questionnaires covered potential risk factors for sport injuries, and measurements included football-related functional performance tests. Data were collected prospectively with a weekly online questionnaire for 52 weeks covering, e.g., injuries, training, and match play hours/week. A total of 62% of the players reported at least one traumatic injury during the 52 weeks. The coping strategy "positive reframing" had the strongest association with the risk of traumatic injuries. The combination of more frequent use of the coping strategy, positive reframing, and high levels of physical performance capacity may prevent a traumatic injury in adolescent female footballers. Coaches are encouraged to adopt both physiological and psychological factors when preventing injuries in young female footballers.
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Affiliation(s)
- Ulrika Tranaeus
- Department of PNB, The Swedish School of Sport and Health Sciences, 144 86 Stockholm, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; (N.W.); (E.S.)
- Correspondence:
| | - Andreas Ivarsson
- Center of Research on Welfare Health and Sport, Halmstad University, 301 18 Halmstad, Sweden; (A.I.); (U.J.)
- Department of Sport Science and Physical Education, University of Agder, 4630 Kristiansand, Norway
| | - Urban Johnson
- Center of Research on Welfare Health and Sport, Halmstad University, 301 18 Halmstad, Sweden; (A.I.); (U.J.)
| | - Nathan Weiss
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; (N.W.); (E.S.)
- Department of Health Promotion Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, 114 86 Stockholm, Sweden
| | - Martin Samuelsson
- Naprapathögskolan—Scandinavian College of Naprapathic Manual Medicine, 114 19 Stockholm, Sweden;
| | - Eva Skillgate
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden; (N.W.); (E.S.)
- Department of Health Promotion Science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, 114 86 Stockholm, Sweden
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22
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The dominant leg is more likely to get injured in soccer players: systematic review and meta-analysis. Biol Sport 2021; 38:397-435. [PMID: 34475623 PMCID: PMC8329968 DOI: 10.5114/biolsport.2021.100265] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 08/31/2020] [Accepted: 09/03/2020] [Indexed: 12/26/2022] Open
Abstract
In soccer (football), dominant limb kicking produces higher ball velocity and is used with greater frequency than the non-dominant limb. It is unclear whether limb dominance has an effect on injury incidence. The purpose of this systematic review with meta-analysis is to examine the relationship between limb dominance and soccer injuries. Studies were identified from four online databases according to PRISMA guidelines to identify studies of soccer players that reported lower extremity injuries by limb dominance. Relevant studies were assessed for inclusion and retained. Data from retained studies underwent meta-analyses to determine relative risk of dominant versus non-dominant limb injuries using random-effects models. Seventy-four studies were included, with 36 of them eligible for meta-analysis. For prospective lower extremity injury studies, soccer players demonstrated a 1.6 times greater risk of injury to the dominant limb (95% CI [1.3-1.8]). Grouped by injury location, hamstring (RR 1.3 [95% CI 1.1-1.4]) and hip/groin (RR 1.9 [95% CI 1.3-2.7]) injuries were more likely to occur to the dominant limb. Greater risk of injury was present in the dominant limb across playing levels (amateurs RR 2.6 [95% CI 2.1-3.2]; youths RR 1.5 [95% CI 1.26-1.67]; professionals RR 1.3 [95% CI 1.14-1.46]). Both males (RR 1.5 [95% CI 1.33-1.68)] and females (RR 1.5 [95% CI 1.14-1.89]) were more likely to sustain injuries to the dominant limb. Future studies investigating soccer injury should adjust for this confounding factor by using consistent methods for assigning limb dominance and tracking use of the dominant versus non-dominant limb.
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23
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Randell RK, Clifford T, Drust B, Moss SL, Unnithan VB, De Ste Croix MBA, Datson N, Martin D, Mayho H, Carter JM, Rollo I. Physiological Characteristics of Female Soccer Players and Health and Performance Considerations: A Narrative Review. Sports Med 2021; 51:1377-1399. [PMID: 33844195 PMCID: PMC8222040 DOI: 10.1007/s40279-021-01458-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 12/18/2022]
Abstract
Female soccer has seen a substantial rise in participation, as well as increased financial support from governing bodies over the last decade. Thus, there is an onus on researchers and medical departments to develop a better understanding of the physical characteristics and demands, and the health and performance needs of female soccer players. In this review, we discuss the current research, as well as the knowledge gaps, of six major topics: physical demands, talent identification, body composition, injury risk and prevention, health and nutrition. Data on female talent identification are scarce, and future studies need to elucidate the influence of relative age and maturation selection across age groups. Regarding the physical demands, more research is needed on the pattern of high-intensity sprinting during matches and the contribution of soccer-specific movements. Injuries are not uncommon in female soccer players, but targeting intrinsically modifiable factors with injury prevention programmes can reduce injury rates. The anthropometric and physical characteristics of female players are heterogeneous and setting specific targets should be discouraged in youth and sub-elite players. Menstrual cycle phase may influence performance and injury risk; however, there are few studies in soccer players. Nutrition plays a critical role in health and performance and ensuring adequate energy intake remains a priority. Despite recent progress, there is considerably less research in female than male soccer players. Many gaps in our understanding of how best to develop and manage the health and performance of female soccer players remain.
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Affiliation(s)
- Rebecca K Randell
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK.
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - Thomas Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Barry Drust
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Samantha L Moss
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK
- Department of Sport and Exercise Sciences, University of Chester, Chester, UK
| | - Viswanath B Unnithan
- Institute of Clinical Exercise and Health Science, Division of Sport and Exercise, School of Health and Life Sciences, University of the West of Scotland, Hamilton, Scotland, UK
| | | | - Naomi Datson
- Institute of Sport, University of Chichester, Chichester, UK
| | - Daniel Martin
- School of Sport and Exercise Science, University of Lincoln, Lincoln, UK
| | - Hannah Mayho
- Sports Science Department, Manchester City Football Club, Manchester, UK
| | - James M Carter
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK
| | - Ian Rollo
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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24
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Hilska M, Leppänen M, Vasankari T, Aaltonen S, Kannus P, Parkkari J, Steffen K, Kujala UM, Konttinen N, Räisänen AM, Pasanen K. Neuromuscular Training Warm-up Prevents Acute Noncontact Lower Extremity Injuries in Children's Soccer: A Cluster Randomized Controlled Trial. Orthop J Sports Med 2021; 9:23259671211005769. [PMID: 35146027 PMCID: PMC8822004 DOI: 10.1177/23259671211005769] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/16/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Prevention of sports injuries is essential in youth, as injuries are associated with less future physical activity and thus greater all-cause morbidity. Purpose: To investigate whether a neuromuscular training warm-up operated by team coaches is effective in preventing acute lower extremity (LE) injuries in competitive U11-U14 soccer players. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Twenty top-level U11 to U14 soccer clubs in Finland were randomized into intervention and control groups and assessed for 20 weeks. Participants included 1403 players (280 female, 1123 male; age range, 9-14 years): 673 players (44 teams) in the intervention group and 730 players (48 teams) in the control group. The intervention group team coaches were introduced to a neuromuscular training warm-up to replace the standard warm-up 2 to 3 times per week. The control teams were asked to perform their standard warm-up. Injury data collection was done via weekly text messages. The primary outcome measure was a soccer-related acute LE injury, and the secondary outcome measure was an acute noncontact LE injury. Results: A total of 656 acute LE injuries occurred: 310 in the intervention group and 346 in the control group. The overall acute LE injury incidence was 4.4 per 1000 hours of exposure in the intervention group and 5.5 per 1000 hours of exposure in the control group, with no significant difference between groups (incidence rate ratio [IRR], 0.82 [95% CI, 0.64-1.04]). There were 302 acute noncontact LE injuries: 129 in the intervention group (incidence, 1.8 per 1000 hours) and 173 in the control group (2.7 per 1000 hours). A significant reduction in acute noncontact LE injuries of 32% (IRR, 0.68 [95% CI, 0.51-0.93]) was observed in the intervention group compared with the control group. Furthermore, significant reductions in injury incidence in favor of the intervention group were seen in the subanalyses of acute noncontact LE injuries, leading to ≤7 days of time loss and fewer ankle and joint/ligament injuries. Conclusion: A neuromuscular training warm-up operated by team coaches was found to be effective in preventing acute noncontact LE injuries in children’s soccer, but this was not seen in all acute LE injuries. Clinical Relevance: We encourage children’s soccer coaches and health care professionals to implement neuromuscular training warm-up in youth sports. Registration: ISRCTN14046021 (ISRCTN registry).
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Affiliation(s)
- Matias Hilska
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
- Matias Hilska, BM, UKK Institute, Kaupinpuistonkatu 1, 33500 Tampere, Finland ()
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Kathrin Steffen
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niilo Konttinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Research Institute for Olympic Sports, Jyväskylä, Finland
| | - Anu M. Räisänen
- Department of Physical Therapy Education, College of Health Sciences, Western University of Health Sciences, Lebanon, Oregon, USA
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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25
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Malina RM, Martinho DV, Valente-dos-Santos J, Coelho-e-Silva MJ, Kozieł SM. Growth and Maturity Status of Female Soccer Players: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1448. [PMID: 33557121 PMCID: PMC7913875 DOI: 10.3390/ijerph18041448] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 12/20/2022]
Abstract
Reported mean ages, heights and weights of female soccer players aged <19 years in 161 studies spanning the years 1992-2020 were extracted from the literature or calculated from data available to the authors; 35 studies spanning the years 1981-2020 also included an indicator of biological maturation. Heights and weights were plotted relative to U.S. reference data. Preece-Baines Model 1 was fitted to moving averages to estimate ages at peak velocity. Maturity indicators included skeletal age, pubertal status, age at menarche, percentage of predicted adult height and predicted maturity offset. Heights and weights showed negligible secular variation across the time interval. Heights were slightly above or approximated the reference medians through 14 years old and then varied between the medians and 75th percentiles through 18 years old. Weights were above the reference medians from 9 to 18 years old. Mean ages at menarche ranged from 12.7 to 13.0 years. The trend in heights and weights suggested the persistence and/or selection of taller and heavier players during adolescence, while estimated age at peak height velocity (PHV) and ages at menarche were within the range of mean ages in European and North American samples. Data for skeletal and sexual maturity status were limited; predicted maturity offset increased linearly with mean ages and heights at prediction.
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Affiliation(s)
- Robert M. Malina
- Department of Kinesiology and Health Education, University of Texas, Austin, TX 78712, USA
- School of Public Health and Information Sciences, University of Louisville, Louisville, KY 40292, USA
| | - Diogo V. Martinho
- University of Coimbra, FCDEF, CIDAF (uid/dtp/042143/2020), 3040-248 Coimbra, Portugal; (D.V.M.); (M.J.C.-e.-S.)
| | - João Valente-dos-Santos
- Faculty of Physical Education and Sport, Lusófona University, 1749-024 Lisbon, Portugal;
- Faculty of Sports Science and Physical Education, University of Coimbra, CIDAF (uid/dtp/042143/2020), 3040-248 Coimbra, Portugal
| | - Manuel J. Coelho-e-Silva
- University of Coimbra, FCDEF, CIDAF (uid/dtp/042143/2020), 3040-248 Coimbra, Portugal; (D.V.M.); (M.J.C.-e.-S.)
| | - Sławomir M. Kozieł
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland;
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26
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Hausken-Sutter SE, Pringle R, Schubring A, Grau S, Barker-Ruchti N. Youth sport injury research: a narrative review and the potential of interdisciplinarity. BMJ Open Sport Exerc Med 2021; 7:e000933. [PMID: 33489308 PMCID: PMC7805357 DOI: 10.1136/bmjsem-2020-000933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 11/17/2022] Open
Abstract
To prevent sports injuries, researchers have aimed to understand injury aetiology from both the natural and social sciences and through applying different methodologies. This research has produced strong disciplinary knowledge and a number of injury prevention programmes. Yet, the injury rate continues to be high, especially in youth sport and youth football. A key reason for the continued high injury rate is the development of injury prevention programmes based on monodisciplinary knowledge that does not account for the complex nature of sport injury aetiology. The purpose of this paper is to consider and outline an interdisciplinary research process to research the complex nature of sport injury aetiology. To support our proposition, we first present a narrative review of existing youth football and youth sport injury research demonstrating an absence of paradigmatic integration across the research areas’ main disciplines of biomedicine, psychology and sociology. We then demonstrate how interdisciplinary research can address the complexity of youth sport injury aetiology. Finally, we introduce the interdisciplinary process we have recently followed in a youth football injury research project. While further research is necessary, particularly regarding the integration of qualitative and quantitative sport injury data, we propose that the pragmatic interdisciplinary research process can be useful for researchers who aim to work across disciplines and paradigms and aim to employ methodological pluralism in their research.
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Affiliation(s)
| | - Richard Pringle
- Faculty of Education, Monash University, Melbourne, Victoria, Australia
| | - Astrid Schubring
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Grau
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Natalie Barker-Ruchti
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.,School of Health Sciences, Örebro University, Örebro, Sweden
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27
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Fomin S, Gauffin H, Kvist J. Short-term recovery of physical activity and knee function after an acute knee injury. BMJ Open Sport Exerc Med 2020; 6:e000950. [PMID: 33437496 PMCID: PMC7780533 DOI: 10.1136/bmjsem-2020-000950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives To describe self-reported knee function, participation in physical activity and the number of knee surgeries at 3 and 6 months following acute knee injury. Methods Prospective cohort study. Participants, aged 15–40 years with an acute knee injury sustained no more than 6 weeks prior to inclusion, were recruited. There were 279 participants with ACL injury and 101 participants with other acute knee injuries included. Follow-up questionnaires were sent at 3 and 6 months after injury. Demographic information, activity participation, International Knee Documentation Committee subjective knee form (IKDC-SKF) and the Single Assessment Numeric Evaluation (SANE) score were collected. Additional knee injuries were obtained from self-report and medical charts. Results The IKDC-SKF, SANE and physical activity participation were reduced at 3-month and 6-month follow-up. The number of participants who achieved health-promoting physical activity levels was reduced by 50% at 6-month follow-up compared with before injury. Seventeen per cent of participants with ACL injury and 41% of participants with other acute knee injuries had returned to their preinjury physical activity at 6 months. Participants with ACL injury reported worse knee function, lower physical activity participation and had more surgeries (128 surgeries, including 109 ACL-reconstructions) compared with participants with other acute knee injuries (six surgeries). Conclusion Acute knee injuries, including ACL injuries, affected self-reported knee function and physical activity participation for at least 6 months after index injury. More research is needed to understand how best to help people with acute knee injuries return to physical activity and achieve satisfactory knee function.
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Affiliation(s)
- Sanne Fomin
- Unit of Physioptherapy, Department of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden
| | - Håkan Gauffin
- Orthopaedics. Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Joanna Kvist
- Unit of Physioptherapy, Department of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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28
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Bram JT, Pascual-Leone N, Patel NM, DeFrancesco CJ, Talathi NS, Ganley TJ. Do Pediatric Patients With Anterior Cruciate Ligament Tears Have a Higher Rate of Familial Anterior Cruciate Ligament Injury? Orthop J Sports Med 2020; 8:2325967120959665. [PMID: 33195715 PMCID: PMC7607774 DOI: 10.1177/2325967120959665] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/07/2020] [Indexed: 01/12/2023] Open
Abstract
Background: Several studies have examined the anterior cruciate ligament (ACL) injury history among relatives of patients undergoing ACL reconstruction (ACLR), but they have primarily analyzed adults with variable results. Hypothesis: We hypothesized that he rate of familial ACL injuries among pediatric patients with ACL tears would be greater than that among pediatric patients with uninjured knees. Study Design: Cohort study; Level of evidence, 3. Methods: Pediatric patients (≤18 years of age) who underwent ACLR between January 2009 and May 2016 were contacted to complete a questionnaire on subsequent complications and family history of ACL tears. A control cohort was recruited from children with uninjured knees seen in the concussion clinic of our institution. Binary logistic regression was used to determine the factors predictive of having a familial ACL tear history or complications. Results: Overall, 450 pediatric patients with primary ACL tears were included. Age at the time of surgery was 14.9 ± 2.2 years with a follow-up of 4.3 ± 2.1 years. When compared with 267 control patients, those with an ACL tear reported a higher rate of first-degree relatives with an ACL injury history (25.1% vs 12.0%; P < .001). In multivariate analysis, children with ACL injury had nearly 3 times (odds ratio [OR], 2.7) higher odds of having a first-degree relative with an ACL tear (95% CI, 1.7-4.2; P < .001). Patients were stratified by the number of first-degree relatives with ACL tears: no relatives, 1 relative, or ≥2 relatives. Children with ≥2 first-degree relatives were more likely to sustain a postoperative graft failure (OR, 5.1; 95% CI 1.7-15.2; P = .003) or a complication requiring surgical intervention (OR, 7.5; 95% CI, 2.6-22.0; P < .001). Conclusion: A family history of ACL injury is more likely in pediatric patients with ACL tears than in uninjured children. Further, patients undergoing primary ACLR as well as a strong family history of ACL tears are more likely to sustain a postoperative graft rupture or complication requiring surgery.
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Affiliation(s)
- Joshua T Bram
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Neeraj M Patel
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | | | - Nakul S Talathi
- University of California, Los Angeles, Los Angeles, California, USA
| | - Theodore J Ganley
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Investigation performed at the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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29
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Owoeye OBA, VanderWey MJ, Pike I. Reducing Injuries in Soccer (Football): an Umbrella Review of Best Evidence Across the Epidemiological Framework for Prevention. SPORTS MEDICINE - OPEN 2020; 6:46. [PMID: 32955626 PMCID: PMC7505904 DOI: 10.1186/s40798-020-00274-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/19/2020] [Indexed: 01/31/2023]
Abstract
Soccer is the most popular sport in the world. Expectedly, the incidence of soccer-related injuries is high and these injuries exert a significant burden on individuals and families, including health and financial burdens, and on the socioeconomic and healthcare systems. Using established injury prevention frameworks, we present a concise synthesis of the most recent scientific evidence regarding injury rates, characteristics, mechanisms, risk and protective factors, interventions for prevention, and implementation of interventions in soccer. In this umbrella review, we elucidate the most recent available evidence gleaned primarily from systematic reviews and meta-analyses. Further, we express the exigent need to move current soccer injury prevention research evidence into action for improved player outcomes and widespread impact through increased attention to dissemination and implementation research. Additionally, we highlight the importance of an enabling context and effective implementation strategies for the successful integration of evidence-based injury prevention programs into real-world soccer settings. This narrative umbrella review provides guidance to inform future research, practice, and policy towards reducing injuries among soccer players.
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Affiliation(s)
- Oluwatoyosi B A Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Allied Health Professions Building, 3437 Caroline Street, St. Louis, MO, 63104, USA.
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
| | - Mitchell J VanderWey
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Allied Health Professions Building, 3437 Caroline Street, St. Louis, MO, 63104, USA
| | - Ian Pike
- Department of Paediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC, Canada
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30
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Farley JB, Barrett LM, Keogh JWL, Woods CT, Milne N. The relationship between physical fitness attributes and sports injury in female, team ball sport players: a systematic review. SPORTS MEDICINE - OPEN 2020; 6:45. [PMID: 32926228 PMCID: PMC7490320 DOI: 10.1186/s40798-020-00264-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/20/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Understanding the relationships between physical fitness characteristics and sports injury may assist with the development of injury minimisation programs. The purpose of this systematic review was to investigate the association between physical fitness attributes and sports injury in female, team ball sport players. METHODS Four scientific databases (MEDLINE, EMBASE, SPORTDiscus, Scopus) and reference lists of relevant research were searched for eligible studies up to September 2, 2019. Full-text articles examining the relationship between physical fitness and sports injury in female, team ball sport players were included. A modified Downs and Black checklist was used to assess methodological quality. Data synthesis determined summary conclusions based on the number of significant relationships divided by the total relationships investigated and reported as a percentage. Level of certainty was identified for summary conclusions based on level of evidence. Sub-analyses regarding competition level, age, and single injury types were also conducted. RESULTS A total of 44 studies were included. Data synthesis revealed no associations (low to moderate certainty) between body composition (1/9; 11%), flexibility (18-20%), and balance (2/8; 25%) and 'any injury' classification. No associations (mostly of moderate certainty) were found between flexibility (0-27%), muscular strength (0-27%), and body composition (14-33%) and various body region injury classifications, whereas mixed summary conclusions were shown for balance (0-48%). Many associations between physical fitness and sports injury were deemed 'unknown' or with an insufficient level of certainty. Sub-analyses revealed no association between strength and noncontact ACL injuries (0/5; 0%) or ankle sprains (0/12; 0%), and between flexibility and ankle sprains (1/5; 20%); however, insufficient certainty of these results exists. Clear associations were concluded between balance and lower body injuries in female, non-elite (10/16; 63%) and junior (9/12; 75%) team ball sport players, with moderate and insufficient certainty of these results, respectively. CONCLUSION Limited evidence is available to demonstrate relationships between physical fitness and sports injury in female, team ball sport players. High-quality evidence investigating the multifactorial nature of sports injury, including the interactions physical fitness qualities have with other injury determinants, is needed to better understand the role of physical fitness in minimising sports injuries in female, team ball sport players. TRIAL REGISTRATION CRD42017077374 (PROSPERO on September 14, 2017).
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Affiliation(s)
- Jessica B. Farley
- grid.1033.10000 0004 0405 3820Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD Australia
| | - Lily M. Barrett
- grid.10049.3c0000 0004 1936 9692Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Justin W. L. Keogh
- grid.1033.10000 0004 0405 3820Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD Australia
- grid.252547.30000 0001 0705 7067Sports Performance Research Centre New Zealand, AUT University, Auckland, New Zealand
- grid.1034.60000 0001 1555 3415Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Australia
- grid.411639.80000 0001 0571 5193Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Carl T. Woods
- grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, VIC Australia
| | - Nikki Milne
- grid.1033.10000 0004 0405 3820Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, QLD Australia
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31
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Nae J, Creaby MW, Ageberg E. Extended Version of a Test Battery for Visual Assessment of Postural Orientation Errors: Face Validity, Internal Consistency, and Reliability. Phys Ther 2020; 100:1542-1556. [PMID: 32402078 PMCID: PMC7462053 DOI: 10.1093/ptj/pzaa092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Undesirable postural orientation may be a risk factor for a second anterior cruciate ligament (ACL) injury. The purpose of this study was to evaluate face validity, internal consistency, and interrater reliability of an extended version of a previous test battery for visual assessment of postural orientation errors (POEs) in patients during the late phase of rehabilitation following ACL reconstruction (ACLR) (ie, when they have initiated jumping exercises). METHODS This study used a cross-sectional design. Fifty-three patients (45% women) in the late phase of ACLR rehabilitation performed 5 functional tasks of varying difficulty. POEs of the lower extremity and trunk were visually assessed from video and scored on a scale from 0 (good) to 2 (poor). RESULTS The side-hop and 2 new POEs (femur medial to shank, femoral valgus) were added to the test battery after expert focus group discussions. Internal consistency was calculated for all tasks (α = .712-.823). Interrater reliability showed fair to substantial agreement for femur medial to shank and femoral valgus during all tasks (K = 0.31-0.815) and almost perfect agreement for side-hop (intraclass correlation coefficient = 0.88). CONCLUSIONS The good internal consistency and reliability after adding side-hop, femur medial to shank, and femoral valgus suggests that this test battery is a suitable tool to quantify postural orientation throughout ACLR rehabilitation. IMPACT This test battery for visual assessment of POEs was evaluated in a heterogeneous group of patients in different phases of ACLR battery and can be used in clinical practice to measure POEs in patients with ACLR, including in the late phase of rehabilitation to return to sport. This study encourages research on more demanding tasks and additional POEs to cover the entire rehabilitation period after ACL injury or reconstruction.
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Affiliation(s)
- Jenny Nae
- Address all correspondence to Mrs Nae at:
| | - Mark W Creaby
- School of Exercise Science, Australian Catholic University, Brisbane, Australia
| | - Eva Ageberg
- Department of Health Sciences, Lund University
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Sokka T, Hilska M, Vasankari T, Leppänen M, Kannus P, Parkkari J, Haapasalo H, Forsman H, Raitanen J, Pasanen K. Females Sustain more Ankle Injuries than Males in Youth Football. Int J Sports Med 2020; 41:1017-1023. [PMID: 32688416 DOI: 10.1055/a-1192-5399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This prospective study evaluated the incidence and pattern of acute injuries in youth (9- to 14-year- old) football players. Ten football clubs [n=730 players (567 males, 163 females)] participated in the 20-week follow-up study (January-June 2015). Data was collected by sending a standardized weekly SMS to players' parents/guardians with follow-up interviews for injured players. During the study period, 278 players (38%) sustained 410 acute injuries. The overall injury incidence for males and females was 6.47 (95% CI, 5.84-7.09) injuries per 1000 h of football exposure. Most injuries (40%) caused minimal absence from sports. Eighty-four percent of the injuries affected the lower extremities, with the ankle (30%), knee (17%), and thigh (16%) being the most commonly injured body sites. Females had significantly higher ankle injury rate (IRR) 1.85 (95% CI, 1.18-2.91, p=0.007) and non-contact ankle injury rate IRR 2.78 (95% CI, 1.91-4.02, p<0.001) than males. In conclusion, our results showed that the acute injury incidence among youth football is moderately high, and females are at higher risk for ankle injuries. Injury prevention programs aimed at preventing ankle injuries should be considered in the future.
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Affiliation(s)
- Taru Sokka
- UKK Institute, Tampere Research Centre of Sports Medicine, UKK Instituutti, Tampere, Finland
| | - Matias Hilska
- UKK Institute, Tampere Research Centre of Sports Medicine, UKK Instituutti, Tampere, Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, UKK Instituutti, Tampere, Finland
| | - Mari Leppänen
- UKK Institute, Tampere Research Centre of Sports Medicine, UKK Instituutti, Tampere, Finland
| | - Pekka Kannus
- The UKK Institute for Health Promotion Research, UKK Instituutti, Tampere, Finland
| | - Jari Parkkari
- UKK Institute, Tampere Research Centre of Sports Medicine, UKK Instituutti, Tampere, Finland
| | - Heidi Haapasalo
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
| | - Hannele Forsman
- Eerikkilä Sports Institute Training Center, Eerikkilä, Tammela, Finland
| | - Jani Raitanen
- The UKK Institute for Health Promotion Research, UKK Instituutti, Tampere, Finland.,Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
| | - Kati Pasanen
- Sport Injury Prevention Research Centre Faculty of Kinesiology Alberta Children's Hospital Research Institute, McCaig Institute for Bone and Joint Health, Calgary, Canada
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Andrade MS, Junqueira MS, Andre Barbosa De Lira C, Vancini RL, Seffrin A, Nikolaidis PT, Rosemann T, Knechtle B. Age-related differences in torque in angle-specific and peak torque hamstring to quadriceps ratios in female soccer players from 11 to 18 years old: Α Cross-sectional study. Res Sports Med 2020; 29:77-89. [PMID: 32200660 DOI: 10.1080/15438627.2020.1742713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of this study was to evaluate and compare the hamstring (H) and quadriceps (Q) strength, bilateral difference and balance ratios in female soccer players. Ninety-three athletes from three age groups: under 13 (U13), 15 (U15) and 18 (U18) participated in the study performing isokinetic tests to measure peak torque, total work, average power and torque at 30º of thigh muscles. Conventional strength balance ratios, angle-specific balance ratio and bilateral strength difference were evaluated. There was bilateral strength difference for extensor muscles total work (p = 0.02) in U13 and flexor muscles peak torque (p = 0.02) in U15. All variables were superior in U15 than U13 (p <.05). There was no strength difference between U15 and U18. Balance ratios did not differ between sides or age groups. The study showed that although peak torque values were higher in U15 than in U13, balance ratios were similar.
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Affiliation(s)
- Marilia S Andrade
- Laboratório de Fisiologia do Exercício, Escola Paulista de Medicina, Departamento de Fisiologia, Universidade Federal de São Paulo , São Paulo, Brazil
| | - Marina S Junqueira
- Laboratório de Fisiologia do Exercício, Escola Paulista de Medicina, Departamento de Fisiologia, Universidade Federal de São Paulo , São Paulo, Brazil
| | - Claudio Andre Barbosa De Lira
- Laboratório de Avaliação do Movimen to Humano, Faculdade de Educação Física E Dança, Setor de Fisiologia Humana e do Exercício, Universidade Federal de Goiás , Goiânia, Brazil
| | - Rodrigo L Vancini
- Centro de Educação Física e Desportos, Departamento de Desportos, Universidade Federal do Espírito Santo , Vitória, Brazil
| | - Aldo Seffrin
- Laboratório de Fisiologia do Exercício, Escola Paulista de Medicina, Departamento de Fisiologia, Universidade Federal de São Paulo , São Paulo, Brazil
| | | | - Thomas Rosemann
- Institute of Primary Care, University Hospital Zurich , Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University Hospital Zurich , Switzerland.,Medbase St. Gallen Am Vadianplatz , St. Gallen, Switzerland
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Tanaka MJ, Jones LC, Forman JM. Awareness of Anterior Cruciate Ligament Injury-Preventive Training Programs Among Female Collegiate Athletes. J Athl Train 2020; 55:359-364. [PMID: 32160059 DOI: 10.4085/1062-6050-150-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Neuromuscular training programs can reduce the rate of noncontact anterior cruciate ligament (ACL) injuries, particularly in female athletes. OBJECTIVE To assess the awareness of, experience with, and factors associated with participation in preventive training programs (PTPs) among female collegiate athletes and their knowledge of ACL injuries. DESIGN Cross-sectional study. SETTING National Collegiate Athletic Association (NCAA) sports programs. PATIENTS OR OTHER PARTICIPANTS A total of 440 female NCAA athletes (age = 20 ± 1 years) representing 20 sports during the 2017-2018 academic year. MAIN OUTCOME MEASURE(S) We used a 12-item survey to collect data on each participant's age, sport, position, college, NCAA division, and awareness of and experience with PTPs. We performed descriptive statistics and used odds ratios (ORs) to assess relationships between demographic data and awareness of or interest in PTPs. RESULTS Of the 440 respondents, 85% (n = 373) knew that female athletes were at higher risk for sustaining ACL injuries than male athletes, and 89% (n = 391) knew that ACL injuries were preventable. Thirty-three percent (n = 143) were familiar with the concept of ACL PTPs. Only 15% (n = 64) had ever performed PTPs, but 89% (n = 391) reported they would perform a daily PTP if it could prevent ACL injuries. Fifty-two of the 64 respondents (81%) who had performed PTPs said athletic trainers or coaches oversaw the PTPs. Participants were more likely to be familiar with ACL PTPs if they (OR = 3.5; 95% confidence interval [CI] = 2.0, 5.8) or a teammate (OR = 4.6; 95% CI = 2.1, 9.8) had sustained an ACL injury. Respondents were more willing to perform PTPs if they (OR = 2.3; 95% CI = 0.80, 6.6) or a teammate (OR = 3.4; 95% CI = 1.8, 6.6) had sustained an ACL injury. CONCLUSIONS Although 89% of respondents expressed interest in performing daily ACL PTPs, only 15% had performed such programs, and only 33% were familiar with the concept of ACL PTPs.
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Affiliation(s)
- Miho J Tanaka
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.,Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lynne C Jones
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jared M Forman
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
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Philp F, Al-Shallawi A, Kyriacou T, Blana D, Pandyan A. Improving predictor selection for injury modelling methods in male footballers. BMJ Open Sport Exerc Med 2020; 6:e000634. [PMID: 32095267 PMCID: PMC7010990 DOI: 10.1136/bmjsem-2019-000634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives This objective of this study was to evaluate whether combining existing methods of elastic net for zero-inflated Poisson and zero-inflated Poisson regression methods could improve real-life applicability of injury prediction models in football. Methods Predictor selection and model development was conducted on a pre-existing dataset of 24 male participants from a single English football team's 2015/2016 season. Results The elastic net for zero-inflated Poisson penalty method was successful in shrinking the total number of predictors in the presence of high levels of multicollinearity. It was additionally identified that easily measurable data, that is, mass and body fat content, training type, duration and surface, fitness levels, normalised period of 'no-play' and time in competition could contribute to the probability of acquiring a time-loss injury. Furthermore, prolonged series of match-play and increased in-season injury reduced the probability of not sustaining an injury. Conclusion For predictor selection, the elastic net for zero-inflated Poisson penalised method in combination with the use of ZIP regression modelling for predicting time-loss injuries have been identified appropriate methods for improving real-life applicability of injury prediction models. These methods are more appropriate for datasets subject to multicollinearity, smaller sample sizes and zero-inflation known to affect the performance of traditional statistical methods. Further validation work is now required.
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Affiliation(s)
- Fraser Philp
- School of Health and Rehabilitation, Keele University, Keele, Staffordhire, UK
| | - Ahmad Al-Shallawi
- Institute of Science and Technology in Medicine, Keele University, Keele, Staffordshire, UK.,The Engineering Technical College of Mosul, Northern Technical University, Mosul, Nineveh, Iraq
| | - Theocharis Kyriacou
- School of Computing and Mathematics, Keele University, Keele, Staffordshire, UK
| | - Dimitra Blana
- Institute of Science and Technology in Medicine, Keele University, Keele, Staffordshire, UK
| | - Anand Pandyan
- School of Health and Rehabilitation, Keele University, Keele, Staffordhire, UK
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Tervo T, Nyström H, Nordström A. Injuries in Swedish floorball players: A nationwide matched cohort study. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1673087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Taru Tervo
- Umeå School of Sport Sciences, Umeå University, Umeå, 901 87, Sweden
- Floorball Research and Development Center, Umeå School of Sports Sciences, Umeå University, Umeå, Sweden
| | - Helena Nyström
- Umeå School of Sport Sciences, Umeå University, Umeå, 901 87, Sweden
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå 901 87, Sweden
| | - Anna Nordström
- Umeå School of Sport Sciences, Umeå University, Umeå, 901 87, Sweden
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå 901 87, Sweden
- School of Sport Science, UiT The Arctic University of Norway, Postboks 6050 Langnes, Tromsø 9037, Norway
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Standing R, Maulder P. The Effectiveness of Progressive and Traditional Coaching Strategies to Improve Sprint and Jump Performance Across Varying Levels of Maturation within a General Youth Population. Sports (Basel) 2019; 7:sports7080186. [PMID: 31366104 PMCID: PMC6723898 DOI: 10.3390/sports7080186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 11/21/2022] Open
Abstract
Literature pertaining to youth development has identified the importance of understanding the physical, intellectual and emotional needs of adolescents prior to, during, and after their peak height velocity (PHV) period. The purpose of this study was to compare the use of a ‘traditional’ and ‘progressive’ coaching style to train a general male youth population to improve sprint and jump performances whilst assessing enjoyment to comment on long-term application. Maximal sprint times, sprint kinematics, unilateral jump distances and repetitive tuck jump scores were measured alongside anthropometric variables to characterise performance. The results revealed significant (p < 0.05) pre/post differences in anthropometric variables across all maturation groups, and each of the maturational levels displayed a tendency to favor a particular coaching or control condition. Pre-PHV groups responded most effectively to the progressive style of coaching, displaying improvements in horizontal jump performances, and −0.7% to −2.7% improvements in all sprint times, despite also showing the largest increase in tuck jump scores (25.8%). The circa-PHV group produced their greatest improvements in the traditional intervention, as displayed through significant improvements (p < 0.05) in 20-m sprint times and dominant-leg horizontal jump performance, whilst also revealing the greatest deterioration in tuck jump scores (14.2%). Post-PHV displayed the greatest improvements in the control setting, suggesting that the natural benefits gained through adolescent development were greater than the influence of the training interventions. In conclusion, the results suggest that matching coaching strategies and delivery techniques to the period of biological maturation may have implications for both performance and athlete safety.
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Affiliation(s)
- Regan Standing
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, 3200 Hamilton, New Zealand.
| | - Peter Maulder
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, 3200 Hamilton, New Zealand
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38
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Standing RJ, Maulder PS, Best R, Berger NJA. The influence of maturation on functional performance and injury markers in male youth. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1632017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Regan J. Standing
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, Hamilton, New Zealand
| | - Peter S. Maulder
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, Hamilton, New Zealand
| | - Russ Best
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, Hamilton, New Zealand
- School of Health and Social Care, Teesside University, Middlesbrough, UK
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Eustace SJ, Page RM, Greig M. Isokinetic strength differences between elite senior and youth female soccer players identifies training requirements. Phys Ther Sport 2019; 39:45-51. [PMID: 31254916 DOI: 10.1016/j.ptsp.2019.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To compare traditional and angle-specific isokinetic strength of eccentric knee flexors and concentric knee extensors in female senior professional and youth soccer players. DESIGN Cross-sectional study design. SETTING University's Laboratory. PARTICIPANTS A total of 34 players (17 seniors [age 25.31 ± 4.51 years; height 167.89 ± 7.04 cm; mass 63.12 ± 7.79 kg] and 17 youths [16.91 ± 1.16 years; height 165.92 ± 4.42 cm; mass 60.07 ± 4.48 kg]) from the Women's Super League 1 completed strength assessments at 180, 270 and 60°∙s-1. MAIN OUTCOME MEASURES Peak torque (PT), dynamic control ratio (DCR), angle of peak torque (APT), functional range (FR), angle-specific torque (AST) and angle-specific DCR (DCRAST) were compared between age groups. RESULTS The PT (P = 0.016) AST (P = 0.041) were significantly higher in seniors compared to youths; however APT (P = 0.141), DCR (P = 0.524) FR (P = 0.821) and DCRAST (P = 0.053) were not significant between playing age. CONCLUSION The use of absolute and angle-specific strength measures were able to distinguish between female playing ages, whereas DCR and DCRAST was unable to identify differences. The PT and AST metrics may be the most useful metrics to help identify and inform training needs, particularly in youths.
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Affiliation(s)
- Steven James Eustace
- School of Life Sciences Science & Health Building, Coventry University, 20 Whitefriars Street, Coventry, CV1 2DS, United Kingdom; Sports Injuries Research Group, Department of Sport and Physical Activity, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, United Kingdom.
| | - Richard Michael Page
- Sports Injuries Research Group, Department of Sport and Physical Activity, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, United Kingdom.
| | - Matt Greig
- Sports Injuries Research Group, Department of Sport and Physical Activity, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, United Kingdom.
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Bisciotti GN, Chamari K, Cena E, Bisciotti A, Bisciotti A, Corsini A, Volpi P. Anterior cruciate ligament injury risk factors in football. J Sports Med Phys Fitness 2019; 59:1724-1738. [PMID: 31062538 DOI: 10.23736/s0022-4707.19.09563-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Anterior cruciate ligament (ACL) lesion represents one of the most dramatic injuries in a football (soccer) player's career. There are many injury risk factors related to intrinsic (non-modifiable) and/or extrinsic (modifiable) factors of ACL injury. EVIDENCE ACQUISITION Research of the studies was conducted until September 2018 without publication data limitation or language restriction on the following databases: PubMed/MEDLINE, Scopus, ISI, EXCERPTA. EVIDENCE SYNTHESIS To date, evidence from the literature suggests that the risk of ACL injury is multifactorial and involves biomechanical, anatomical, hormonal, and neuromuscular factors. Despite this relative complexity, the mechanisms of injury are well known and rationally classified into two categories: mechanisms of injury based on contact or on non-contact with another player, with the non-contact injury mechanisms clearly prevailing over the mechanisms of contact injury. One of the most frequent biomechanical risk factors, associated with ACL non-contact injury, is represented by the valgus knee in the pivoting and cutting movements and in the landing phase after jumping. Gender-related risk factors show female populations to have a higher predisposition to ACL injury than males However, there are still some theoretical and practical aspects that need further investigation such as; genetic risks together with the role of estrogen and progesterone receptors in female populations, and the in-vivo interaction shoe-playing surface. In particular, the genetic risk factors of ACL lesion seem to be an interesting and promising field of investigation, where considerable progress has still to be made. CONCLUSIONS This narrative review provides an insight into the risk factors of ACL injury that could be used by practitioners for preventing injury in football (soccer).
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Affiliation(s)
- Gian Nicola Bisciotti
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar -
| | - Karim Chamari
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | - Emanuele Cena
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | | | | | | | - Piero Volpi
- FC Internazionale Milano, Milan, Italy.,Unit of Traumatology, Department of Knee Orthopedic and Sports, Humanitas Research Hospital, Rozzano, Milan, Italy
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De Ste Croix M, Hughes J, Ayala F, Taylor L, Datson N. Efficacy of Injury Prevention Training Is Greater for High-Risk vs Low-Risk Elite Female Youth Soccer Players. Am J Sports Med 2018; 46:3271-3280. [PMID: 30227000 DOI: 10.1177/0363546518795677] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The efficacy of robustness training for high- versus low-risk individuals within high-risk groups is currently unknown. PURPOSE To explore the efficacy of robustness training on injury risk factors among female youth soccer players and to examine if high-risk athletes are greater responders to such training. STUDY DESIGN Controlled laboratory study. METHODS A total of 125 elite youth female soccer players on the English FA talent pathway were randomly selected into a training group (n = 71) or a control group (n = 54). Relative leg stiffness, 2-dimensional knee valgus and knee flexion range of motion from a single-legged countermovement jump, and probability of high knee abduction moment (pKAM) risk were all determined before and after a 16-week robustness training program. For further analysis, participants in the training group were split into groups based on risk: high risk (pKAM >0.80, n = 33) and low risk (pKAM <0.55, n = 33). Magnitude-based inferences were used to explore differences between the control and intervention groups and the high- and low-risk groups. RESULTS Magnitude-based inferences demonstrated significant beneficial effects in the training group for knee valgus, pKAM, and leg stiffness as compared with the control group. The control group demonstrated possible worthwhile differences in knee flexion range of motion as compared with the intervention group. The high-risk group demonstrated likely/very likely worthwhile differences versus the low-risk group for all parameters. CONCLUSION/CLINICAL RELEVANCE Robustness training induces significant beneficial improvements in injury risk factors among female youth soccer players. The beneficial effects of this multidimensional program are greater for those classified as high risk.
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Affiliation(s)
- Mark De Ste Croix
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - Jonathan Hughes
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - Francisco Ayala
- Sports Research Centre, Miguel Hernandez University of Elche, Alacant, Spain
| | - Luke Taylor
- English Football Association, St Georges Park, Burton, UK.,Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Naomi Datson
- English Football Association, St Georges Park, Burton, UK.,Institute of Sport, University of Chichester, Chichester, UK
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Hausken S, Barker-Ruchti N, Schubring A, Grau S. Injury-Free Children and Adolescents: Towards Better Practice in Swedish Football (FIT project). RESEARCH IDEAS AND OUTCOMES 2018. [DOI: 10.3897/rio.4.e30729] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This interdisciplinary research project will produce evidence-based recommendations on how injuries in Swedish youth football (soccer) can be prevented. Fewer injuries will positively impact athlete health, performance and career longevity and have the potential to promote life-long physical activity and wellbeing.
Injury pattern research demonstrates that injuries are a significant problem in (Swedish) youth sport. Football has a higher traumatic and overuse injury rate than many contact/collision sports (e.g., field hockey, basketball). In research on youth football, the incidence of overuse training injuries was measured as high as 15.4 injuries per 1000 training hours, and the incidence of traumatic and overuse match injuries was 47.5 injuries per 1000 match hours. The injury frequency is alarming and applies to the 54% of children aged 7-14 and the 39% of youths aged 15-19 years who participate in Swedish organised sports. A large body of research identifies injury risk factors and preventative strategies; however, as the recent IOC consensus statement on youth athletic development points out, the existing, mostly bio-medical knowledge does not provide effective evidence-based injury prevention strategies. To address this deficit, interdisciplinary and context-driven knowledge on injury development in youth sport is needed.
The proposed project will produce scientific evidence through four consecutive studies: a) Questionnaire to register the types, frequency and management of injuries; b) Laboratory testing of biomechanical, clinical and training-specific parameters to establish individual physical and sport-specific dispositions; c) Observation of sporting contexts to understand sporting cultures, coaching methods and coach-athlete relationships; and d) Interviews with coaches and players to recognize knowledge that shapes coaching and training. The sample of youth players will be recruited from Sweden’s most popular and injury-prone sport: football. Each of the four studies will conduct its own data production and analyses, and a collective analysis will produce integrated evidence. Concrete recommendations for best sporting practice will be developed, which will serve sporting federations, sport education institutions, coaches, sport support staff and players.
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Sugimoto D, Howell DR, Tocci NX, Meehan WP. Risk factors associated with self-reported injury history in female youth soccer players. PHYSICIAN SPORTSMED 2018; 46:312-318. [PMID: 29633890 DOI: 10.1080/00913847.2018.1462651] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND studies that investigate risk factors for musculoskeletal injuries in female youth athletes are limited, especially related to training attributes and position status. OBJECTIVE to determine risk factors including training attributes and position status for a self-reported musculoskeletal injury history in female youth soccer players. METHODS we conducted a cross-sectional study of young female soccer players (mean age: 13.6 ± 2.3 years). we asked about their history of musculoskeletal injuries using an electronic questionnaire. the proportion of young female soccer players with and without a history of soccer-related musculoskeletal injuries were compared based on physical characteristics, training attributes, position status (single vs. multiple), lower extremity strength, and joint laxity. a binary logistic regression analysis was used to generate, and adjusted odds ratios adjusted for potential co-variates (aor). a 95% confidence interval (95%ci) that did not cross one or p < 0.05 were considered statistically significant. RESULTS a total of 160 young female soccer players (mean age: 13.6 ± 2.3 years) participated in the study. an independent association was found between prior musculoskeletal injuries and older ages (aor: 1.60, 95%ci: 1.17, 2.20, p = 0.004), higher weight (aor: 1.10, 95%ci: 1.01, 1.20, p = 0.026), and greater bmi (aor: 1.43, 95%ci: 1.07, 1.90, p = 0.014). CONCLUSIONS musculoskeletal injuries were associated with age, weight, and bmi in female youth players. the current study indicates that maintaining proper body composition may be beneficial to reduce musculoskeletal injuries among female youth soccer players.
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Affiliation(s)
- Dai Sugimoto
- a The Micheli Center for Sports Injury Prevention , Waltham , MA , USA.,b Division of Sports Medicine, Department of Orthopedics , Boston Children's Hospital , Boston , MA , USA.,c Harvard Medical School , Boston , MA , USA
| | - David R Howell
- a The Micheli Center for Sports Injury Prevention , Waltham , MA , USA.,d Sports Medicine Center , Children's Hospital Colorado , Aurora , CO , USA.,e School of Medicine, Department of Orthopedics , University of Colorado Denver , Aurora , CO , USA
| | - Noah X Tocci
- f Center of Healthcare Delivery Science , Beth Israel Deaconess Medical Center , Boston , MA , USA
| | - William P Meehan
- a The Micheli Center for Sports Injury Prevention , Waltham , MA , USA.,b Division of Sports Medicine, Department of Orthopedics , Boston Children's Hospital , Boston , MA , USA.,c Harvard Medical School , Boston , MA , USA
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Klein C, Henke T, Platen P. Injuries in football (soccer)—a systematic review of epidemiology and aetiological aspects. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2018. [DOI: 10.1007/s12662-018-0530-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Prevention of Ankle Sprain Injuries in Youth Soccer and Basketball: Effectiveness of a Neuromuscular Training Program and Examining Risk Factors. Clin J Sport Med 2018; 28:325-331. [PMID: 29864071 DOI: 10.1097/jsm.0000000000000462] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The primary objective of this study was to examine the effectiveness of a neuromuscular training (NMT) warm-up program in reducing the risk of ankle sprain injury (ASI) in youth soccer and basketball. The secondary objective included the evaluation of risk factors for ASI. STUDY DESIGN Secondary analysis of pooled data from 5 studies. PARTICIPANTS Male and female youth (11-18 years) soccer and basketball players (n = 2265) in Alberta, Canada. OUTCOME MEASURES Ankle sprain injury was the primary outcome and was recorded using a validated prospective injury surveillance system consistent in all studies. The primary exposure of interest was NMT warm-up, which included aerobic, strength, agility, and balance components. Multivariable Poisson regression, controlling for clustering by team and offset for exposure hours, was used to estimate incidence rate ratios (IRRs) with 95% confidence intervals (CIs), with considerations for confounding and effect modification and evaluating all covariates as potential risk factors. RESULTS A total of 188 ASIs were reported in 171 players. Neuromuscular training significantly reduced the risk of ASI [IRR = 0.68 (95% CI; 0.46-0.99)]. Independent risk factors for ASI included previous ASI [IRR = 1.98 (95% CI; 1.38-2.81)] and participation in basketball versus soccer [IRR = 1.83 (95% CI; 1.18-2.85)]. Sex, age, body mass index, and previous lower extremity injury (without previous ASI) did not predict ASI (P > 0.05). CONCLUSIONS Exposure to an NMT program is significantly protective for ASI in youth soccer and basketball. Risk of ASI in youth basketball is greater than soccer, and players with a history of ASI are at greater risk.
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Increased injury rates after the restructure of Germany's national second league of team handball. Knee Surg Sports Traumatol Arthrosc 2018; 26:1884-1891. [PMID: 29404652 DOI: 10.1007/s00167-018-4851-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/26/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Scientific injury data in men's professional team handball injuries are rare and even less scientific information exists on injury prevention. In 2011, Germany's national second team handball league was restructured by merging the existing two regional leagues into one league. This study evaluates the injury patterns in professional team handball and compares the injury rates between the first and second league before and after the restructure. METHODS All players of Germany's national first and second men's team handball leagues have mandatory trauma insurance with the same insurance company. This retrospective cohort study analysed the injury data of three consecutive seasons 2010-2013 using standardized injury definitions. RESULTS 1194 professional team handball players were included in this study. The majority of severe injuries affected the lower extremities, shoulders, and hands. The average injury incidence significantly differed between the first (4.9 injuries per 1000 h) and the second league (3.9 per 1000 h, p < 0.01). The injury incidence in the restructured second league had increased from 3.7 to 4.1 per 1000 h (p < 0.01) and prevalence from 67.1 to 79.3% (p < 0.001), thus almost to the same levels of the first league. The second league showed more time-loss injuries at all severity levels. CONCLUSION This study yielded a high injury incidence after the restructure of the national second team handball league and presents details on prevalence, incidence, and patterns of injury in professional men's team handball. This study is an important basis for developing injury prevention strategies that should focus on the shoulders, hands, and lower extremities and on reducing the number of matches and travel burden. LEVEL OF EVIDENCE III.
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Neuromuscular exercises prevent severe knee injury in adolescent team handball players. Knee Surg Sports Traumatol Arthrosc 2018; 26:1901-1908. [PMID: 29058022 DOI: 10.1007/s00167-017-4758-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Team handball is associated with a high risk of severe knee injury that needs to be reduced, particularly at the youth level. The purpose of this study was to show how an injury-prevention programme effectively reduces severe knee injury in adolescent team handball players. METHODS Of 23 adolescent handball teams of both sexes, 13 were randomly allocated into the intervention group (168 players) and 10 into the control group (111 players). Players of the intervention group regularly participated in an injury-prevention programme for one season. Handball exposure and sustained injuries were documented for both groups on a monthly basis. The primary outcome parameter of the injury-prevention programme was the incidence of severe knee injury. RESULTS Of the 279 included players, 68 (24%) sustained 82 injuries yielding an overall incidence of 1.85 injuries per 1000 h handball exposure (intervention group: 50 injuries/incidence: 1.90/1000 h; control group: 32 injuries/incidence: 1.78/1000 h). Knee injury was the second most frequent injury in adolescent team handball. The primary outcome parameter, severe knee injury occurred significantly more often in the control group [mean age (SD) 15.1 (1.0), injury incidence 0.33/1000 h] than in the intervention group [mean age (SD) 14.9 (0.9), injury incidence 0.04/1000 h]. The odds ratio was 0.11 (95% CI 0.01-0.90), p = 0.019. Other injuries to the lower extremities showed no significant difference between the two groups. CONCLUSIONS Frequent neuromuscular exercises prevent severe knee injury in adolescent team handball players and should thus be included in the practical routine as well as in the education of team coaches.
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Anterior cruciate ligament ruptures in German elite soccer players: Epidemiology, mechanisms, and return to play. Knee 2018; 25:219-225. [PMID: 29478904 DOI: 10.1016/j.knee.2018.01.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/19/2018] [Accepted: 01/28/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Anterior cruciate ligament ruptures (ACLRs) are severe sports-related injuries with significant consequences for affected players and teams. This study aims to identify the epidemiology and injury-related lay-off after ACLR in professional male soccer players from the first-division German Bundesliga. METHODS Exposure times and incidence of anterior cruciate ligament ruptures were collected during 7.5 consecutive seasons using two media-based registers. RESULTS A total of 72 total ACLRs were registered in 66 different players with an incidence of 0.040 per 1000h of exposure (95% CI 0.009-0.12). On average there were 9.6 ACLRs per season and 0.53 per team and season. The mean age of players affected was 24 (standard deviation±3.6) years. The number of ACLRs recorded per season fluctuated during the period observed. Goalkeepers are significantly (P<0.05) less prone to suffer an ACLR compared to outfield players. CONCLUSIONS Understanding ACLR loading mechanisms, knowing risk factors for the injury and mean off time after ACLR are essential information for the coach, the medical staff, the elite soccer players, the insurance and team managers. Our results are in accordance with reports based on information from medical team staff. Therefore, our analysis of ACLR based on media sources may serve as an alternative for injury reports in elite soccer. The information of this study may be helpful for the medical staff taking care of professional soccer players and for orthopedic surgeons performing ACL reconstructions in this patient population.
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das Graças D, Nakamura L, Barbosa FSS, Martinez PF, Reis FA, Oliveira-Junior SAD. Could current factors be associated with retrospective sports injuries in Brazilian jiu-jitsu? A cross-sectional study. BMC Sports Sci Med Rehabil 2017; 9:16. [PMID: 29075501 PMCID: PMC5651575 DOI: 10.1186/s13102-017-0080-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 10/15/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Brazilian jiu-jitsu is characterized by musculoskeletal disorders and high occurrence of sports injuries. The present study was aimed to analyze some internal factors, as well as to describe occurrence and characteristics of retrospective musculoskeletal injuries in different age groups of Brazilian jiu-jitsu practitioners. METHODS One hundred ninety-three Brazilian jiu-jitsu practitioners, which were divided into three age groups: Adolescent, Adult, and Master. Besides anthropometric characterization, standard clinical tests were conducted to analyze the global and segmental joint flexibility, lumbar spine range of motion, and handgrip strength. Sports injury occurrence and total physical activity were obtained from an adapted morbidity survey and International Physical Activity Questionnaire - Short Form (IPAQ-SF), respectively. RESULTS A total of 247 cases of retrospective injuries was registered (1.27 injury/ participant). Occurrence of rectus femoral muscle retraction in the right leg was increased within Master. Adult and Master have exhibited higher occurrence of sports injuries than Adolescent group (p < 0.05). Joint injuries were the most common sports-related injuries by all Brazilian jiu-jitsu practitioners. While female gender and exposure time constituted the most predictive variables for sports injury occurrence in Adolescent, graduation level was more associated with sports injuries occurrence in Adult. CONCLUSIONS Joint injuries derived from combat demands were the main sports injury in all age categories of Brazilian jiu-jitsu. Master subjects presented a higher occurrence of clinical changes and retrospective musculoskeletal injuries in relation to other age groups. Female gender and exposure time constituted the main predictive factors in adolescent subjects, while graduation category was more directly associated with retrospective injury onset in the Adult group.
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Affiliation(s)
- Dayana das Graças
- Postgraduate Program in Health and Development, Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil.,Laboratoty of Striated Muscle Study (LEME/ CEI), Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil
| | - Letícia Nakamura
- School of Physical Therapy, Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil.,Laboratoty of Striated Muscle Study (LEME/ CEI), Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil
| | - Fernando Sérgio Silva Barbosa
- Postgraduate Program in Health and Development, Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil.,Laboratoty of Striated Muscle Study (LEME/ CEI), Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil
| | - Paula Felippe Martinez
- Postgraduate Program in Health and Development, Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil.,School of Physical Therapy, Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil.,Laboratoty of Striated Muscle Study (LEME/ CEI), Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil
| | - Filipe Abdalla Reis
- School of Physical Therapy, Anhanguera University - UNIDERP, Campo Grande, MS Brazil
| | - Silvio Assis de Oliveira-Junior
- Postgraduate Program in Health and Development, Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil.,School of Physical Therapy, Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil.,Laboratoty of Striated Muscle Study (LEME/ CEI), Federal University of Mato Grosso do Sul, Campo Grande, MS Brazil
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Abstract
As female athlete sports participation has continued to increase, the rate of anterior cruciate ligament (ACL) rupture in female athletes has also increased. Individualized, patient-specific treatment is crucial to achieving optimal outcomes; ACL reconstruction must accurately restore native ACL anatomy and address any concomitant injury to secondary stabilizers. Rehabilitation programs should target hip, core, and trunk neuromuscular control; allow adequate time for graft ligamentization; and address the psychosocial needs of the athlete.
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