The NBA and Youth Basketball: Recommendations for Promoting a Healthy and Positive Experience

Head Contact and Suspected Concussion Rates in Youth Basketball: Time to Target Head Contact Penalties for Prevention

OBJECTIVE

To compare game events, head contact (HC) rates, and suspected concussion incidence rates (IRs) in boys' and girls' youth basketball.

DESIGN

Cross-sectional.

SETTING

Canadian club basketball teams (U16-U18).

PARTICIPANTS

Players from 24 boys' and 24 girls' Canadian club basketball teams during the 2022 season.

ASSESSMENT OF RISK FACTORS

Recorded games were analyzed using Dartfish video analysis software to compare sexes.

MAIN OUTCOME MEASURES

Poisson regression analyses were used to estimate HCs [direct (HC1) and indirect (HC2)], suspected concussion IRs, and IR ratios (IRRs). Game event, court location, and HC1 fouls were reported.

RESULTS

Division 1 HC rates did not differ between boys (n = 238; IR = 0.50/10 player-minutes; 95% confidence interval [CI], 0.43-0.56) and girls (n = 220; IR = 0.46/10 player-minutes; 95% CI, 0.40-0.52). Division 2 boys experienced 252 HCs (IR = 0.53/10 player-minutes; 95% CI, 0.46-0.59); girls experienced 192 HCs (IR = 0.40/10 player-minutes; 95% CI, 0.35-0.46). Division 2 boys sustained higher HC1 IRs compared with Division 2 girls (IRR = 1.42; 95% CI, 1.15-1.74). Head contacts, rates did not differ between boys and girls in either Division. Suspected concussion IRs were not significantly different for boys and girls in each Division. Head contacts occurred mostly in the key for boys and girls in each Division. Despite illegality, HC1 penalization ranged from 3.9% to 19.7%. Head contact mechanisms varied across Divisions and sexes.

CONCLUSIONS

Despite current safety measures, both HCs and suspected concussions occur in boys' and girls' basketball. Despite the illegality and potential danger associated with HC, only a small proportion of direct HCs were penalized and therefore targeting greater enforcement of these contacts may be a promising prevention target.

Epidemiology of Injuries Among National Basketball Association Players: 2013-2014 Through 2018-2019

BACKGROUND

Understanding the epidemiology of injuries to athletes is essential to informing injury prevention efforts.

HYPOTHESIS

The incidence and impact of basketball-related injuries among National Basketball Association (NBA) players from 2013-2014 through 2018-2019 is relatively stable over time.

STUDY DESIGN

Descriptive epidemiology study.

LEVEL OF EVIDENCE

Level 3.

METHODS

Injuries from 2013-2014 through 2018-2019 were analyzed using the NBA Injury and Illness Database from an electronic medical record system. Descriptive statistics were calculated for injuries by season, game-loss, and onset. Incidence rates were estimated using Poisson models and linear trend tests.

RESULTS

Between 552 and 606 players participated in ≥1 game per season during the study. Annual injury incidence ranged from 1550 to 1892, with 33.6% to 38.5% resulting in a missed NBA game. Game-loss injury rates ranged from 5.6 to 7.0 injuries per 10,000 player-minutes from 2014-2015 through 2018-2019 (P = 0.19); the rate was lower in 2013-2014 (5.0 injuries per 10,000 player-minutes), partly due to increased preseason injury rates and transition of reporting processes. The 6-year game-loss injury rate in preseason and regular season games was 6.9 (95% CI 6.0, 8.0) and 6.2 (95% CI 6.0, 6.5) injuries per 10,000 player-minutes; the rate in playoff games was lower (P < 0.01) at 2.8 (95% CI 2.2, 3.6). Most (73%) game-loss injuries had acute onset; 44.4% to 52.5% of these involved contact with another player.

CONCLUSION

From 2013-2014 through 2018-2019, over one-third of injuries resulted in missed NBA games, with highest rates of game-loss injuries in preseason games and lowest rates in playoff games. Most game-loss injuries had acute onset, and half of those involved contact with another player.

CLINICAL RELEVANCE

These findings - through reliable data reporting by team medical staff in an audited system - can guide evidence-based injury reduction strategies and inform player health priorities.

Global prevalence and pattern of injuries in basketball players: a systematic review

INTRODUCTION

Basketball, as a widely popular sport, can be associated with a high risk of injury. This study aimed to provide a comprehensive overview of basketball-related injuries in various groups through the utilization of a systematic review methodology.

EVIDENCE ACQUISITION

An extensive search was conducted in the four valid databases using three groups of keywords up to November 2023 based on the PRISMA guidance. Two reviewers independently performed the steps of the study, including study selection, data extraction, and quality assessment. In case of any disagreements, the opinion of a third researcher was sought to achieve agreement in each step. The agreement between the reviewers was examined by computing Cohen's kappa coefficient. The quality assessment of the articles in this study was conducted using the Joanna Briggs Institute (JBI) critical appraisal tools.

EVIDENCE SYNTHESIS

The prevalence range of injuries in these people was between 0.38% and 92.0%. Ankle injuries in 12 out of 28 studies (42.86%), knee injuries in 7 out of 28 studies (25.00%), head and tooth injuries in 3 out of 28 studies (10.71%), and shoulder and hand injuries in three out of 28 studies (10.71%) had the highest prevalence among various injuries. Five out of six studies (83.33%) showed a higher percentage of the injuries in males. Only a study compared the prevalence of injuries between people with various ages.

CONCLUSIONS

These findings emphasize the need for injury prevention and management strategies, particularly targeting vulnerable areas like the ankle and knee.

The efficacy of Air Alert plyometric training program on enhancing biomotor skills in adolescent basketball players

BACKGROUND

Basketball is an important sport that utilizes a variety of biomotor skills. Diverse training programs are employed to enhance the biomotor attributes and elevate the performance levels of basketball players. Plyometric training (PT) is frequently used to improve athlete performance. However, different models of PT can yield varying effects on athletic performance.

METHODS

This study aimed to determine the impact of a PT program named "Air Alert" on athletes' biomotor skills. Twenty-four basketball players aged 15 to 16 years voluntarily participated in the study. The participants were randomly assigned to 2 groups: the Air Alert plyometric training group (AIR) (n = 12) and the plyometric training group (n = 12). The AIR was trained 3 days a week, while the plyometric training group was trained 2 days a week for 15 weeks. Pre- and posttest measurements of height (cm), body weight (kg), vertical jump, line agility, 20 m sprint, Illinois agility, repeated sprint, and flamingo balance tests were performed for all participants.

RESULTS

There were no significant differences in height (cm) (F = 1.035, P = .320, ηp2 = .045), weight (F = 1.735, P = .201, ηp2 = .073), and BMI measurements (F = 1.376, P = .253, ηp2 = .059) within and between groups. However, significant differences were observed between the groups in vertical jump (F = 14.343, P = .001, ηp2 = .395), line agility (F = 75.366, P = .000, ηp2 = .774), 20 m sprint (F = 93.001, P = .000, ηp2 = .809), balance (F = 59.513, P = .000, ηp2 = .730), Illinois agility test (F = 143.243, P = .000, ηp2 = .867), and repeated sprint test (F = 140.986, P = .000, ηp2 = .865).

CONCLUSION

The results of this study indicate that the AIR program is more effective in enhancing the biomotor skills of basketball players than other plyometric training programs. Based on these results, it is recommended that coaches who aim to develop training strategies to enhance athletic performance should consider incorporating an Air Alert program.

Optimizing athletic engagement and performance of obese students: an adaptive approach through basketball in physical education

Introduction

Obesity in adolescents is associated with reduced physical activity and athletic engagement, highlighting the need for tailored physical education programs. This study evaluated the effects of a 7-week adapted basketball program on the performance and athletic engagement of students with obesity.

Methods

Sixty-two students with obesity (23 boys, 39 girls, aged 15-17) were randomly assigned to an experimental group (EG, n = 30; 11 boys, 19 girls) participating in adapted basketball sessions or a control group (CG, n = 32; 12 boys, 20 girls) attending standard basketball lessons. Both groups completed 52-minute sessions twice weekly. Pre- and post-intervention assessments included a questionnaire evaluating perceptions of physical education and athletic performance during final matches.

Results

The EG showed significant improvements in interest, motivation (p < 0.05), perceived competence (p < 0.001), and reduced exercise difficulty (p < 0.001). Perceived fitness levels increased significantly only in EG girls (p = 0.013). In contrast, no significant changes were observed in the CG before and after the intervention for any of the parameters. During matches, the EG outperformed the CG, with more successful shots (girls: p = 0.0004; boys: p = 0.012), fewer missed shots (girls: p = 0.033; boys: p = 0.046), and more successful passes (p = 0.032, η² = 0.042).

Discussion

These results demonstrate that adapted physical education programs can serve as effective interventions for improving physical activity and promoting inclusion among adolescents with obesity while also serving as a preventive measure against obesity.

Injury Risk Factors Related to Sport Specialization in High School Basketball: A Prospective Study

CONTEXT

Research that has examined the association between specialization and injury in basketball has been limited to cross-sectional or retrospective studies.

OBJECTIVE

To determine whether specialization is a risk factor for injury among high school basketball athletes.

DESIGN

Prospective cohort study.

SETTING

Basketball players from 12 high schools participating in the National Athletic Treatment, Injury, and Outcomes Network Surveillance Program (NATION-SP) were recruited before the 2022-2023 interscholastic basketball season.

PATIENTS OR OTHER PARTICIPANTS

One-hundred thirty athletes (mean age ± SD = 15.6 ± 1.3; girls' basketball: n = 68 [52.3%]).

MAIN OUTCOME MEASURE(S)

Before the start of the school basketball season, participants completed a questionnaire that had questions regarding participation in various specialized sport behaviors. During the basketball season, the school's athletic trainer reported all athlete-exposures and injuries (regardless of time loss) for participating athletes into NATION-SP. Injury incidence and incidence rate ratios (IRRs) with 95% CIs were calculated for the specialized sport behaviors previously described.

RESULTS

No difference in injury risk between highly specialized and low specialized athletes was found (IRR [95% CI] = 1.9 [0.9, 3.7]). Players who participated in basketball year round were twice as likely to sustain an injury than those who did not play year round (IRR [95% CI] = 2.1 [1.1, 3.6]). Similarly, players who reported participating in basketball skills camps were at increased risk of injury compared with athletes who did not participate in basketball skill camps (IRR [95% CI] = 2.5 [1.2, 5.7]).

CONCLUSIONS

Injury risk related to sport specialization in basketball may be specific to certain behaviors such as year-round play and participation in skills camps. Validated measures of comprehensive sport activity are needed to better measure specialization in youth sports to better determine injury risk related to sport specialization and develop injury prevention programs for basketball athletes.

The effectiveness of neuromuscular training warm-up program for injury prevention in adolescent male basketball players

This study evaluated the effects of a neuromuscular training (NMT) warm-up program on injury incidence, neuromuscular function, and program adherence, maintenance and acceptance in adolescent basketball players. A total of 275 players from 20 Slovenian teams (15 ± 1.7 years of age), were randomized into an intervention group (IG, n=129) and a control group (CG, n=146). Over three months, the IG incorporated NMT into their warm-ups, while the CG followed their usual practice. Measurements of body anthropometry, muscle contractile properties, and balance were taken before and after the intervention. Also, the injury incidence, training adherence and maintenance were reported. Both groups showed improved balance, with no significant difference between them. However, IG demonstrated reduced delay times in specific muscles, indicating improved neuromuscular function. Injury prevalence proportion (%) during the whole study period was higher in the control group compared to intervention (IG: 10.9% vs. CG: 23.3%), and incidence rate. Moreover, the incidence rate ratio for sustaining an injury was 2.6 on average (ranging from 0.88 to 7.07 for tendon and muscle injuries, respectively), indicating significantly lower injury risk in IG than CG. These findings highlight the effectiveness of NMT warm-ups in reducing injury risk and enhancing neuromuscular function, emphasizing the value of structured injury prevention strategies in youth sports..

Quantifying the training demands of a highly trained male youth basketball players by year, term and position

This study describes the training demands of highly trained male youth basketball players, based on training year, term and playing position. Data was collected from 41 male youth basketballers over two seasons from all on-court coach-led training sessions utilising an LPS. Linear mixed-models and pairwise comparisons were used to analyse by training year (Y1, Y2 and Y3), term (T1, T2, T3 and T4) and playing position (Backcourt, Frontcourt). Results showed no differences in external load metrics between training years. Significant differences existed between training terms, with total distance greater in both T3 and T4 than T1 and 2 (p < 0.03). Total PlayerLoad was significantly greater in T4 than T1 (p < 0.001) and T3 (p = 0.004). Distance/min was greater in T2, T3 and T4 than T1 (p < 0.01). PlayerLoad/min was higher in T4 than T1 and T2 (p < 0.01). Backcourt players showed significantly greater distance/min (p = 0.011), PlayerLoad/min (p = 0.011) and deceleration counts (p < 0.001). Overall, limited year-on-year change existed in external training load metrics (p > 0.05), though volume (p < 0.001) and intensity (p < 0.001) differed between terms. Backcourt players completed higher intensities (p = 0.011) than Frontcourt players. This study provides a description of external loads of training in highly trained youth basketball players assisting coaches and performance practitioners to better understand physical demands within youth basketball development pathways.

The effects of functional training on physical fitness and skill-related performance among basketball players: a systematic review

Background: Evidence suggests that functional training (FT) positively impacts physical fitness and sports performance. However, a systematic review addressing the effects of FT on basketball players remains absent. This systematic review aims to explore the influence of FT on physical fitness and skill-related performance in basketball players. Methods: We searched six databases: Web of Science, Scopus, PubMed, China National Knowledge Infrastructure (CNKI), EBSCOhost, and Google Scholar. The search utilized a combination of keywords related to FT, physical fitness, and basketball. The Eligibility Criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines were followed in this systematic review. Results: 11 studies were ultimately included in this review, collectively recruiting 333 basketball players. These studies demonstrated that FT significantly improved muscle strength, linear speed, cardiovascular endurance, flexibility, balance, and muscular endurance. However, the effects of FT on power, change-of-direction speed, and basketball-related performance were inconsistent. Most studies showed FT significantly improves these three variables, but a small number of studies did not find positive effects of FT using specific tests including standing long jump, Sargent jump, touch high, lane agility, lateral shuffle, dribbling line drill, and free-throw tests. Conclusion: FT is an effective training method for enhancing physical fitness including muscle strength, linear speed, cardiovascular endurance, flexibility, balance, and muscular endurance. However, the effects of FT on power, change-of-direction speed, and basketball-related performance were divergent. Some tests were not improved after FT potentially due to the short program lengths and training session durations, varied athletic levels of players examined, and different foci of the FT exercises administered. The collective evidence suggests FT programs, especially the specific exercises prescribed, should be tailored to the desired training objectives. More studies investigating the effects of FT on physical fitness and basketball-related performance with established tests are encouraged in the future to expand the current evidence base. Systematic Review Registration: https://inplasy.com/, Identifier INPLASY202360072.

Understanding the first injury in athletics and its effect on dropout from sport: an online survey on 544 high-level youth and junior athletics (track and field) athletes

Objective

To describe the first injury and to investigate whether it plays a role in altering athletics' sustainable practice.

Methods

We conducted a cross-sectional study using an exploratory survey on the first injury and its consequences on athletics practice. In 2021, we asked all high-level athletes licensed with the French Federation of Athletics (FFA) under 18 years, under 20 years and under 23 years categories between 2007 and 2021.

Results

Out of 6560 emails sent by FFA, 544 athletes responded, and 93.6% (n=510) reported experiencing at least one injury during their career. The first injury occurred at a mean age of 17.5±3.3 years after 6.1±4.1 years of athletics practice. The main locations of the first injury were the posterior thigh (28.9%), the ankle (16.5%) and the knee (12.6%), and the principal reported injury types were muscle (37.7%), tendon (17.5%) and ligament (15.5%). More than a third of injured athletes (36.7%) reported experiencing ongoing symptoms or sequelae after their first injury, and about half (48.5%) experienced recurrences. About 20% had stopped athletics at the time of the survey, with injury problems the primary cause of athletes dropping out (46.2%), including the first injury (9.4%).

Conclusions

Injuries played an important role in altering sustainable athletics practice, with injury accounting for about 50% of all reported dropouts and the first injury accounting for about 10% of all reported causes. Our results provide evidence to target the prevention of the first injury, which could be considered the origin of the 'vicious circle' of injuries.

Maturity Offset, Anthropometric Characteristics and Vertical Force-Velocity Profile in Youth Basketball Players

This work aimed to analyze the relationships between maturity offset, anthropometric variables and the vertical force-velocity profile in youth (12-18 years old) male basketball players. The vertical force-velocity profile was measured in 49 basketball players, grouped in competitive-age categories, i.e., under 14, 16 and 18 years of age (U-14, U-16 and U-18, respectively). A bivariate correlational analysis was carried out between maturity offset, anthropometric variables (height, body mass, % fat, muscle mass, bone mass and body mass index (BMI)) and vertical force-velocity profile (theoretical maximal force [F0], theoretical maximal velocity [V0], theoretical maximal power [Pmax], force-velocity imbalance [Fvimb] and force-velocity profile orientation). The results showed significant correlations (p < 0.05) between Fvimb and maturity offset at early ages of training (12-15 years). The anthropometric profile was correlated (p < 0.05) with F0 in U-14, V0 in U-16, and Pmax in U-18 basketball players. The current findings suggest a relationship between the vertical force-velocity imbalance and maturity offset and the main vertical force-velocity profile variables. The vertical force-velocity profile is hypothesized as a useful index to correct vertical force-velocity deficits according to the maturity offset of male basketball players.

Beyond athletic development: The effects of parkour-based versus conventional neuromuscular exercises in pre-adolescent basketball players

The purpose of this study was to compare the effects of a parkour-based warm-up to a conventional neuromuscular training (NMT) warm-up on the athletic capabilities of youth basketball players. This was examined through two arms: In Investigation 1, the aims were to measure the effects of the two warm-ups on physical measures of athletic performance in prepubescent basketball players. Using post-intervention semi-structured interviews, Investigation 2 aimed to gain insights from the players in relation to the perceived benefits of the two warm-ups. Pre-adolescent children were recruited from two youth level basketball teams. Participants from one club were randomly assigned to either a conventional NMT warm-up group or a parkour warm-up group, while a control group was formed of participants from the second club. Participants of both experimental groups were required to complete a 15-minute warm-up once per week before their regular basketball practice across 8-weeks. For both groups, the coach adopted the same pedagogical approach, utilising a guided discovery strategy. Pre-post test measures of overhead squat performance, countermovement jump, and 10-metre sprint speed were recorded in all three groups. Additionally, pre-post measures were recorded for a timed parkour-based obstacle course for the two experimental groups. No significant between-group differences were found between pre- and post-test measures. However, analysis using Cohen's d effect sizes revealed improvements in both intervention groups versus the control. Moreover, between group effect size differences were observed between the two experimental groups. Following the intervention, participants from both experimental groups were also invited to take part in a post-intervention semi-structured interview to discuss their experiences. The thematic analysis of these semi-structured interviews revealed three higher order themes: Enjoyment; Physical literacy; and Docility; of which the two former themes appear to align to constructs relating to the wider concept of physical literacy. In summary, warm-ups designed to improve athleticism can include less structured and more diverse movement skills than are typical of conventional NMT warm-ups. Specifically, we provide evidence that advocates for warm ups that include parkour-related activities alongside conventional NMT exercises to preserve physical fitness qualities and to simultaneously evoke a sense of enjoyment, fun, and purpose. The benefit of such activities may extend beyond athletic development and, more broadly, contribute to the development of physical literacy.

A comparative study of Chinese women 3 × 3 basketball players exercise load in Tokyo Olympic preparation cycle

Objective: The aim of this study was to compare the variances in-game loads exhibited by Chinese women's 3 × 3 basketball team across different stages of the preparation cycle for the Tokyo Olympic Games, and to summarize the fundamental regulations governing Chinese women's 3 × 3 basketball training and games, in order to establish a theoretical research foundation for the team's new preparation cycle. Methods: This study measured load-related data during the preparation and main competition periods of the 2019-2021 Tokyo Olympics, from April to August 2019 and from April to June 2021. The aim was to compare the changes and differences in a load of competition during different stages and to explore patterns of load changes during the preparation period. This study used wearable devices authorized by FIFA and NBA, along with the Catapult GPS performance monitoring system from Australia (Catapult&Polar Team) as instruments for collecting sports load data. The OptimEye S5 device was worn around the athlete's neck to collect data prior to the game, while the Open Field™ system was utilized for data editing and report generation post-game. Results: Compared to the primary competition load during the 2019 preparation period, the 2021 preparation period exhibited significant increases and decreases (p < 0.05) in competition load, high-intensity load, the number of explosive moves, the number of high-intensity acceleration, several changes to the left and right, and the number of explosive jumps. During the 2021 preparation period, the mean heart rate, mean heart rate percentage, and mean speed of the race demonstrated significant decreases in comparison to the race during the 2019 preparation period (p < 0.05). Throughout the training period spanning from 2019 to 2021, no significant differences were observed in running distance and maximum speed (p > 0.05). Conclusion: The findings of this study reveal that the national training team has fostered positive adaptive changes in athletes, resulting in a significant enhancement in both load and sports performance science data during competition from 2019 to 2021.

Pediatric Health Care Provider Awareness, Perceptions, and Utility of Sport Specialization Recommendations

CONTEXT

Sport specialization, or focused participation in a single sport, is associated with an increased rate of overuse injury and burnout. Medical associations and sport organizations have published recommendations for sport specialization aimed at reducing its negative consequences. Health care providers (HCPs) are often identified as individuals who can educate athletes and parents about these important recommendations.

OBJECTIVE

To compare knowledge, perceptions, awareness, confidence in knowledge, and use of sport specialization recommendations among HCPs who work with pediatric athletes.

DESIGN

Cross-sectional study.

SETTING

An online web-based survey was developed to assess HCPs' knowledge, perceptions, awareness, confidence in knowledge, and clinical use of sport specialization recommendations.

PATIENTS OR OTHER PARTICIPANTS

Participants were recruited from the research survey services of 4 professional organizations.

MAIN OUTCOME MEASURE(S)

Dependent variables were responses for awareness, perceptions, confidence in knowledge, use, and barriers sections of the survey. Data were analyzed with descriptive statistics; comparisons among HCPs were made through χ2 and Kruskal-Wallis tests.

RESULTS

The survey was completed by 770 HCPs (completion rate = 95.1%). Respondents lacked awareness specific to recommendations surrounding the maximum number of sport participation months per year (39.5%), maximum hours per week (40.7%), and maximum number of teams on which youth athletes should participate concurrently (43.9%). Physicians were the most aware of medical organization recommendations generally (48%-68.8%) and confident in their knowledge (41.5%-75.1%). All HCPs were less aware and confident in their knowledge of sport organization recommendations, with no differences among HCPs. Physicians did not perceive many barriers to the use of the recommendations, whereas athletic trainers felt that patient (39.9%) and parent (45.3%) behaviors were the greatest barriers to usage.

CONCLUSIONS

Awareness, perceptions, and use of sport specialization recommendations varied by discipline, but most respondents believed they were associated with a decreased risk of injury. Future researchers should focus on improved education and implementation of recommendations across all roles.

Landing Technique and Ankle-dorsiflexion Range of Motion are not Associated with the History of Lower Limb Injuries among Youth Basketball Athletes

Background

Lower limb injuries generate a significant health burden in basketball. Landing technique and ankle-dorsiflexion range of motion have been suggested as risk factors for lower limb injuries among youth athletes, but studies conducted specifically with basketball athletes are lacking.

Hypothesis/Purpose

To describe the period prevalence of basketball-related injuries and to examine the association of the history of lower limb injuries with landing technique and ankle-dorsiflexion range of motion asymmetry among youth basketball athletes.

Study Design

Cross-Sectional Survey.

Methods

Youth basketball athletes were asked to complete a paper-based survey to investigate personal characteristics, training characteristics and their three-month history of basketball-related injuries. The Landing Error Scoring System and the Weight-Bearing Lunge Test were used to evaluate landing technique and ankle-dorsiflexion range of motion. Binary logistic regression was utilized to examine the association of the investigated variables with the presence of history of lower limb injuries among the athletes.

Results

A total of 534 athletes participated. The three-month prevalence of basketball-related injuries was 23.2% (95% CI 19.7 - 27), and the majority of the reported injuries affected the lower limbs (69.7%; n=110). Sprains were the most frequent type of injury (29.1%; n=46), and the ankle (30.4%; n=48) and knee (21.5%; n=34) were the most affected anatomic locations. Landing technique (p = 0.105) and ankle-dorsiflexion range of motion asymmetry (p = 0.529) were not associated with the history of lower limb injuries.

Conclusion

The three-month prevalence of basketball-related injuries was 23.2%. Although ankle sprains were the most frequent injury, landing technique and ankle-dorsiflexion range of motion asymmetry were not associated with the history of lower limb injuries among youth basketball athletes.

Level of Evidence

3.

Defining Training and Performance Caliber: A Participant Classification Framework

Throughout the sport-science and sports-medicine literature, the term "elite" subjects might be one of the most overused and ill-defined terms. Currently, there is no common perspective or terminology to characterize the caliber and training status of an individual or cohort. This paper presents a 6-tiered Participant Classification Framework whereby all individuals across a spectrum of exercise backgrounds and athletic abilities can be classified. The Participant Classification Framework uses training volume and performance metrics to classify a participant to one of the following: Tier 0: Sedentary; Tier 1: Recreationally Active; Tier 2: Trained/Developmental; Tier 3: Highly Trained/National Level; Tier 4: Elite/International Level; or Tier 5: World Class. We suggest the Participant Classification Framework can be used to classify participants both prospectively (as part of study participant recruitment) and retrospectively (during systematic reviews and/or meta-analyses). Discussion around how the Participant Classification Framework can be tailored toward different sports, athletes, and/or events has occurred, and sport-specific examples provided. Additional nuances such as depth of sport participation, nationality differences, and gender parity within a sport are all discussed. Finally, chronological age with reference to the junior and masters athlete, as well as the Paralympic athlete, and their inclusion within the Participant Classification Framework has also been considered. It is our intention that this framework be widely implemented to systematically classify participants in research featuring exercise, sport, performance, health, and/or fitness outcomes going forward, providing the much-needed uniformity to classification practices.

An Activity Scale for All Youth Athletes? Clinical Considerations for the HSS Pedi-FABS

Background

The Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS) has demonstrated normally distributed scores in children aged 10 to 18 years. It has been used to evaluate knee injuries; however, there is limited information regarding its use in evaluating other injury types.

Purpose

To (1) assess the validity and utility of HSS Pedi-FABS in youth athletes with injuries to different parts of the body and (2) evaluate the association between the HSS Pedi-FABS and the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health 7 (PGH), as well as PROMIS-Pain Interference (PGH-PI) and PROMIS-Fatigue (PGH-F) components.

Study Design

Cohort study (diagnosis); Level of evidence, 3.

Methods

The authors performed a retrospective review of youth athletes aged 10 to 18 years who completed the HSS Pedi-FABS as part of their previsit intake questionnaire between April 2016 and July 2020. HSS Pedi-FABS score distributions were compared and evaluated for ceiling effects in cohorts determined by demographic, injury characteristic, and sports participation variables; a ceiling effect was determined to be present if >15% of respondents received the highest possible score. HSS Pedi-FABS scores were analyzed for a correlation with PGH, PGH-PI, and PGH-F components.

Results

Included were 2274 patients (mean age, 14.6 ± 2.1 years; 53.0% female) participating in 21 distinct primary sports for 9.6 ± 7.9 hours per week. The mean HSS Pedi-FABS scores by injury group were as follows: elbow (22.7 ± 6.7), shoulder (21.0 ± 8.7), ankle (20.2 ± 8.8), knee (19.5 ± 9.1), and hip (15.4 ± 10.4) (P < .001). Broad distribution was seen in each cohort, with no floor or ceiling effects. The HSS Pedi-FABS score correlated with patient-reported hours per week (r = 0.33), days per week (r = 0.33), and years of participation (r = 0.21) (P < .001 for all). All 3 PROMIS components correlated with HSS Pedi-FABS: PGH (r = 0.28), PGH-PI (r = -0.11), and PGH-F (r = -0.15) (P < .001).

Conclusion

Study findings indicated that the HSS Pedi-FABS is a valid tool for measuring physical activity level in most injured youth athletes, not just those with knee injuries. The correlation of HSS Pedi-FABS with the PGH suggests a positive relationship of childhood physical activity with general health.

Is Cumulative Load Associated with Injuries in Youth Team Sport? A Systematic Review

Background

High cumulative external and internal load may predispose athletes to increased risk for injury across a variety of sports, competition levels, and age groups. However, evidence of an association between cumulative load and injury in youth sport remains inconclusive. The objective of this study was to determine the current evidence for cumulative load and injury risk relationships in youth team sport through a systematic review of the existing literature.

Methods

A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Literature searches were conducted in PubMed, Web of Science, SCOPUS, and CINAHL for relevant articles published between January 2010 and April 2021. The authors conducted independent review and quality assessment of the eligible studies. Eleven articles evaluating youth (less than 18 years old) team sport were included for qualitative synthesis.

Results

Fifty-nine percent (n = 39/66) of the relationships assessed revealed an association between cumulative load and injury across the team sports studied, including the presence of load–injury associations in 84% (n = 16/19) of assessments in youth soccer. Of those relationships where an association was present, 79% (n = 31/39) were positive associations between cumulative load and injury. Risk of bias assessment scores ranged from three to six out of seven possible (median = 5) for cohort studies and from four to seven out of 10 possible (median = 5.5) for cross-sectional studies.

Conclusions

There is some evidence for a positive association between load and injury in youth team sport. Youth soccer was the most studied team sport, and a substantial number of positive load–injury associations were reported. Current evidence lacks consistency in the measures and metrics used in defining load–injury relationships.

Trial Registration PRISMA ID - CRD42020203622.

The effects of plyometric jump training on physical fitness attributes in basketball players: A meta-analysis

BACKGROUND

There is a growing body of experimental evidence examining the effects of plyometric jump training (PJT) on physical fitness attributes in basketball players; however, this evidence has not yet been comprehensively and systematically aggregated. Therefore, our objective was to meta-analyze the effects of PJT on physical fitness attributes in basketball players, in comparison to a control condition.

METHODS

A systematic literature search was conducted in the databases PubMed, Web of Science, and Scopus, up to July 2020. Peer-reviewed controlled trials with baseline and follow-up measurements investigating the effects of PJT on physical fitness attributes (muscle power, i.e., jumping performance, linear sprint speed, change-of-direction speed, balance, and muscle strength) in basketball players, with no restrictions on their playing level, sex, or age. Hedge's g effect sizes (ES) were calculated for physical fitness variables. Using a random-effects model, potential sources of heterogeneity were selected, including subgroup analyses (age, sex, body mass, and height) and single training factor analysis (program duration, training frequency, and total number of training sessions). Computation of meta-regression was also performed.

RESULTS

Thirty-two studies were included, involving 818 total basketball players. Significant (p < 0.05) small-to-large effects of PJT were evident on vertical jump power (ES = 0.45), countermovement jump height with (ES = 1.24) and without arm swing (ES = 0.88), squat jump height (ES = 0.80), drop jump height (ES = 0.53), horizontal jump distance (ES = 0.65), linear sprint time across distances ≤10 m (ES = 1.67) and >10 m (ES = 0.92), change-of-direction performance time across distances ≤40 m (ES = 1.15) and >40 m (ES = 1.02), dynamic (ES = 1.16) and static balance (ES = 1.48), and maximal strength (ES = 0.57). The meta-regression revealed that training duration, training frequency, and total number of sessions completed did not predict the effects of PJT on physical fitness attributes. Subgroup analysis indicated greater improvements in older compared to younger players in horizontal jump distance (>17.15 years, ES = 2.11; ≤17.15 years, ES = 0.10; p < 0.001), linear sprint time >10 m (>16.3 years, ES = 1.83; ≤16.3 years, ES = 0.36; p = 0.010), and change-of-direction performance time ≤40 m (>16.3 years, ES = 1.65; ≤16.3 years, ES = 0.75; p = 0.005). Greater increases in horizontal jump distance were apparent with >2 compared with ≤2 weekly PJT sessions (ES = 2.12 and ES = 0.39, respectively; p < 0.001).

CONCLUSION

Data from 32 studies (28 of which demonstrate moderate-to-high methodological quality) indicate PJT improves muscle power, linear sprint speed, change-of-direction speed, balance, and muscle strength in basketball players independent of sex, age, or PJT program variables. However, the beneficial effects of PJT as measured by horizontal jump distance, linear sprint time >10 m, and change-of-direction performance time ≤40 m, appear to be more evident among older basketball players.

Multidisciplinary Neuromuscular and Endurance Interventions on Youth Basketball Players: A Systematic Review with Meta-Analysis and Meta-Regression

The main aims of this systematic review with meta-analysis and meta-regression were to describe the effect of multidisciplinary neuromuscular and endurance interventions, including plyometric training, mixed strength and conditioning, HIIT basketball programs and repeated sprint training on youth basketball players considering age, competitive level, gender and the type of the intervention performed to explore a predictive model through a meta-regression analysis. A structured search was conducted following PRISMA guidelines and PICOS model in Medline (PubMed), Web of Science (WOS) and Cochrane databases. Groups of experiments were created according to neuromuscular power (vertical; NPV and horizontal; NPH) and endurance (E). Meta-analysis and sub-groups analysis were performed using a random effect model and pooled standardized mean differences (SMD). A random effects meta-regression was performed regressing SMD for the different sub-groups against percentage change for NPV and NPH. There was a significant positive overall effect of the multidisciplinary interventions on NPV, NPH and E. Sub-groups analysis indicate differences in the effects of the interventions on NPV and NPH considering age, gender, competitive level and the type of the intervention used. Considering the current data available, the meta-regression analysis suggests a good predictability of U-16 and plyometric training on jump performance. Besides, male and elite level youth basketball players had a good predictability on multidirectional speed and agility performance.

Relationships Between Sports Club Participation and Health Determinants in Adolescents and Young Adults

Physical fitness is a powerful marker of health in adolescents and young adults. The purpose of this study was to measure the relationships between age, sex, body mass index, and sports club participation on physical fitness. The population included 49,988 participants (23,721 girls and 26,267 boys) who were divided into five age groups (11–12, 13–14, 15–16, 17–18, and 19–21 years). Body mass index was calculated. Physical fitness was assessed with the Diagnoform^® Tonic battery. Sports club participation was also documented. The practiced sport was collected. The effects of age, sex, body mass index class, and sports club participation were tested. Boys' PF increased with age at a faster rate and was better than that of girls, except for flexibility (p < 0.001). For girls, a decrease was observed in endurance, speed and flexibility at 17-18 years. Sports club participation was greater for boys at every age. Obese participants had the lowest physical fitness and sports club participation. Sports club participation increased physical fitness. Team sports seemed best for improving physical fitness, except flexibility. The study shows that sports club participation may be a key element for building health in adolescents. Preventive healthcare projects that promote sports club are needed to target sports club dropouts (obese adolescents and girls). Bridges should be built between physical education classes and sports clubs in adolescence to improve the health status of young people.

The Most Highly Cited Publications on Basketball Originate From English-Speaking Countries, Are Published After 2000, Are Focused on Medicine-Related Topics, and Are Level III Evidence

Purpose

To identify the 50 most highly cited research publications in the sport of basketball.

Methods

Using the Clarivate Analytics Web of Knowledge database and the search term “basketball”, we identified 2,704 articles. These articles were filtered by the total number of citations and the top 50 most cited articles with a central focus on basketball were selected for this analysis. For each article, we further identified and analyzed author name, publication year, country of origin, journal name, article type, main research topic area, competitive level, gender of study population, and the level of evidence.

Results

Medicine-related topics, particularly those involving knee injuries, are more common than nonmedical topics (coaching, sports psychology etc.) among the highest cited articles. Articles originated from 13 different countries, with 48% originating in the United States. Only four authors had more than one article included in the top 50 most cited articles.

Conclusion

A majority of the top 50 research articles were from English-speaking countries, published after 2000, primarily focused on medicine-related topics, and were Level III evidence. Publications examining knee injuries were the most highly cited and appear to be of high interest to current investigators. The prestige of an author’s name appeared to be less influential to the number of citations.

Clinical Relevance

The top 50 most cited articles list will provide researchers, medical students, residents, and fellows with a foundational list of the most important and influential academic contributions to the basketball literature.

Performance Differences in Male Youth Basketball Players According to Selection Status and Playing Position: An Evaluation of the Basketball Learning and Performance Assessment Instrument

The Basketball Learning and Performance Assessment Instrument (BALPAI) has been initially developed and evaluated to assess the performance of students or youth basketball players on the entry level. As it is currently the only observational instrument that allows an overall assessment of players’ in-game performance, it might represent a valuable tool for talent identification and development purposes. To investigate this potential field of application, this study aimed to evaluate the BALPAI regarding reliability and diagnostic validity when assessing youth basketball players within a competitive setting. The study sample comprised N = 54 male youth players (M_age = 14.36 ± 0.33 years) of five regional selection teams (Point Guards, PG: n = 19; Shooting Guards and Small Forwards, SG/SF: n = 21; and Power Forwards and Centers, PF/C: n = 14) that competed at the annual U15 national selection tournament of the German Basketball Federation (n = 24 selected; n = 30 non-selected). A total of 1997 ball-bound actions from five games were evaluated with BALPAI. The inter-rater reliability was assessed for technical execution, decision making, and final efficacy. The diagnostic validity of the instrument was examined via mean group comparisons of the players’ offensive game involvement and performance regarding both selection-dependent and position-dependent differences. The inter-rater reliability was confirmed for all performance-related components (κ_adj ≥ 0.51) while diagnostic validity was established only for specific the BALPAI variables. The selection-dependent analysis demonstrated higher offensive game involvement of selected players in all categories (p < 0.05, 0.27 ≤ Φ ≤ 0.40) as well as better performance in shooting and receiving (p < 0.05, 0.23 ≤ Φ ≤ 0.24). Within the positional groups, the strongest effects were demonstrated among PG (p < 0.05, 0.46 ≤ Φ ≤ 0.60). The position-dependent analysis revealed that PG are more involved in total ball-bound actions (p < 0.05; 0.34 ≤ Φ ≤ 0.53), passing (p < 0.001; 0.55 ≤ Φ ≤ 0.67), and dribbling (p < 0.05, 0.45 ≤ Φ ≤ 0.69) compared to players in other positions. Further differences between players according to selection status and playing position were not detected. The results of this evaluation indicate that the instrument, in its current form, is not yet applicable in competitive youth basketball. The findings highlight the importance of optimizing BALPAI for reliable and valid performance assessments in this context. Future studies should investigate the application of stricter and position-specific criteria to use the observational tool for talent identification and development purposes.

On-site Ultrasound Screens out Asymptomatic Knee Lesions in Elite Adolescent Male Basketball Players

Basketball is a popular sport worldwide with a high injury risk. In this study, we conducted survey composed of clinical symptom reporting scale, physical examination and meticulous portable musculoskeletal ultrasound to 19 elite male high school basketball players and 15 regular male high school students. Our study showed the incidence of ultrasonographic findings of any lesion, suprapatellar effusion and proximal patellar tendinopathy is significantly higher in player group, and the incidence of asymptomatic ultrasonographic lesion is also higher in player group. Screening for asymptomatic lesions bares clinical relevance and plays a role in prevention of symptom development. With the concise and easy-to-perform ultrasonography protocol we performed and being interpreted by sports team physician, the protocol can offer precise diagnosis of common injury and screening for asymptomatic lesion potentially progressive.

Age of Early Specialization, Competitive Volume, Injury, and Sleep Habits in Youth Sport: A Preliminary Study of US Youth Basketball

BACKGROUND

Concerns for youth sports in the United States often focus on early sport specialization, overemphasis on competition, injuries, and burnout. Little research has addressed relationships among the preceding and other concerns, including time away from organized sport, sleep, and perceptions of physical and psychological well-being.

HYPOTHESIS

There is an association between reported competitive gameplay volume and specialization, injury, and fatigue among elite youth basketball players.

STUDY DESIGN

Cross-sectional study; convenience sample.

LEVEL OF EVIDENCE

Level 4.

METHODS

An anonymous questionnaire was administered to a convenience sample of youth basketball players between 13 and 18 years of age from across the United States. Participants were queried about multiple factors, including the extent of their participation in organized basketball and other sports, time away from organized basketball, injury, sleep, and feelings of exhaustion related to basketball participation.

RESULTS

A total of 772 participants (145 girls, 627 boys) completed a survey. All participants played for a select or elite club basketball team and/or a high school basketball team. Overall, 49% played more than 50 games within the past year. A total of 73% were specialized in basketball, 58% prior to age 14 years, and 35% prior to age 11 years. In all, 70% reported less than 1 month away from organized basketball within the past year, and 28% reported no time away. A total of 54% reported sleeping less than the recommended 8 hours each night during the school year. Within the prior year, 55% reported feeling physically exhausted and 45% reported feeling mentally exhausted from basketball. Regression analysis did not find any significant relationships between early specialization prior to age 14 years and basketball-related injury or feelings of mental or physical exhaustion.

CONCLUSION

In this select group of youth basketball players, the majority specialized in basketball prior to age 14 years and reported a large number of competitive events with little time away from organized basketball.

CLINICAL RELEVANCE

The results from a sample of highly competitive youth basketball players indicate issues that warrant further attention and research regarding the potential impact of specialization, frequent competitions, lack of time away from organized sport, and perceptions of well-being in young athletes.

A Glimpse of the Sports Nutrition Awareness in Spanish Basketball Players

Basketball is a team sport, with many fans and practitioners worldwide from all ages and levels. In all cases, players accumulate high levels of fatigue, and there is also limited time to recover between games or practices. In particular, nutrition plays a key role in optimizing performance and recovery. However, it is typical to observe erroneous nutritional behaviors among basketball players. It has been theorized that these behaviors are influenced by habits acquired based on the individual’s knowledge. Therefore, the main aim of this study was to conduct a descriptive research of the sports nutrition knowledge and practices in a sample of Spanish basketball players, from athletes under 18 years old (n = 69) to nonprofessional (n = 14) and professional adult players (n = 21). The sample was comprised of 49 men and 55 women. This was a transversal, cross-sectional, observational and descriptive study. All participants (n = 104) completed an anonymous online survey in order to analyze their sports nutrition knowledge and practices. In view of the obtained results, we can conclude that the knowledge of sport-specific nutrition in players under 18 years old, as well as non-professional and professional adult basketball players, is insufficient through all the categories and levels. The lack of professional support and time management difficulties were identified as some of the main barriers.

Gamifying App-Based Low-Intensity Psychological Interventions to Prevent Sports Injuries in Young Athletes: A Review and Some Guidelines

Sports injuries have become a real health concern. Particularly noticeable is the increasing number of severe sports injuries among young people. Sports injury (SI) is a multifactorial event where many internal and external, proximal and remote factors play a role in a recursive way, including physical and psychological variables. Accordingly, many voices expressing the need of tackling that and several prevention programs have arisen. Nevertheless, different barriers and limitations prevent a wide extension of well-controlled programs, closely monitored by highly specialized professionals in ordinary sports grass-root organizations. These have helped flourishing different low intensity (LI)-interventions and e-Health apps focusing on both physical warmup, training and fitness, and mental skills aimed at reducing athlete's vulnerability to SIs. This kind of intervention usually uses self-administered techniques and/or non-specialized staff that can effectively monitoring the program. In fact, LI-interventions have shown to be effective coping with different health and psychological issues. However, these interventions face an important challenge: the lack of engagement people usually show. The current paper proposes how gamification can contribute to the engagement to such interventions. Based on the mechanics-dynamics-aesthetics framework to analyze game design, the paper suggests a set of guidelines app- and web-LI interventions aimed at preventing SIs should include to foster motivation and reduce attrition.

Early Sport Specialization

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Early sport specialization has been recognized as a potential factor in the relationship between physical activity and health since the early 1970s.

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There is no universally agreed-upon terminology or definition for early sport specialization, but early sport specialization typically encompasses preteen athletes who play 1 sport competitively throughout the year or play on several teams within 1 season, leading to intensive participation without variation in physical activity.

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There is a limited number of comprehensive long-term outcome studies that have identified a potential link between early sport specialization and musculoskeletal injury or burnout.

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Methodologically sound prospective research looking at chronologic age and years of participation by sports played will help to answer whether there is an impact from early sport specialization on the relationship with successful participation and injury occurrence.

The Effectiveness of Neuromuscular Warmups for Lower Extremity Injury Prevention in Basketball: A Systematic Review

BACKGROUND

Neuromuscular warmups have gained increasing attention as a means of preventing sports-related injuries, but data on effectiveness in basketball are sparse. The objective of this systematic review was to evaluate evidence of the effectiveness of neuromuscular warmup-based strategies for preventing lower extremity injuries among basketball athletes.

METHODS

PubMed and Cochrane Library databases were searched in February 2019. Studies were included if they were English-language randomized controlled, non-randomized comparative, or prospective cohort trials, tested neuromuscular and/or balance-focused warmup interventions among basketball players, and assessed at least one type of lower extremity injury as a primary outcome. Criteria developed by the USPSTF were used to appraise study quality, and GRADE was used to appraise the body of evidence for each outcome. Due to heterogeneity in the included studies, meta-analyses could not be performed.

RESULTS

In total, 825 titles and abstracts were identified. Of the 13 studies which met inclusion criteria for this review, five were balance interventions (3 randomized controlled trials) and eight were multicomponent interventions involving multiple categories of dynamic neuromuscular warmup (5 randomized controlled trials). Authors of four of the studies were contacted to obtain outcome data specific to basketball athletes. Basketball specific results from the studies suggest significant protective effects for the following lower extremity injuries: ankle injuries (significant in 4 out of the 9 studies that assessed this outcome); ACL injuries (2 of 4 studies); knee injuries generally (1 of 5 studies); and overall lower extremity injuries (5 of 7 studies). All but one of the non-significant results were directionally favorable. Evidence was moderate for the effect of multicomponent interventions on lower extremity injuries generally. For all other outcomes, and for balance-based interventions, the quality of evidence was rated as low.

CONCLUSION

Overall, the evidence is supportive of neuromuscular warmups for lower extremity injury prevention among basketball players. However, most studies are underpowered, some used lower-quality research study designs, and outcome and exposure definitions varied. Due to the nature of the study designs, effects could not be attributed to specific intervention components. More research is needed to identify the most effective bundle of warmup activities.

The Burden and Risk Factors of Patellar and Achilles Tendinopathy in Youth Basketball: A Cohort Study

This study aimed at evaluating the burden and risk factors of patellar and Achilles tendinopathy among youth basketball players. Patellar and Achilles tendinopathy were prospectively monitored in 515 eligible male and female youth basketball players (11–18 years) through a competitive season. Overall, the season prevalence of patellar tendinopathy was 19.0% (95% CI: 15.7–22.7%), 23.2% (95% CI: 18.6–28.2%) in males and 12.5% (95% CI: 8.3–17.9%) in females. The season prevalence of Achilles tendinopathy was 4.3% (95% CI: 2.7–6.4%), 4.1% (95% CI: 2.2–7.0%) in males and 4.5% (95% CI: 2.1–8.4%) in females. Median proportion of symptoms duration was 83% of average total weeks of basketball exposure for patellar tendinopathy and 75% for Achilles tendinopathy. Median time to patellar tendinopathy onset was 8 weeks for male players and 6 weeks for female players. Higher odds of patellar tendinopathy risk were seen in males (OR: 2.23, 95% CI: 1.10–4.69) and players with previous anterior knee pain had significantly elevated odds (OR: 8.5, 95% CI: 4.58–16.89). The burden and risk of patellar tendinopathy is high among competitive youth basketball players. Risk factors include sex and previous anterior knee pain. These findings provide directions for practice and future research.

Knowledge, Attitudes, and Beliefs of Parents of Youth Basketball Players Regarding Sport Specialization and College Scholarship Availability

Background:

Previous surveys of youth sport parents have revealed that while parents believe early sport specialization is beneficial for improving sport ability, they also overestimate their child’s chances of receiving a college scholarship.

Purpose:

To (1) describe knowledge, attitudes, and beliefs of parents of youth basketball players regarding sport specialization and college scholarships and (2) examine potential differences in child basketball participation characteristics based on parent income.

Study Design:

Cross-sectional study.

Methods:

A total of 805 parents (mean age, 39.9 ± 7.1 years; 353 female [43.9%]) of youth basketball players (mean age, 12.9 ± 2.5 years; 241 female [29.9%]) were recruited via Qualtrics Online Panels to complete an anonymous online questionnaire. Participants were required to be a parent of a child between 8 and 18 years of age who participated in organized youth basketball (ie, school, club, or recreational/local league). Participants were recruited to be nationally representative with regard to race/ethnicity (White, 62.7%; Hispanic/Latino of any race, 15.3%; African American/Black, 13.3%; Asian, 4.6%; ≥2 races, 2.9%; American Indian/Alaskan Native, 1.1%; Native Hawaiian/other Pacific Islander, 0.1%). The questionnaire was adapted from previous research on parent knowledge, attitudes, and beliefs and consisted of 3 sections: (1) parent and child characteristics; (2) child basketball participation information (months per year of basketball participation, sport specialization status, receiving private coaching, traveling regularly for basketball competitions, participating on multiple teams at the same time); and (3) parent attitudes, beliefs, and knowledge regarding sport specialization and college basketball scholarships.

Results:

Most parents believed specialization increased their child’s chances of making a high school (71.4%) or college team (69.7%). Parents underestimated the availability of college basketball scholarships at the National Collegiate Athletics Association (NCAA) Division I and II levels (8.9 ± 5.1 vs reality of 13-15 per team) but overestimated availability at the Division III level (8.6 ± 5.7 vs reality of 0 per team). High-income parents spent significantly more money ($4748 USD [$1214-$10,246]) than middle-income ($2250 USD [$727-$5079]; P < .001) and low-income ($1043 USD [$368-$2444]; P < .001) parents.

Conclusion:

Parents believed specialization was important for sport success, but they underestimated college scholarship availability at the NCAA Division I and II levels while overestimating scholarship availability at the Division III level.

Sport Specialization Behaviors Are Associated With History of Reported Injury in Youth Basketball

BACKGROUND

There is significant emerging evidence that early sport specialization is a potential risk factor for injury in youth sports. Despite basketball being the most popular youth team sport in the United States, sport specialization research, specifically in youth basketball players, has been limited. The purpose of this paper was to examine the association of sport specialization behaviors with injury history by surveying a nationally representative sample of parents of youth basketball athletes. We hypothesized that athletes who specialized in basketball, participated on multiple teams at the same time, and traveled regularly for basketball competitions would be more likely to report a basketball-related injury in the previous year.

METHODS

A nationally representative sample of 805 parents of 805 youth basketball players (female N=241, 29.9%; age: 12.9±2.5 y old) completed an online questionnaire that had 3 sections: (1) parent/child demographics, (2) child basketball participation information for the previous year, and (3) child basketball injury history in the previous year. Multivariate logistic regression examined the associations between variables of interest and injury history, adjusting for covariates. Odds ratios (ORs) with 95% confidence intervals (95% CI) were calculated for the variables of interest from the logistic regression model.

RESULTS

Highly specialized athletes were more likely than low specialization athletes to report history of basketball injury in the previous year [OR (95% CI): 2.47 (1.25-4.88), P=0.009]. The odds of reporting an injury in the previous year were twice as great among athletes who played on a basketball team at the same time as another sport team compared with those who played basketball only [OR (95% CI): 1.98 (1.30-3.01), P=0.001]. The odds of reporting an injury in the previous year were 3 times greater among athletes who received private coaching compared with those who did not receive private coaching [OR (95% CI): 2.91 (1.97-4.31), P<0.001].

CONCLUSION

Specialization in basketball, along with several other behaviors that have become typical of modern youth sport participation, were associated with reported injury history. Further prospective research is necessary to determine whether sport specialization behaviors increase the risk of injury in youth basketball.

LEVEL OF EVIDENCE

Level III-cross-sectional study.

Effect of scaling basket height for young basketball players during the competition: seeking out positive sport experiences

Proper scaling of sports equipment is necessary to ensure an optimal teaching-learning process . This study aimed to analyse the effect of reducing basket height on the technical-tactical actions, physical participation, self-efficacy, cooperation and enjoyment of young basketball players in the competition. 51 under-14 male basketball players from four teams were chosen as the sample. The data collection included 2,286 attack phases during 12 matches. All players competed in two tournaments using official basketball rules but different basket heights (official basket height, 3.05 metres, and modified basket height, 2.80 metres). The dependent variables were: a) types of shooting actions, shot efficacy, and shooting conditions; b) the duration, type, number of passes done, and efficacy of the attack phases; c) heart rate values; and d) perception of specific and physical self-efficacy, collective efficacy, cooperation, and enjoyment. The results show that the scaled basket promoted game styles that increased the occurrence of fast-breaks and long positional attack phase. Shot efficacy for all shot types improved (not-significantly) and brought change in players' specific self-efficacy and enjoyment. These findings show that scaling equipment can help the transition from mini-basket to regular basket (under-14 age group) by generating better conditions for players' development.

'The Little Engine That Could': A Qualitative Study of Medical Service Access and Effectiveness among Adolescent Athletics Athletes Competing at the Highest International Level

Little is known about provision of medical services to adolescents prior to participating in international top-level sports. This study aimed to investigate experiences of medical service provision among high-level adolescent athletics (track and field) athletes from three continents. A thematic narrative analysis was applied to data collected from 14 athletes by semi-structured interviews. Although competing at the highest international level, these adolescent athletes had difficulties making sense of symptoms of ill health, especially on their own. With increasing exercise loads, the athletes’ medical support needs had extended beyond the capacity of parents and local communities. As there was no organized transfer of the responsibility for medical support to sports organizations, the athletes often had to manage their health problems by themselves. There were major variations among the adolescent athletes with regards to medical service access and quality. The services used ranged from sophisticated computer-assisted biomechanical analyses to traditional healers. Decreased exercise load was the common sports injury treatment. The results of this study demonstrate how the ethical standards underpinning youth sports as well as the equal provision of medical services to adolescents are challenged across the world. Further research on health service provision to adolescent top-level athletes is warranted.

Heads Up Play: Acute Assessment and Management of Basketball-Related Craniofacial Injuries by On-Court Personnel

INTRODUCTION

With a following of over 825 million people, basketball currently ranks amongst the world's most popular sports. Despite a number of concussion awareness and player safety protocols that have been implemented at the professional level of organized play, a standardized, layperson-friendly algorithm for the acute management of basketball-related craniofacial injuries does not appear to presently exist.

METHODS

This 10-year retrospective cohort study was conducted using the National Electronic Injury Surveillance System database to examine basketball-related craniofacial injuries from 2010 to 2019. Within the National Electronic Injury Surveillance System dataset, factors including patient age, gender, diagnosis, injury type, and injury location were included in our analysis.

RESULTS

Overall, 22,529 basketball-related craniofacial injuries occurred between 2010 and 2019 in players ages 5 to 49 years old. Adolescent (12-18-year-old) and young adult (19-34-year-old) age groups had the highest incidence of craniofacial injuries. The adolescent cohort experienced a significantly greater proportion of concussions and lower proportion of both facial lacerations and fractures compared with the within group null hypothesis of equal proportions (P < 0.05). The young adult cohort experienced a significantly greater proportion of facial lacerations and fractures and lower proportion of concussions, contusions/abrasions, hematomas, and internal injuries compared to this cohort's null hypothesis (P < 0.05). Males experienced a significantly greater proportion of fractures, lacerations, and dental injuries and lower proportion of concussions, contusions/abrasions, and internal injuries compared to the hypothesized equality of proportions (P < 0.05). Females experienced a significantly greater proportion of concussions, contusions/abrasions, and internal injuries and lower proportion of fractures, lacerations, and dental injuries compared to the hypothesized equality of proportions (P < 0.05).

CONCLUSIONS

Although several steps have already been taken at the professional level to try to promote player safety, particularly with concussion protocols and prevention of lower extremity injuries, there remains a paucity of resources to guide management of other types of acute craniofacial injury. The role of layperson-friendly educational interventions remains intriguing as a potential means of improving outcomes regardless of socioeconomic status or health literacy. Additional studies still need to be completed to determine efficacy and best future direction.

The association of sport participation behaviors with throwing-arm health in Little League Baseball pitchers

Background and Hypothesis

There is increasing concern about the role sport specialization might play in the increasing injury rates observed among youth baseball pitchers. However, existing research on specialization in baseball has focused on high school and professional baseball populations. We hypothesized that pitchers who were highly specialized, reported pitching more than eight months in the past year, received private coaching, or pitched with pain or fatigue in the previous year would report worse throwing-arm health.

Methods

One-hundred eighty-four Little League pitchers (boys N = 181, age 9.8 ± 1.6 years old) between 7 and 12 years of age completed an anonymous, online questionnaire with their parents' assistance. The questionnaire consisted of participant demographics, sport specialization status, months of pitching per year, whether they traveled regularly to participate in showcases, if they received private coaching, whether they pitched with elbow or shoulder pain, whether they pitched with fatigue, and the Youth Throwing Score (YTS), a valid and reliable patient-reported outcome measure for youth baseball players. The associations between variables of interest and YTS were examined using multivariable linear regression, adjusting for covariates.

Results

Sport specialization, pitching year-round, and receiving private coaching were not associated with the YTS (P > .05). Pitching with pain in the previous year was associated with a worse YTS score than pitching without pain (least square mean [standard error]: 49.6 [1.8] vs. 57.8 [1.1], P < .001). Similarly, pitching with fatigue in the previous year was associated with worse YTS scores (least square mean [standard error]: 52.1 [1.4] vs. 55.3 [1.3], P = .01). Pitchers who reported traveling regularly for showcases scored worse on the YTS compared with those who did not travel regularly for showcase events (least square mean [standard error]: 51.0 [2.0] vs. 56.4 [0.9], P = .01).

Conclusions

Pitching with pain or fatigue was associated with worse throwing-arm health in Little League baseball pitchers. While traveling at least once a month to participate in showcases was also associated with worse throwing-arm health, specialization and private coaching were not related to worse throwing health. Clinicians working with pediatric patient populations should be aware that while the factors examined in this article were reported relatively infrequently, screening for Little League pitchers who participate in showcases or pitch with pain or fatigue may be an effective strategy for identifying these individuals who are at higher risk of injury.

Assessing parents, youth athletes and coaches subjective health literacy: A cross-sectional study

OBJECTIVES

The aim was to describe levels of subjective Health Literacy (HL), and to examine possible differences in prevalence proportions between sexes, age groups and level of educations among youth athletes and their mentors (coaches, parents/caregivers) in Swedish Athletics.

DESIGN

Cross-sectional.

METHODS

Data on subjective HL were collected using the Swedish Communicative and Critical Health Literacy (S-CCHL) instrument for mentors and for youth the School-Aged Children (HLSAC) instrument. Questions assessing mentors' literacy on sports injury and return to play were also included.

RESULTS

The surveys were completed by 159 (91%) mentors and 143 youth athletes (87%). The level of S-CCHL was sufficient in 53% of the mentors. Of youth athletes, 28% reported a high level of HL and the item with least perceived high HL (21%) was critical thinking. Ninety-four percent of the mentors believed that it is quite possible to prevent injuries in athletics and 53% perceived having a very good knowledge about how to prevent injuries. Forty-six percent of the mentors perceived having a very good knowledge of return to sport criteria.

CONCLUSIONS

The level of health literacy was low with about half of the mentors and one out of three youth athletes having adequate HL levels. Only half of the mentors stated having a good knowledge of various injury prevention strategies. To reduce health consequences in youth sport and enable talent development more work is needed to understand the facilitators and barriers for the uptake of various health promotion and injury prevention strategies.

Decision-Making Skills in Youth Basketball Players: Diagnostic and External Validation of a Video-Based Assessment

Decision-making is a central skill of basketball players intending to excel individually and contribute to their teams’ success. The assessment of such skills is particularly challenging in complex team sports. To address this challenge, this study aimed to conceptualize a reliable and valid video-based decision-making assessment in youth basketball. The study sample comprised youth basketball players of the German U16 national team (n = 17; M_Age = 16.01 ± 0.25 years) and students of a sports class (n = 17; M_Age = 15.73 ± 0.35 years). Diagnostic validity was tested by determination of the performance levels according to response accuracy as well as response time in the assessment. External validity was examined by investigation of the correlation between the diagnostic results of the elite athletes and their real game performance data associated with passing skills. Logistic regression analysis revealed that the diagnostic results discriminate between performance levels (χ²(2) = 20.39, p < 0.001, Nagelkerke’s R² = 0.60). Multiple regression analysis demonstrated a positive relationship between the diagnostic results and assists (F(2,10) = 4.82, p < 0.05; R² = 0.49) as well as turnovers per game (F(2,10) = 5.23, p < 0.05; R² = 0.51). However, no relationship was detected regarding the assist-turnover ratio. Further, response time discriminated within the elite athletes’ performance data but not between performance levels while for response accuracy the opposite is the case. The results confirm the diagnostic and external validity of the assessment and indicate its applicability to investigate decision-making skills in youth basketball.

Physiology of Basketball - Field Tests. Review Article

The game of basketball is characterized by short and intense bouts of activity at medium to high frequency. Basketball entails specific types of movements, physiological requirements and energy sources. The duration of physiological responses involving ATP, CP and glycolysis responses to this type of activity is 5-6 seconds for a single sprint, and a contribution of the aerobic system is of less than 10%. Recovery periods in basketball, as a rule, are not long enough to fill the gap for such high intensity activities. It is hard to achieve the same level of performance consistently over time in repeated sprints. This means that basketball players need great athletic ability in order to demonstrate speed, strength and power required to produce a successful performance most proficiently. Therefore, tests are needed to help coaches to monitor their players and ensure that they have the physiological capacity required for the game. The aim of fitness tests is to assess the condition of athletes in terms of each fitness component, in order to determine what needs to be improved through the training program and to conduct retests at set times to assess whether their condition has changed. The literature offers a number of widely used tests to measure aerobic and anaerobic fitness. This article reviews the physiological demands of basketball and analyzes the field tests commonly used at present. The article emphasizes the need for a specific test that will serve coaches and physical fitness trainers in monitoring their players.

Measuring Physical Demands in Basketball: An Explorative Systematic Review of Practices

BACKGROUND

Measuring the physical work and resultant acute psychobiological responses of basketball can help to better understand and inform physical preparation models and improve overall athlete health and performance. Recent advancements in training load monitoring solutions have coincided with increases in the literature describing the physical demands of basketball, but there are currently no reviews that summarize all the available basketball research. Additionally, a thorough appraisal of the load monitoring methodologies and measures used in basketball is lacking in the current literature. This type of critical analysis would allow for consistent comparison between studies to better understand physical demands across the sport.

OBJECTIVES

The objective of this systematic review was to assess and critically evaluate the methods and technologies used for monitoring physical demands in competitive basketball athletes. We used the term 'training load' to encompass the physical demands of both training and game activities, with the latter assumed to provide a training stimulus as well. This review aimed to critique methodological inconsistencies, establish operational definitions specific to the sport, and make recommendations for basketball training load monitoring practice and reporting within the literature.

METHODS

A systematic review of the literature was performed using EBSCO, PubMed, SCOPUS, and Web of Science to identify studies through March 2020. Electronic databases were searched using terms related to basketball and training load. Records were included if they used a competitive basketball population and incorporated a measure of training load. This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO Registration # CRD42019123603), and approved under the National Basketball Association (NBA) Health Related Research Policy.

RESULTS

Electronic and manual searches identified 122 papers that met the inclusion criteria. These studies reported the physical demands of basketball during training (n = 56), competition (n = 36), and both training and competition (n = 30). Physical demands were quantified with a measure of internal training load (n = 52), external training load (n = 29), or both internal and external measures (n = 41). These studies examined males (n = 76), females (n = 34), both male and female (n = 9), and a combination of youth (i.e. under 18 years, n = 37), adults (i.e. 18 years or older, n = 77), and both adults and youth (n = 4). Inconsistencies related to the reporting of competition level, methodology for recording duration, participant inclusion criteria, and validity of measurement systems were identified as key factors relating to the reporting of physical demands in basketball and summarized for each study.

CONCLUSIONS

This review comprehensively evaluated the current body of literature related to training load monitoring in basketball. Within this literature, there is a clear lack of alignment in applied practices and methodological framework, and with only small data sets and short study periods available at this time, it is not possible to draw definitive conclusions about the true physical demands of basketball. A detailed understanding of modern technologies in basketball is also lacking, and we provide specific guidelines for defining and applying duration measurement methodologies, vetting the validity and reliability of measurement tools, and classifying competition level in basketball to address some of the identified knowledge gaps. Creating alignment in best-practice basketball research methodology, terminology and reporting may lead to a more robust understanding of the physical demands associated with the sport, thereby allowing for exploration of other research areas (e.g. injury, performance), and improved understanding and decision making in applying these methods directly with basketball athletes.

Dissemination and implementation research in sports and exercise medicine and sports physical therapy: translating evidence to practice and policy

Knowledge from research evidence is wasted unless it is applied. While the scientific evidence base for many sports and exercise medicine and sports physical therapy interventions is robust, real-world implementation and evolution to scale remains an ongoing challenge. Dissemination and implementation research is important to generate evidence-informed, cost-effective and context-specific strategies for implementation partners and stakeholders to effectively apply and sustain the best research evidence in public health and clinical practice. However, this field of inquiry remains underexplored in sports and exercise medicine and sports physical therapy. Most intervention studies in sports and exercise medicine and sports physical therapy are terminated at the efficacy trial stage without considerations for best practices for translation to community and clinical settings. Lack of context-specific dissemination and implementation strategies to drive the translation of evidence-based interventions results in poor execution of, and attrition from, interventions, and this is associated with suboptimal outcomes and increased healthcare costs. Theory-driven quality research informing the successful dissemination and implementation of evidence-based interventions is needed to address lingering evidence-to-practice gaps. Dissemination and implementation research completes the final stage in the research-to-practice pipeline. It seeks to close evidence-to-practice gaps, thereby ensuring speedy application of research evidence to achieve desired public health outcomes while making more efficient use of limited resources. This review introduces sports and exercise medicine and sports physical therapy researchers and stakeholders to key concepts and principles in dissemination and implementation research.

Higher Vertical Jumping Asymmetries and Lower Physical Performance are Indicators of Increased Injury Incidence in Youth Team-Sport Athletes

Fort-Vanmeerhaeghe, A, Milà-Villarroel, R, Pujol-Marzo, M, Arboix-Alió, J, and Bishop, C. Higher vertical jumping asymmetries and lower physical performance are indicators of increased injury incidence in youth team-sport athletes. J Strength Cond Res XX(X): 000-000, 2020-To date, the literature about the association between injury-risk factors and actual injury incidence in young elite team-sports athletes is scarce. The main objective of this study was to examine how modifiable factors may affect injury incidence. Eighty-one young elite team-sports athletes (age: under-14 to under-18) performed the countermovement jump (CMJ), a single leg CMJ (SLCMJ), the one-legged hop test (OLHT), a 30-m sprint test, the V-cut test, a repeated sprint ability, and the 30-15 intermittent fitness test (IFT) during the pre-season period. Interlimb asymmetries were calculated for SLCMJ and OLHT. Injuries were recorded prospectively for the entirety of the 2017-2018 season. Comparison of injury and noninjury data was performed using a two-way analysis of variance (ANOVA). Results of the ANOVA according to injury showed significant differences in CMJ (p = 0.01), SLCMJ on the lowest performing limb (p = 0.03), and SLCMJ asymmetry (<0.001). Sex × injury interaction was significant from CMJ (p = 0.018) and 30-15 IFT (p = <0.001). In conclusion, this study indicated that athletes with greater interlimb asymmetries, less vertical jump capacity, and lower intermittent aerobic fitness had a greater predisposition to injury. Therefore, monitoring CMJ, aerobic performance, and interlimb asymmetries is recommended given their sensitivity to detect significant differences between injured and healthy youth athletes.

Effects of an 8-week basketball-specific proprioceptive training with a single-plane instability balance platform

BACKGROUND

To avoid injuries in basketball players, they are recommended to pay more attention to improve their body balance. Therefore new training methods and equipment need to be devised. This study examined the effects of an 8-week basketball-specific proprioception training program while using a new developed one plane instability balance board during warm-up for improving balance ability in basketball players. Players who obtained basketball-specific balance training were compared to a control group.

METHODS

Thirty-one male university basketball players (age: 21.35, SD = 0.605 years; height: 190.97, SD = 1.88; body mass: 86.95, SD = 2.61) participated in this study. Seventeen participants were assigned to the basketball-specific 8-week balance training group (BTG) while 14 participants served as a control group (CG). Both groups were tested with the Y balance test (YBT) and postural stability test (PST) at baseline and 8 weeks later.

RESULTS

The results indicate significant improvements in the overall YBT for both legs in BTG, but not in CG. However, no group differences were found for dynamic balance performance, but static balance (i.e., postural stability) differed between groups after 8 weeks. A statistically significant moderate inverse correlation was computed between the total score of YBT and the total score of the overall stability index (r=-0.404; p= 0.041).

CONCLUSIONS

An 8-week basketball-specific proprioception training program with a single-plane instability balance platform improved balance ability (Y balance test and postural stability test) of basketball players.

The Talent Development Pathway for Elite Basketball Players in China

A large portion of previous sport talent development research has been conducted using Western countries study subjects such as Canadian, Swedish, Spanish, British, or American athletes. However, the factors that affect oriental culture athletes remain an unexplored field. The aims of this investigation were to consolidate the exploration of the pilot study that studied the key factors for Chinese elite basketball players' careers and understand what facts have helped them to achieve the highest sportive level through qualitative research. The pathway to excellence of 11 Chinese elite basketball players were analyzed through a semi-structured interview with different categories such as social context, sport context, tactical factors, or anthropometric factors. Results showed that cultural factors, family tradition, academic studies, coaches, mental strength, training structuration, and international competitions had a great effect and influence in the talent development of Chinese basketball players.

Selected Musculoskeletal Issues in Adolescents

Musculoskeletal care of the adolescent patient involves unique knowledge of their rapidly changing physical and psychological health. In this article, the importance of preventing early sports specialization is elucidated, and an encouragement of the safety and necessity of resistance training in adolescents is undertaken. It also explores two common conditions, one affecting the immature skeleton (apophysitis), and one affecting the improperly developed muscular system (patellofemoral syndrome), both of which are diagnosed clinically, and require little advanced imaging. Finally, a brief overview of relative energy deficiency in sport is given.