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Krommes K, Thorborg K, Clausen MB, Rathleff MS, Olesen JL, Kallemose T, Hölmich P. Self-management including exercise, education and activity modification compared to usual care for adolescents with Osgood-Schlatter (the SOGOOD trial): protocol of a randomized controlled superiority trial. BMC Sports Sci Med Rehabil 2024; 16:89. [PMID: 38643184 PMCID: PMC11032598 DOI: 10.1186/s13102-024-00870-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/25/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Osgood-Schlatter is the most frequent growth-related injury affecting about 10% of physically active adolescents. It can cause long-term pain and limitations in sports and physical activity, with potential sequela well into adulthood. The management of Osgood-Schlatter is very heterogeneous. Recent systematic reviews have found low level evidence for surgical intervention and injection therapies, and an absence of studies on conservative management. Recently, a novel self-management approach with exercise, education, and activity modification, demonstrated favorable outcomes for adolescents with patellofemoral pain and Osgood-Schlatter in prospective cohort studies. AIM The aim of this trial is to assess the effectiveness of the novel self-management approach compared to usual care in improving self-reported knee-related function in sport (measured using the KOOS-child 'Sport/play' subscale) after a 5-month period. METHODS This trial is a pragmatic, assessor-blinded, randomized controlled trial with a two-group parallel arm design, including participants aged 10-16 years diagnosed with Osgood-Schlatter. Participants will receive 3 months of treatment, consisting of either usual care or the self-management approach including exercise, education, and activity modification, followed by 2 months of self-management. Primary endpoint is the KOOS-child 'Sport/play' score at 5 months. This protocol details the planned methods and procedures. DISCUSSION The novel approach has already shown promise in previous cohort studies. This trial will potentially provide much-needed level 1 evidence for the effectiveness of the self-management approach, representing a crucial step towards addressing the long-term pain and limitations associated with Osgood-Schlatter. TRIAL REGISTRATION Clinicaltrials.gov: NCT05174182. Prospectively registered December 30th 2021. Date of first recruitment: January 3rd 2022. Target sample size: 130 participants.
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Affiliation(s)
- Kasper Krommes
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre, Copenhagen University Hospital, Kettegaard Allé 30, Hvidovre, DK-2650, Denmark.
| | - Kristian Thorborg
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre, Copenhagen University Hospital, Kettegaard Allé 30, Hvidovre, DK-2650, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Mikkel Bek Clausen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Sigurdsgade 26, DK-2200, Copenhagen N, Denmark
| | - Michael Skovdal Rathleff
- Center for General Practice at Aalborg University, Aalborg. Fyrkildevej 7, DK-9220, Aalborg, Denmark
- Department of Health Science and Technology, Aalborg University, Selma Lagerløfs Vej 249, DK-9220, Aalborg, Denmark
| | - Jens Lykkegaard Olesen
- Center for General Practice at Aalborg University, Aalborg. Fyrkildevej 7, DK-9220, Aalborg, Denmark
| | - Thomas Kallemose
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Sigurdsgade 26, DK-2200, Copenhagen N, Denmark
- Department of Clinical Research, Amager-Hvidovre, Copenhagen University Hospital, Kettegaard Alle 30, Hvidovre, DK-2610, Danmark
| | - Per Hölmich
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre, Copenhagen University Hospital, Kettegaard Allé 30, Hvidovre, DK-2650, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
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Boudreau SA, Jakobsen TL, Haraldsson BÞ, Clausen MB. Digital mapping of shoulder pain in patients with shoulder disorders: a reliability study. Physiother Theory Pract 2024:1-13. [PMID: 38214518 DOI: 10.1080/09593985.2023.2300753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Digital body mapping can be used to document and quantify the area and location (distribution) of pain and discomfort and support assessment, monitoring, and treatment in clinical populations. This study determines the test-retest reliability of drawings detailing pain and pins and needles using digital body charts and their relationship to pain intensity and patient-reported shoulder function. METHODS Sixty-two participants with shoulder disorder completed pain and pins and needles drawings with test-retest interval of 30 minutes. Pain intensity in the last week and the patient-reported shoulder function questionnaires were completed. Area and radiating extent were determined using customized software. To assess relative and absolute test-retest reliability, the intraclass correlation coefficient (ICC3,1), standard error of measurement (SEM) and minimal detectable change (MDC95) were calculated. Regression analysis evaluated relation between area and radiating extent of pain and pins and needles with patient-reported function questionnaires. RESULTS Relative reliability for pain area and radiating extent was excellent (>0.90). Absolute reliability (SEM and MDC95) values for the pain area and radiating extent were 0.20%/34 pixels and 0.57%/94 pixels. Absolute reliability improves for smaller pain areas. Regression analysis revealed the area and radiation extent for both pain and pins and needles are independent constructs to the patient-reported function outcome when adjusted for pain intensity. CONCLUSIONS Digital body mapping assessing pain area and radiation extent in patients with shoulder disorders are reliable. The magnitude of absolute reliability suggests other sources of variability on repeat testing in this population. Pain area and radiation extent appear to be independent constructs.
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Affiliation(s)
- Shellie Ann Boudreau
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Bjarki Þór Haraldsson
- Physiotherapy Degree Programme, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen NV, Denmark
| | - Mikkel Bek Clausen
- Physiotherapy Degree Programme, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen NV, Denmark
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Clausen MB, Rathleff MS, Graven-Nielsen T, Bandholm T, Christensen KB, Hölmich P, Thorborg K. Level of pain catastrophising determines if patients with long-standing subacromial impingement benefit from more resistance exercise: predefined secondary analyses from a pragmatic randomised controlled trial (the SExSI Trial). Br J Sports Med 2023; 57:842-848. [PMID: 36898767 PMCID: PMC10439263 DOI: 10.1136/bjsports-2022-106383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE The primary aim was to investigate the effectiveness of adding more resistance exercise to usual care on pain mechanisms (including temporal summation, conditioned pain modulation (CPM) and local pain sensitivity) and pain catastrophising in people with subacromial impingement at 16 weeks follow-up. Second, to investigate the modifying effect of pain mechanisms and pain catastrophising on the interventions' effectiveness in improving shoulder strength and disability METHODS: 200 consecutive patients were randomly allocated to usual exercise-based care or the same plus additional elastic band exercise to increase total exercise dose. Completed add-on exercise dose was captured using an elastic band sensor. Outcome measures recorded at baseline, 5 weeks, 10 weeks and 16 (primary end point) weeks included temporal summation of pain (TSP) and CPM assessed at the lower leg, pressure pain threshold at the deltoid muscle (PPT-deltoid), pain catastrophising and the Shoulder Pain and Disability Index. RESULTS Additional elastic band exercise was not superior to usual exercise-based care in improving pain mechanisms (TSP, CPM and PPT-deltoid) or pain catastrophising after 16 weeks. Interaction analyses showed that pain catastrophising (median split) modified the effectiveness of additional exercises (effect size 14 points, 95% CI 2 to 25), with superior results in the additional exercise group compared with the usual care group in patients with less pain catastrophising. CONCLUSION Additional resistance exercise added to usual care was not superior to usual care alone in improving pain mechanisms or pain catastrophising. Additional exercise was, however, superior in improving self-reported disability in patients with lower levels of pain catastrophising at baseline. TRIAL REGISTRATION NUMBER NCT02747251.
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Affiliation(s)
- Mikkel Bek Clausen
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Michael Skovdal Rathleff
- Center for General Practice, Aalborg University, Aalborg, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Thomas Bandholm
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Clinical Research, Copenhagen University Hospital, Hvidovre, Denmark
| | - Karl Bang Christensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Per Hölmich
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Thorborg
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Hvidovre, Denmark
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Bak J, Thorborg K, Clausen MB, Johannsen FE, Kirk JW, Bandholm T. Using the app "Injurymap" to provide exercise rehabilitation for people with acute lateral ankle sprains seen at the Hospital Emergency Department-A mixed-method pilot study. PLOS Digit Health 2023; 2:e0000221. [PMID: 37186574 PMCID: PMC10184914 DOI: 10.1371/journal.pdig.0000221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/27/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Acute lateral ankle sprains (LAS) account for 4-5% of all Emergency Department (ED) visits. Few patients receive the recommended care of exercise rehabilitation. A simple solution is an exercise app for mobile devices, which can deliver tailored and real-time adaptive exercise programs. PURPOSE The purpose of this pilot study was to investigate the use and preliminary effect of an app-based exercise program in patients with LAS seen in the Emergency Department at a public hospital. MATERIALS AND METHODS We used an app that delivers evidence-based exercise rehabilitation for LAS using algorithm-controlled progression. Participants were recruited from the ED and followed for four months. Data on app-use and preliminary effect were collected continuously through the exercise app and weekly text-messages. Baseline and follow-up data were collected though an online questionnaire. Semi-structured interviews were performed after participants stopped using the app. Results: Health care professionals provided 485 patients with study information and exercise equipment. Of those, 60 participants chose to enroll in the study and 43 became active users. The active users completed a median of 7 exercise sessions. Most of the active users were very satisfied or satisfied (79%-93%) with the app and 95.7% would recommend it to others. The interviews showed that ankle sprains were considered an innocuous injury that would recover by itself. Several app users expressed they felt insufficiently informed from the ED health care professionals. Only 39% felt recovered when they stopped exercising, and 33% experienced a recurrent sprain in the study period. Conclusion: In this study, only few patients with LAS became active app users after receiving information in the ED about a free app-based rehabilitation program. We speculate the reason for this could be the perception that LAS is an innocuous injury. Most of the patients starting training were satisfied with the app, although few completed enough exercise sessions to realistically impact clinical recovery. Interestingly more than half of the participants did not feel fully recovered when they stopped exercising and one third experienced a recurrent sprain. TRIAL-IDENTIFIERS https://clinicaltrials.gov/ct2/show/NCT03550274, preprint (open access): https://www.medrxiv.org/content/10.1101/2022.01.31.22269313v1.
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Affiliation(s)
- Jonas Bak
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
| | - Kristian Thorborg
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Amager and Hvidovre, Denmark
| | - Mikkel Bek Clausen
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen N, Denmark
| | - Finn Elkjær Johannsen
- Institute of Sports Medicine Copenhagen, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Injurymap Aps, Copenhagen N, Denmark
| | - Jeanette Wassar Kirk
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Health and Social Context, National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Thomas Bandholm
- Department of Clinical Research, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Physical Medicine & Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Amager and Hvidovre, Denmark
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Witten A, Mikkelsen K, Wagenblast Mayntzhusen T, Clausen MB, Thorborg K, Hölmich P, Barfod KW. Terminology and diagnostic criteria used in studies investigating patients with subacromial pain syndrome from 1972 to 2019: a scoping review. Br J Sports Med 2023:bjsports-2022-106340. [PMID: 36813537 DOI: 10.1136/bjsports-2022-106340] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION There is no recognised terminology, nor diagnostic criteria, for patients with subacromial pain syndrome (SAPS). This is likely to cause heterogeneity across patient populations. This could be a driver of misconceptions and misinterpretations of scientific results. We aimed to map the literature regarding terminology and diagnostic criteria used in studies investigating SAPS. MATERIALS AND METHODS Electronic databases were searched from inception to June 2020. Original peer-reviewed studies investigating SAPS (also known as subacromial impingement or rotator cuff tendinopathy/impingement/syndrome) were eligible for inclusion. Studies containing secondary analyses, reviews, pilot studies and studies with less than 10 participants were excluded. RESULTS 11 056 records were identified. 902 were retrieved for full-text screening. 535 were included. 27 unique terms were identified. Mechanistic terms containing 'impingement' are used less than before, while SAPS is used increasingly. For diagnoses, combinations of Hawkin's, Neer's, Jobe's, painful arc, injection test and isometric shoulder strength tests were the most often used, though this varied considerably across studies. 146 different test combinations were identified. 9% of the studies included patients with full-thickness supraspinatus tears and 46% did not. CONCLUSION The terminology varied considerably across studies and time. The diagnostic criteria were often based on a cluster of physical examination tests. Imaging was primarily used to exclude other pathologies but was not used consistently. Patients with full-thickness supraspinatus tears were most often excluded. In summary, studies investigating SAPS are heterogeneous to an extent that makes it difficult, and often impossible, to compare studies.
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Affiliation(s)
- Adam Witten
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Karen Mikkelsen
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Thomas Wagenblast Mayntzhusen
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Mikkel Bek Clausen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Kristian Thorborg
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Per Hölmich
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Kristoffer Weisskirchner Barfod
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
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Andersen RM, Skou ST, Clausen MB, Jäger M, Zangger G, Grøntved A, Brønd JC, Soja AMB, Tang LH. Maintenance of physical activity after cardiac rehabilitation (FAIR): study protocol for a feasibility trial. BMJ Open 2022; 12:e060157. [PMID: 35383088 PMCID: PMC8984013 DOI: 10.1136/bmjopen-2021-060157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION To enhance health and prevent secondary consequences for patients with cardiovascular disease (CVD), maintenance of an active lifestyle following participation in cardiac rehabilitation (CR) is important. However, levels of physical activity often decrease after completion of a structured CR programme. Models that support long-term behaviour change with a sustained level of physical activity are imperative. The aim of this study is to evaluate the feasibility of a mobile health intervention based on the Health Action Process Approach theoretical model of behaviour change in patients with CVD for 3 months after completion of a CR programme. METHODS AND ANALYSIS In a feasibility trial design, we will recruit 40 participants from CR programmes at Slagelse Hospital, the City of Slagelse (municipality), or Holbæk Hospital. After completing the standard structured CR programme, each participant will create an action plan for physical activity together with a physiotherapist. Following that, participants are sent 2 weekly text messages for 3 months. The first text message prompts physical activity, and the second will check if the action plan has been followed. If requested by participants, a coordinator will call and guide the physical activities behaviour. The feasibility of this maintenance intervention is evaluated based on predefined progression criteria. Physical activity is measured with accelerometers at baseline and at 3 months follow-up. ETHICS AND DISSEMINATION Study approval was waived (EMN-2021-00020) by the Research Ethics Committee of Region Zealand, Denmark. Study results will be made public and findings disseminated to patients, health professionals, decision-makers, researchers and the public. TRIAL REGISTRATION NUMBER NCT05011994.
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Affiliation(s)
- Rune Martens Andersen
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Søren Thorgaard Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mikkel Bek Clausen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Madalina Jäger
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Graziella Zangger
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jan Christian Brønd
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Lars H Tang
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200 Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Clausen MB, Hölmich P, Rathleff MS, Bandholm T, Christensen KB, Zebis MK, Thorborg K. Effectiveness of Adding a Large Dose of Shoulder Strengthening to Current Nonoperative Care for Subacromial Impingement: A Pragmatic, Double-Blind Randomized Controlled Trial (SExSI Trial): Response. Am J Sports Med 2022; 50:NP20-NP23. [PMID: 35289223 DOI: 10.1177/03635465211055449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Christensen KB, Clausen MB, King E, Franklyn-Miller A, Harøy J, Andersen TE, Hölmich P, Thorborg K. Validation of the Copenhagen Hip and Groin Outcome Score (HAGOS) using modern test theory across different cultures and languages: a cross-sectional study of 452 male athletes with groin pain. Br J Sports Med 2021; 56:333-339. [PMID: 34815222 DOI: 10.1136/bjsports-2021-104412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2021] [Indexed: 12/17/2022]
Abstract
BKGROUND No studies have tested the validity of the Copenhagen Hip and Groin Outcome Score (HAGOS) using modern test theory, across different cultures and languages. OBJECTIVE To validate the Danish, English and Norwegian versions of HAGOS and its six subscales (Symptoms (S, Item 1-7), Pain (P, Item 1-10), activities of daily living (Item 1-5), Sport and recreation (Sport/rec, Item 1-8), Participation in physical activity (item 1-2) and quality of life (item 1-5)) by evaluating differential item functioning (DIF) and measurement invariance across the three language versions in male multidirectional team athletes with groin pain. Second, to modify subscales depending on goodness-of-fit to the item response theory models and calculate conversion tables if language DIF was observed. METHODS We included individual responses to the Danish (n=157), English (n=146) and Norwegian (n=149) language versions of HAGOS from 452 athletes (median age 24 years old, range 20-28) with groin pain. Overall fit, model fit, individual item fit, local response dependence and measurement invariance was examined using confirmatory factor analysis and graphical Rasch models. RESULTS The removal of seven misfitting items (S2, P1, P2, A4, SP1, SP5, Q3) resulted in 6 HAGOS subscales with acceptable psychometric properties. For the Symptoms, Pain and Sports subscales evidence of DIF was disclosed between the three different language-versions of HAGOS and conversion tables were created. CONCLUSIONS A revised HAGOS derived using modern test theory provides valid measurements for male multidirectional athletes with groin pain across different cultures and languages. Conversion tables must be applied to compare HAGOS scores from Danish, Norwegian and English language versions.
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Affiliation(s)
- Karl Bang Christensen
- Department of Public Health, Section of Biostatistics, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark
| | - Mikkel Bek Clausen
- School of Physiotherapy, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Kobenhavn, Denmark.,School of Physiotherapy, University College Copenhagen, Copenhagen
| | - Enda King
- Sports Medicine, Sports Surgery Clinic, Dublin, Ireland
| | - Andrew Franklyn-Miller
- Sports Surgery Clinic, Dublin, Ireland.,CHESM, University of Melbourne, Melbourne, Victoria, Australia
| | - Joar Harøy
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,The Norwegian FA Sports Medicine Clinic, Oslo, Norway
| | - Thor Einar Andersen
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,The Norwegian FA Sports Medicine Clinic, Oslo, Norway
| | - Per Hölmich
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center - Copenhagen (SORC-C), Amager-Hvidovre Hospital, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark
| | - Kristian Thorborg
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center - Copenhagen (SORC-C), Amager-Hvidovre Hospital, University of Copenhagen Faculty of Health and Medical Sciences, Kobenhavn, Denmark
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Clausen MB, Hölmich P, Rathleff M, Bandholm T, Christensen KB, Zebis MK, Thorborg K. Effectiveness of Adding a Large Dose of Shoulder Strengthening to Current Nonoperative Care for Subacromial Impingement: A Pragmatic, Double-Blind Randomized Controlled Trial (SExSI Trial). Am J Sports Med 2021; 49:3040-3049. [PMID: 34048281 PMCID: PMC8411479 DOI: 10.1177/03635465211016008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND A strong recommendation against subacromial decompression surgery was issued in 2019. This leaves nonoperative care as the only treatment option, but recent studies suggest that the dose of strengthening exercise is not sufficient in current nonoperative care. At this point, it is unknown if adding more strengthening to current nonoperative care is of clinical value. PURPOSE To assess the effectiveness of adding a large dose of shoulder strengthening to current nonoperative care for subacromial impingement compared with usual care alone. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS In this double-blinded, pragmatic randomized controlled trial, we randomly allocated 200 consecutive patients referred to orthopaedic shoulder specialist care for long-standing shoulder pain (>3 months), aged 18 to 65 years and diagnosed with subacromial impingement using validated criteria, to the intervention group (IG) or control group (CG). Outcome assessors were blinded, and participants were blinded to the study hypothesis as well as to the treatment method in the other group. The CG received usual nonoperative care; the IG underwent the same plus an add-on intervention designed to at least double the total dose of shoulder strengthening. The primary outcome was the Shoulder Pain and Disability Index (SPADI; 0-100) at 4-month follow-up, with 10 points defined as the minimal clinically important difference. Secondary outcomes included shoulder strength, range of motion, health-related quality of life, and the Patient Acceptable Symptom State (PASS). RESULTS Intention-to-treat and per-protocol analyses showed no significant or clinically relevant between-group differences for any outcome. From baseline to 4-month follow-up, SPADI scores improved in both groups (intention-to-treat analysis; IG, -22.1 points; CG, -22.7 points; between-group mean difference, 0.6 points [95% CI, -5.5 to 6.6]). At 4 months after randomization, only 54% of the IG and 48% of the CG (P = .4127) reached the PASS. No serious adverse events were reported. CONCLUSION Adding a large dose of shoulder strengthening to current nonoperative care for patients with subacromial impingement did not result in superior shoulder-specific patient-reported outcomes. Moreover, approximately half of all randomized patients did not achieve the PASS after 4 months of nonoperative care, leaving many of these patients with unacceptable symptoms. This study showed that adding more exercise is not a viable solution to this problem. REGISTRATION NCT02747251 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Mikkel Bek Clausen
- Sports Orthopedic Research
Center–Copenhagen, Department of Orthopedic Surgery, Amager-Hvidovre Hospital,
Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Department of Midwifery, Physiotherapy,
Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College
Copenhagen, Copenhagen, Denmark,Mikkel Bek Clausen, PhD,
Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor
Therapy, Faculty of Health, University College Copenhagen, Sigurdsgade 26,
Copenhagen N, DK-2200, Denmark ()
(Twitter: @mikkelbek)
| | - Per Hölmich
- Sports Orthopedic Research
Center–Copenhagen, Department of Orthopedic Surgery, Amager-Hvidovre Hospital,
Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Michael Rathleff
- Center for General Practice, Aalborg
University, Aalborg, Denmark,Department of Health Science and
Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Thomas Bandholm
- Physical Medicine and Rehabilitation
Research–Copenhagen, Department of Physical and Occupational Therapy, Copenhagen
University Hospital, Hvidovre, Denmark,Clinical Research Centre, Copenhagen
University Hospital, Hvidovre, Denmark
| | - Karl Bang Christensen
- Section of Biostatistics, Department
of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mette Kreutzfeldt Zebis
- Department of Midwifery, Physiotherapy,
Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College
Copenhagen, Copenhagen, Denmark
| | - Kristian Thorborg
- Sports Orthopedic Research
Center–Copenhagen, Department of Orthopedic Surgery, Amager-Hvidovre Hospital,
Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Physical Medicine and Rehabilitation
Research–Copenhagen, Department of Physical and Occupational Therapy, Copenhagen
University Hospital, Hvidovre, Denmark
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10
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Clausen MB, Nielsen MF, Merrild MB, Hölmich P, Thorborg K. High incidence of lost workdays in patients with subacromial impingement syndrome. Dan Med J 2021; 68:A07200496. [PMID: 34060461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Loss of workdays is the main societal cost related to shoulder disorders with nine lost workdays per six months on average. The most common shoulder disorder is subacromial impingement syndrome (SIS), but it remains unknown if SIS is also a leading cause of shoulder-related loss of worktime. We aimed to investigate the incidence of workdays lost due to SIS during the six months following a SIS diagnosis in specialised care. METHODS Among 157 consecutive patients diagnosed with SIS in secondary care, 129 (82%) completed a structured six-month follow-up interview. Job status, average working hours and sick leave due to SIS were recorded. Only patients holding a job (n = 58) and patients who lost their job due to SIS (n = 8) were considered to be at risk of losing workdays, leaving 66 patients in the at-risk group. The number of lost workhours due to SIS was calculated and normalised to full-time workdays, and incidences of lost workdays were estimated using Poisson regressions. RESULTS In total, 1,781 workdays were lost. The mean number of lost workdays per six months was 27 days (95% confidence interval (CI): 18-40) for patients at risk (n = 66), corresponding to 14 days on average (95% CI: 9-21 days) for the entire cohort (n = 129). A total of 33 patients were responsible for all loss of workdays. CONCLUSIONS We found that an average of 27 workdays (> 5 work weeks) were lost due to SIS during the first six months after the diagnosis in patients who were otherwise fit to work. This is three times higher than the nine days previously reported for shoulder problems in general, indicating that productivity loss in patients diagnosed with SIS is a major concern. FUNDING none. TRIAL REGISTRATION not relevant.
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Clausen MB, Merrild MB, Holm K, Pedersen MW, Andersen LL, Zebis MK, Jakobsen TL, Thorborg K. Less than half of patients in secondary care adheres to clinical guidelines for subacromial pain syndrome and have acceptable symptoms after treatment: A Danish nationwide cohort study of 3306 patients. Musculoskelet Sci Pract 2021; 52:102322. [PMID: 33485212 DOI: 10.1016/j.msksp.2021.102322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/01/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Evidence-based guidelines recommend exercise-therapy as first line treatment for subacromial pain syndrome, but no previous study has mapped the content of care for subacromial pain syndrome and knowledge about adherence to clinical guidelines are lacking. We aim to describe the content and outcome of current care and investigate the relationship between content and outcome of care. METHODS We invited all patients diagnosed with subacromial pain syndrome at any Danish hospital to participate in this nationwide retrospective population-based cohort-study. Patient-reported information on content of care was collected using a validated questionnaire. Outcome of care was assessed using global impression of change (GIC) and patient acceptable symptom state (PASS). Invitations were sent 14 weeks after diagnosis. RESULTS In total, 3306 eligible patients participated. At follow-up, 45% had completed the recommended 12 weeks of exercise-therapy. From the total cohort, 12% underwent surgery without completing 12 weeks of exercise-therapy. For patients undergoing non-operative care, 43% reached PASS while 61% were improved since diagnosis at the hospital. Completing 12 weeks with exercise-therapy did not increase the odds of improvement (OR 1.05, 95%CI:0.88-1.24), but having conducted strengthening exercises did (OR 1.65, 95%CI:1.25-2.19). CONCLUSION More than half of patients diagnosed with subacromial pain syndrome in specialist care settings do not adhere to recommendations regarding duration of exercise-therapy, but this is not related to symptom improvement. Conversely, conducting strengthening exercises relates to higher chance of symptom improvement. This challenges current clinical guidelines, indicating that a time-based cut-point may not be relevant while specific types of exercises are.
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Affiliation(s)
- Mikkel Bek Clausen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark.
| | - Mikas Bjørn Merrild
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Kika Holm
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Mads Welling Pedersen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | | | - Mette Kreutzfeldt Zebis
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Thomas Linding Jakobsen
- Section for Orthopaedic and Sports Rehabilitation (SOS-R), Health Centre Nørrebro, City of Copenhagen, Copenhagen, Denmark
| | - Kristian Thorborg
- Sports Orthopedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
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12
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Esteve E, Casals M, Saez M, Rathleff MS, Clausen MB, Vicens-Bordas J, Hölmich P, Pizzari T, Thorborg K. Past-season, pre-season and in-season risk assessment of groin problems in male football players: a prospective full-season study. Br J Sports Med 2021; 56:484-489. [PMID: 33692032 DOI: 10.1136/bjsports-2020-102606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE We assessed past-season, pre-season and in-season risk factors to investigate their association with an in-season groin problem in male amateur football players. METHODS Past-season groin-pain information and pre-season short-lever and long-lever adductor squeeze strength were obtained at baseline, together with anthropometrics (weight, lower limb lever length) and player age. In-season hip-related and groin-related sporting function was monitored every 4 weeks using the Sports and Recreation (Sport) subscale from the Hip And Groin Outcome Score questionnaire (HAGOS (Sport)). Groin problems, including time-loss groin injuries and groin pain irrespective of time loss, were collected over a 39-week competitive in-season. We estimated relative risk (RR), and 95% credibility interval (ICr) from logistic regressions fitted in a Bayesian framework. RESULTS Players (n=245) suffering from groin pain during the past-season had 2.4 times higher risk of experiencing a groin problem in the new season (2.40 RR; 95% ICr 1.5 to 3.7). This risk was reduced by 35% (0.65 RR; 95% ICr 0.42 to 0.99) per unit (N·m/kg) increase in the long-lever adductor squeeze test. Player age, short-lever squeeze test and the HAGOS (Sport) scores were not associated with the risk of a groin problem. CONCLUSIONS Past-season groin pain increased the risk of a groin problem in the new in-season. This risk was reduced by higher pre-season long-lever adductor squeeze strength. Past-season groin-pain information and long-lever adductor squeeze strength can be quickly obtained during pre-season to identify players with an elevated risk of in-season groin problems. This may be key to reduce these problems in the new season.
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Affiliation(s)
- Ernest Esteve
- Universtiy School of Health and Sport (EUSES), University of Girona, Girona, Catalunya, Spain
| | - Marti Casals
- Sport and Physical Activity Studies Centre (CEEAF), Faculty of Medicine, University of Vic-Central University of Catalonia, Vic, Catalunya, Spain.,Servicios Médicos, Futbol Club Barcelona, Barcelona, Catalunya, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health, GRECS, University of Girona, Girona, Catalunya, Spain.,CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Comunidad de Madrid, Spain
| | - Michael Skovdal Rathleff
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.,Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, North Denmark Region, Denmark
| | - Mikkel Bek Clausen
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Hovedstaden, Denmark.,Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Kobenhavn, Hovedstaden, Denmark
| | - Jordi Vicens-Bordas
- Sport and Physical Activity Studies Centre (CEEAF), Faculty of Medicine, University of Vic-Central University of Catalonia, Vic, Catalunya, Spain.,NEOMA Research Group, Department of Medical Sciences, Universitat de Girona, Girona, Catalunya, Spain
| | - Per Hölmich
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Hovedstaden, Denmark
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Hovedstaden, Denmark.,Physical Medicine and Rehabilitation-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University, Hvidovre, Denmark
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13
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Hansen TTD, Omland LH, von Heymann A, Johansen C, Clausen MB, Suetta C, Pappot H, Rafn BS. Development of Sarcopenia in Patients With Bladder Cancer: A Systematic Review. Semin Oncol Nurs 2021; 37:151108. [PMID: 33431235 DOI: 10.1016/j.soncn.2020.151108] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Sarcopenia is known to influence cancer-related complications and overall survival. However, the effect of cancer treatment on the development or progression of sarcopenia is relatively unknown. The primary aim of this systematic review was to determine the prevalence and development of sarcopenia among people with bladder cancer. DATA SOURCES A systematic search was performed in PubMed, Web of Science, and EMBASE. Studies with ≥2 assessments of sarcopenia were eligible for inclusion. Five retrospective cohorts were included with a total of 438 participants. The baseline prevalence of sarcopenia across studies varied from 25% to 69% and post-treatment prevalence from 50% to 81%. The average loss of muscle mass was 2.2% to 10% during a time course of 3 to 12 months. CONCLUSION The prevalence of sarcopenia markedly increased during cancer treatment in patients with bladder cancer. Further research into the effect of different treatment regimens on the development of sarcopenia, and how these changes might affect functional capacity and survival is needed. IMPLICATIONS FOR NURSING PRACTICE The development of sarcopenia is important to understand because of its negative affect on quality of life, complications, and mortality. Further, understanding how sarcopenia develops during treatment could potentially strengthen nurses' future care plans for patients with bladder cancer.
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Affiliation(s)
- Tobias Tuse Dunk Hansen
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Lise Høj Omland
- Department of Oncology, 5073, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Annika von Heymann
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Christoffer Johansen
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Mikkel Bek Clausen
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy. University College Copenhagen, Faculty of Health, Copenhagen, Denmark
| | - Charlotte Suetta
- Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Bispebjerg and Frederiksberg Hospital-Bispebjerg, Copenhagen, Denmark; Geriatric Research Unit, Department of Medicine, Herlev and Gentofte Hospitals, Herlev Denmark; CopenAge-Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, 5073, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Bolette Skjødt Rafn
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
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14
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Esteve E, Rathleff MS, Hölmich P, Casals M, Clausen MB, Vicens-Bordas J, Pizzari T, Thorborg K. Groin problems from pre- to in-season: a prospective study on 386 male Spanish footballers. Res Sports Med 2020; 29:498-504. [PMID: 33317337 DOI: 10.1080/15438627.2020.1860044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study investigated the weekly prevalence of groin problems over a 3-week football pre-season, compared to a 39-week competitive in-season. We registered time-loss groin injuries, and self-reported weekly groin-pain in 17 amateur male football teams (386 players). The average weekly prevalence of groin problems (prevalence ratio (PR)) was 1.8 times higher (95% CI 1.6 to 2.0) during pre-season (21%) compared to in-season (12%). We found a higher weekly prevalence (PR 1.8; 95% CI 1.6 to 2.1) of groin problems without time loss, during the pre-season (19%) compared to the in-season (10%), but no significant difference in the weekly prevalence of groin problems with time loss (PR 1.5; 95% CI 1.0 to 2.4). Attention should be given to optimal load progression, and early implementation of preventive measures during the football pre-season to reduce the prevalence of groin problems in both pre- and in-season.
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Affiliation(s)
- Ernest Esteve
- School of Health and Sport Sciences (EUSES), Universitat de Girona, Salt, Spain.,Sportclínic, Physiotherapy and Sports Training Centre, Girona, Spain
| | - Michael Skovdal Rathleff
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.,Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
| | - Per Hölmich
- Sports Orthopedic Research Center (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Martí Casals
- Sport and Physical Activity Studies Centre (CEEAF), Faculty of Medicine, University of Vic - Central University of Catalonia, Barcelona, Spain.,Medical Department, Futbol Club Barcelona, Barça Innovation Hub, Barcelona, Spain
| | - Mikkel Bek Clausen
- Sports Orthopedic Research Center (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Jordi Vicens-Bordas
- Sportclínic, Physiotherapy and Sports Training Centre, Girona, Spain.,Sport and Physical Activity Studies Centre (CEEAF), Faculty of Medicine, University of Vic - Central University of Catalonia, Barcelona, Spain
| | - Tania Pizzari
- Department of Rehabilitation, Nutrition and Sport, La Trobe University Sport and Exercise Medicine Research Centre, Bundoora, Australia
| | - Kristian Thorborg
- Sports Orthopedic Research Center (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Denmark.,Physical Medicine and Rehabilitation - Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University, Hvidovre, Denmark
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15
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Lysdal FG, Bandholm T, Tolstrup JS, Clausen MB, Mann S, Petersen PB, Grønlykke TB, Kersting UG, Delahunt E, Virgile A, Thorborg K. Infographic. Does the Spraino low-friction shoe patch prevent lateral ankle sprain injury in indoor sports? A 510-participant pilot RCT. Br J Sports Med 2020; 55:510-511. [PMID: 33055132 DOI: 10.1136/bjsports-2020-103342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Filip Gertz Lysdal
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark .,Spraino ApS, Copenhagen, Denmark
| | - Thomas Bandholm
- Clinical Research Centre, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Physical and Occupational Therapy, Physical Medicine and Rehabilitation Research-Copenhagen, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Mikkel Bek Clausen
- School of Physiotherapy, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Kobenhavn, Denmark.,Department of Orthopedic Surgery, Sports Orthopedic Research Center-Copenhagen, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Stephanie Mann
- Clinical Research Centre, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Uwe G Kersting
- Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Adam Virgile
- College of Nursing and Health Sciences, University of Vermont, Burlington, Vermont, USA
| | - Kristian Thorborg
- Department of Physical and Occupational Therapy, Physical Medicine and Rehabilitation Research-Copenhagen, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Orthopedic Surgery, Sports Orthopedic Research Center-Copenhagen, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
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16
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Lysdal FG, Bandholm T, Tolstrup JS, Clausen MB, Mann S, Petersen PB, Grønlykke TB, Kersting UG, Delahunt E, Thorborg K. Does the Spraino low-friction shoe patch prevent lateral ankle sprain injury in indoor sports? A pilot randomised controlled trial with 510 participants with previous ankle injuries. Br J Sports Med 2020; 55:92-98. [PMID: 32796016 PMCID: PMC7788191 DOI: 10.1136/bjsports-2019-101767] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2020] [Indexed: 12/26/2022]
Abstract
Background Lateral ankle sprains are common in indoor sports. High shoe–surface friction is considered a risk factor for non-contact lateral ankle sprains. Spraino is a novel low-friction patch that can be attached to the outside of sports shoes to minimise friction at the lateral edge, which could mitigate the risk of such injury. We aimed to determine preliminary effectiveness (incidence rate and severity) and safety (harms) of Spraino to prevent lateral ankle sprains among indoor sport athletes. Methods In this exploratory, parallel-group, two-arm pilot randomised controlled trial, 510 subelite indoor sport athletes with a previous lateral ankle sprain were randomly allocated (1:1) to Spraino or ‘do-as-usual’. Allocation was concealed and the trial was outcome assessor blinded. Match and training exposure, number of injuries and associated time loss were captured weekly via text messages. Information on harms, fear-of-injury and ankle pain was also documented. Results 480 participants completed the trial. They reported a total of 151 lateral ankle sprains, of which 96 were categorised as non-contact, and 50 as severe. All outcomes favoured Spraino with incidence rate ratios of 0.87 (95% CI 0.62 to 1.23) for all lateral ankle sprains; 0.64 (95% CI 0.42 to 0.98) for non-contact lateral ankle sprains; and 0.47 (95% CI 0.25 to 0.88) for severe lateral ankle sprains. Time loss per injury was also lower in the Spraino group (1.8 vs 2.8 weeks, p=0.014). Six participants reported minor harms because of Spraino. Conclusion Compared with usual care, athletes allocated to Spraino had a lower risk of lateral ankle sprains and less time loss, with only few reported minor harms. Trial registration number NCT03311490.
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Affiliation(s)
- Filip Gertz Lysdal
- Department of Health Science and Technology, Sport Sciences, Aalborg University, Aalborg, Denmark .,Spraino ApS, Copenhagen, Denmark
| | - Thomas Bandholm
- Department of Physical and Occupational Therapy, Physical Medicine and Rehabilitation Research-Copenhagen, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.,Clinical Research Centre, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Mikkel Bek Clausen
- Department of Orthopedic Surgery, Sports Orthopedic Research Center-Copenhagen, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.,School of Physiotherapy, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Stephanie Mann
- Clinical Research Centre, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Pelle Baggesgaard Petersen
- Section for Surgical Pathophysiology 7621, Rigshospitalet, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | | | - Uwe G Kersting
- Department of Health Science and Technology, Sport Sciences, Aalborg University, Aalborg, Denmark.,Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Kristian Thorborg
- Department of Physical and Occupational Therapy, Physical Medicine and Rehabilitation Research-Copenhagen, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Orthopedic Surgery, Sports Orthopedic Research Center-Copenhagen, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
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17
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Esteve E, Clausen MB, Rathleff MS, Vicens‐Bordas J, Casals M, Palahí‐Alcàcer A, Hölmich P, Thorborg K. Prevalence and severity of groin problems in Spanish football: A prospective study beyond the time‐loss approach. Scand J Med Sci Sports 2020; 30:914-921. [DOI: 10.1111/sms.13615] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 11/12/2019] [Accepted: 12/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Ernest Esteve
- Sportclínic Physiotherapy and Sports Training Centre Girona Spain
- School of Health and Sports Sciences (EUSES) Universitat de Girona Salt Spain
| | - Mikkel Bek Clausen
- Department of Orthopedic Surgery Sports Orthopedic Research Center (SORC‐C) Copenhagen University Hospital Amager‐Hvidovre Denmark
- Bachelor's Degree Programme in Physiotherapy Faculty of Health and Technology University College Copenhagen Copenhagen Denmark
| | - Michael Skovdal Rathleff
- SMI Department of Health Science and Technology Faculty of Medicine Aalborg University Aalborg Denmark
- Department of Occupational Therapy and Physiotherapy Aalborg University Hospital Aalborg Denmark
| | - Jordi Vicens‐Bordas
- Sportclínic Physiotherapy and Sports Training Centre Girona Spain
- School of Health and Sports Sciences (EUSES) Universitat de Girona Salt Spain
- Department of Medical Sciences Universitat de Girona (UdG) Girona Spain
| | - Martí Casals
- Sport and Physical Activity Studies Centre (CEEAF) University of Vic – Central University of Catalonia Barcelona Spain
| | - Albert Palahí‐Alcàcer
- Sportclínic Physiotherapy and Sports Training Centre Girona Spain
- Nursing Faculty Universitat de Girona (UdG) Girona Catalonia Spain
| | - Per Hölmich
- Department of Orthopedic Surgery Sports Orthopedic Research Center (SORC‐C) Copenhagen University Hospital Amager‐Hvidovre Denmark
| | - Kristian Thorborg
- Department of Orthopedic Surgery Sports Orthopedic Research Center (SORC‐C) Copenhagen University Hospital Amager‐Hvidovre Denmark
- Physical Medicine and Rehabilitation – Copenhagen (PMR‐C) Amager‐Hvidovre Hospital Copenhagen University Hvidovre Denmark
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18
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Vicens-Bordas J, Esteve E, Fort-Vanmeerhaeghe A, Clausen MB, Bandholm T, Opar D, Shield A, Thorborg K. ECCENTRIC HAMSTRING STRENGTH IS ASSOCIATED WITH AGE AND DURATION OF PREVIOUS SEASON HAMSTRING INJURY IN MALE SOCCER PLAYERS. Int J Sports Phys Ther 2020; 15:246-253. [PMID: 32269858 PMCID: PMC7134347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND Eccentric hamstring strength seems important in reducing the odds of future hamstring injuries. While age and previous injury are well-known risk factors for future hamstring injuries, the association of age and previous hamstring injury with eccentric hamstring strength in the following season is unknown. PURPOSE To investigate the association of age and previous hamstring injury with preseason eccentric hamstring strength in soccer players, and to investigate the association between previous hamstring injury duration and preseason eccentric hamstring strength. STUDY DESIGN Descriptive, cross-sectional study. METHODS A convenience sample of 284 male amateur soccer players (age 18-38 years) was included in the analyses. Self-reported information about previous season hamstring injury and its duration (three weeks or less; more than three weeks) was collected. Preseason eccentric hamstring strength was obtained during the Nordic hamstring exercise using a field-based device. RESULTS Age had a negative association with preseason eccentric hamstring strength with 0.9% reduction per year. Players with a previous hamstring injury duration of more than three weeks (n=27) had 13% lower preseason eccentric hamstring strength compared to players without previous hamstring injury. CONCLUSION Older players have lower preseason eccentric hamstring strength than younger players. Players with a previous hamstring injury duration of more than three weeks have lower preseason eccentric hamstring strength than the rest of the players. These results highlight the need to monitor and address the identified weaknesses in eccentric hamstring strength in amateur soccer players, with specific emphasis on older players with a previous hamstring injury of longer duration. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
| | | | - Azahara Fort-Vanmeerhaeghe
- Faculty of Psychology, Education Sciences and Sport (FPCEE) and School of Health Sciences (FCS) Blanquerna, Universitat Ramon Llull, Barcelona, Catalonia, Spain
| | | | - Thomas Bandholm
- Physical Medicine and Rehabilitation Research – Copenhagen (PMR-C), Clinical Research Center, Department of Physical and Occupational Therapy, Department of Orthopedic Surgery, Amager-Hvidovre Hospital, Copenhagen University Hospital, Denmark
| | - David Opar
- School of Exercise Sciences, Australian Catholic University, Melbourne, Australia
| | - Anthony Shield
- Faculty of Health, School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Australia; and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Witten A, Barfod KW, Thorborg K, Foverskov M, Clausen MB. [Subacromial impingement syndrome]. Ugeskr Laeger 2019; 181:V03180215. [PMID: 30950368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Subacromial impingement syndrome is one of the most common causes of shoulder pain and is associated with substantial shoulder impairments. The initial treatment should be non-operative in form of rotator cuff and scapula strengthening exercises for at least three months. Not all patients respond satisfactorily to non-operative treatment, but only patients with persistent symptoms after sufficiently tried non-operative treatment, should be referred to an orthopaedic specialist.
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Christensen KB, Thorborg K, Hölmich P, Clausen MB. Rasch validation of the Danish version of the shoulder pain and disability index (SPADI) in patients with rotator cuff-related disorders. Qual Life Res 2018; 28:795-800. [PMID: 30456715 DOI: 10.1007/s11136-018-2052-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE The psychometric properties of the shoulder pain and disability index (SPADI) have been extensively evaluated using classical test theory, but very few studies have applied Rasch analysis. The purpose of this study was to validate the Danish version using Rasch analysis. METHODS Responses to the SPADI from 229 patients (48% female, mean age 54.5) were included in the Rasch analysis. Overall fit, individual item fit, local response dependence, dimensionality, targeting, reliability, and differential item functioning (DIF) were examined. RESULTS After iterative analyses, good fit to the Rasch model was observed, with acceptable targeting and uni-dimensionality. SPADI should be reported as two separate subscales: Pain and Functional Disability. The pain subscale initially demonstrated misfit due to local dependence and DIF, but a log linear Rasch model showed good fit to the Rasch model with acceptable targeting and uni-dimensionality. A six-item version of the disability subscale exhibited adequate fit in the Danish version. The same items were also found to fit the Rasch model in the English version. CONCLUSIONS The measurement properties of the Danish SPADI are similar to those of the English version. SPADI should be reported as two separate subscales. For the pain subscale, DIF with respect to age was disclosed, but the impact was small. The eight-item disability subscale did not fit the Rasch model. A six-item version of the disability subscale exhibited adequate fit in the Danish version. The same items were also found to fit the Rasch model in the English version.
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Affiliation(s)
- Karl Bang Christensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Kristian Thorborg
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Copenhagen, Denmark
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Per Hölmich
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Copenhagen, Denmark
| | - Mikkel Bek Clausen
- Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Copenhagen, Denmark
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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Clausen MB, Bandholm T, Rathleff MS, Christensen KB, Zebis MK, Graven-Nielsen T, Hölmich P, Thorborg K. The Strengthening Exercises in Shoulder Impingement trial (The SExSI-trial) investigating the effectiveness of a simple add-on shoulder strengthening exercise programme in patients with long-lasting subacromial impingement syndrome: Study protocol for a pragmatic, assessor blinded, parallel-group, randomised, controlled trial. Trials 2018; 19:154. [PMID: 29499710 PMCID: PMC5833202 DOI: 10.1186/s13063-018-2509-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 01/25/2018] [Indexed: 01/26/2023] Open
Abstract
Background Subacromial impingement syndrome (SIS) is a painful, and often long lasting, shoulder condition affecting patient function and quality of life. In a recent study, we observed major strength impairments in shoulder external rotation and abduction (~30%) in a population of patients with pronounced and long-lasting SIS. However, the current rehabilitation of such strength impairments may be inadequate, with novel rehabilitation programmes including exercise therapy only improving external rotation strength by 4–13%. As these previous studies are the basis of current practice, this suggests that the strengthening component could be inadequate in the rehabilitation of these patients, and it seems likely that more emphasis should be placed on intensifying this part of the rehabilitation. The purpose of this study is to investigate the effectiveness of a programme consisting of progressive home-based resistance training using an elastic band, aimed at improving shoulder external rotation and abduction strength, added to usual care and initiated shortly after diagnosis has been established. Methods A pragmatic randomised controlled superiority trial will be conducted, including 200 patients with pronounced and long-lasting SIS, diagnosed using predefined criteria. Participants will be randomised to receive either an add-on intervention of progressive home-based resistance training using an elastic band in addition to usual care or usual care alone in a 1:1 allocation ratio. The randomisation sequence is computer generated, with permuted blocks of random sizes. The primary outcome will be change in Shoulder Pain And Disability Index (SPADI) score from baseline to 16 weeks follow-up. Outcome assessors are blinded to group allocation. Intervention receivers will be kept blind to treatment allocation through minimal information about the content of the add-on intervention and control condition until group allocation is final. Analyses are performed by blinded data analysts. Discussion If effective, the simple shoulder strengthening exercise programme investigated in this trial could easily be added to usual care. The usefulness of the trial is further supported by the magnitude of the problem, the information gained from the study and the pragmatism, patient centeredness and transparency of the trial. Trial registration The trial is pre-registered at ClinicalTrials.gov with the ID NCT02747251 on April 19, 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2509-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mikkel Bek Clausen
- Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Sigurdsgade 26, DK-2200, Copenhagen N, Denmark. .,Sports Orthopaedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Kettegårds Allé 30, DK-2650, Hvidovre, Denmark. .,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Amager-Hvidovre, Kettegårds Allé 30, DK-2650, Hvidovre, Denmark.
| | - Thomas Bandholm
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Amager-Hvidovre, Kettegårds Allé 30, DK-2650, Hvidovre, Denmark.,Clinical Research Centre (056), Copenhagen University Hospital, Amager-Hvidovre, Kettegårds Allé 30, 2650, Hvidovre, Denmark
| | - Michael Skovdal Rathleff
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Health Science and Technology, Faculty of Medicine, Center for Sensory-Motor Interaction (SMI), Aalborg University, Aalborg, Denmark
| | | | - Mette Kreutzfeldt Zebis
- Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Sigurdsgade 26, DK-2200, Copenhagen N, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Fredrik Bajers Vej 7, Aalborg, Denmark
| | - Per Hölmich
- Sports Orthopaedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Kettegårds Allé 30, DK-2650, Hvidovre, Denmark
| | - Kristian Thorborg
- Sports Orthopaedic Research Center - Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Kettegårds Allé 30, DK-2650, Hvidovre, Denmark.,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Copenhagen University Hospital, Amager-Hvidovre, Kettegårds Allé 30, DK-2650, Hvidovre, Denmark
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Esteve E, Rathleff MS, Vicens-Bordas J, Clausen MB, Hölmich P, Sala L, Thorborg K. Preseason Adductor Squeeze Strength in 303 Spanish Male Soccer Athletes: A Cross-sectional Study. Orthop J Sports Med 2018; 6:2325967117747275. [PMID: 29349093 PMCID: PMC5768277 DOI: 10.1177/2325967117747275] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Hip adductor muscle weakness and a history of groin injury both have been identified as strong risk factors for sustaining a new groin injury. Current groin pain and age have been associated with hip adductor strength. These factors could be related, but this has never been investigated. Purpose: To investigate whether soccer athletes with past-season groin pain and with different durations of past-season groin pain had lower preseason hip adductor squeeze strength compared with those without past-season groin pain. We also investigated whether differences in preseason hip adductor squeeze strength in relation to past-season groin pain and duration were influenced by current groin pain and age. Study Design: Cross-sectional study; Level of evidence, 3. Methods: In total, 303 male soccer athletes (mean age, 23 ± 4 years; mean weight, 74.0 ± 7.9 kg; mean height, 178.1 ± 6.3 cm) were included in this study. Self-reported data regarding current groin pain, past-season groin pain, and duration were collected. Hip adductor squeeze strength was obtained using 2 different reliable testing procedures: (1) the short-lever (resistance placed between the knees, feet at the examination bed, and 45° of hip flexion) and (2) the long-lever (resistance placed between the ankles and 0° of hip flexion) squeeze tests. Results: There was no difference between those with (n = 123) and without (n = 180) past-season groin pain for hip adductor squeeze strength when adjusting for current groin pain and age. However, athletes with past-season groin pain lasting longer than 6 weeks (n = 27) showed 11.5% and 15.3% lower values on the short-lever (P = .006) and long-lever (P < .001) hip adductor squeeze strength tests, respectively, compared with those without past-season groin pain. Conclusion: Male soccer athletes with past-season groin pain lasting longer than 6 weeks are likely to begin the next season with a high-risk groin injury profile, including a history of groin pain and hip adduction weakness.
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Affiliation(s)
- Ernest Esteve
- Sportclínic, Physiotherapy and Sports Training Centre, Girona, Spain.,School of Health and Sport Sciences (EUSES), University of Girona, Salt, Spain
| | - Michael Skovdal Rathleff
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.,Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
| | - Jordi Vicens-Bordas
- Sportclínic, Physiotherapy and Sports Training Centre, Girona, Spain.,School of Health and Sport Sciences (EUSES), University of Girona, Salt, Spain
| | - Mikkel Bek Clausen
- Sports Orthopedic Research Center-Copenhagen, Department of Orthopedic Surgery, Amager-Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark.,Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark
| | - Per Hölmich
- Sports Orthopedic Research Center-Copenhagen, Department of Orthopedic Surgery, Amager-Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark
| | - Lluís Sala
- Sportclínic, Physiotherapy and Sports Training Centre, Girona, Spain
| | - Kristian Thorborg
- Sports Orthopedic Research Center-Copenhagen, Department of Orthopedic Surgery, Amager-Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark.,Physical Medicine and Rehabilitation Research-Copenhagen, Amager-Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark
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Ishøi L, Clausen MB, Aagaard P. Inappropriate Methods and Flawed Conclusion in: Can Resistance Training Enhance the Rapid Force Development in Unloaded Dynamic Isoinertial Multijoint Movements? A Systematic Review. J Strength Cond Res 2017; 32:e1-e2. [PMID: 29257797 DOI: 10.1519/jsc.0000000000002305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Lasse Ishøi
- 1Department of Orthopaedic Surgery, Sports Orthopaedic Research Center-Copenhagen (SORC-C), Copenhagen University Hospital, Amager-Hvidovre, Denmark2Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark3Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Thorborg K, Krommes KK, Esteve E, Clausen MB, Bartels EM, Rathleff MS. Infographic: Effects of specific injury prevention programmes in football. Br J Sports Med 2017; 51:1493. [PMID: 28838944 DOI: 10.1136/bjsports-2017-098305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre Hospital, Hvidovre, Copenhagen, Denmark
| | - Kasper Kühn Krommes
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre Hospital, Hvidovre, Copenhagen, Denmark
| | - Ernest Esteve
- Sportclínic, Physiotherapy and Sports Training Center, Girona, Gironés, Spain
| | - Mikkel Bek Clausen
- Bachelor's Degree Programme in Physiotherapy, Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark
| | - Else Marie Bartels
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Michael Skovdal Rathleff
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.,Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
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Clausen MB, Witten A, Holm K, Christensen KB, Attrup ML, Hölmich P, Thorborg K. Glenohumeral and scapulothoracic strength impairments exists in patients with subacromial impingement, but these are not reflected in the shoulder pain and disability index. BMC Musculoskelet Disord 2017; 18:302. [PMID: 28716019 PMCID: PMC5513121 DOI: 10.1186/s12891-017-1667-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 07/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pain and loss of function are cardinal symptoms associated with Subacromial impingement syndrome (SIS), while the presence and magnitude of deficits in strength and range of motion (ROM) are largely undescribed in non-athletic patients with SIS. Moreover, the relevance of impairments in strength and ROM to patient-reported shoulder function is not well described, even though testing of strength is recommended in clinical guidelines. The purpose of this study was, first, to investigate impairments in glenohumeral and scapulothoracic strength and in abduction and internal rotation ROM in patients with SIS. Secondly, to investigate the influence of these impairments on patient-reported shoulder function. METHODS Cross-sectional study based on a consecutive cohort of 157 patients referred to specialist examination and diagnosed with shoulder impingement (SIS) using predefined validated diagnostic criteria. Prior to specialist examination, questionnaires regarding shoulder function (Shoulder Pain And Disability Index, SPADI) demographics and kinesiophobia (TSK-11) were collected, and shoulder strength and ROM was measured by trained testers, with the patient reporting pain levels during testing and for the last week. Impairments in strength (abduction, external-rotation, (protraction and horizontal-extension) and ROM (abduction and internal rotation) were investigated in patients with unilateral shoulder pain, using one-sample t-tests. SPADI total score (SPADI) and SPADI function score (SPADI-F), were chosen as dependent variables in multiple regressions to investigate the influence of impairments on patient-reported shoulder function. Independent variables of interest were; strength in abduction and external rotation, abduction ROM, pain-during-tests, pain-last-week and kinesiophobia. RESULTS Significant impairments were found for all impairment tests, but most pronounced for glenohumeral strength and abduction ROM (29-33% deficits), and less for scapulothoracic strength and internal rotation ROM (8-18% deficits). Pain variables influenced SPADI and SPADI-F score to a high degree (R2 = 23.4-31.6%, p < 0.001), while strength and ROM did not. CONCLUSION Substantial strength and ROM impairments were found in patients with SIS. Only pain significantly influenced patient-reported function, while impairments did not. As SPADI score does not reflect the substantial strength and ROM impairments in external rotation and abduction observed in patients with SIS, supplemental assessment of these impairments seems important.
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Affiliation(s)
- M B Clausen
- Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Sigurdsgade 26, DK-2200, Copenhagen, Denmark. .,Sports Orthopedic Research Center - Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark. .,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
| | - A Witten
- Sports Orthopedic Research Center - Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - K Holm
- Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Sigurdsgade 26, DK-2200, Copenhagen, Denmark
| | - K B Christensen
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - M L Attrup
- Sports Orthopedic Research Center - Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - P Hölmich
- Sports Orthopedic Research Center - Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - K Thorborg
- Sports Orthopedic Research Center - Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark.,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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Thorborg K, Krommes KK, Esteve E, Clausen MB, Bartels EM, Rathleff MS. Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes. Br J Sports Med 2017; 51:562-571. [PMID: 28087568 DOI: 10.1136/bjsports-2016-097066] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To investigate the effect of FIFA injury prevention programmes in football (FIFA 11 and FIFA 11+). DESIGN Systematic review and meta-analysis. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials comparing the FIFA injury prevention programmes with a control (no or sham intervention) among football players. DATA SOURCES MEDLINE via PubMed, EMBASE via OVID, CINAHL via Ebsco, Web of Science, SportDiscus and Cochrane Central Register of Controlled Trials, from 2004 to 14 March 2016. RESULTS 6 cluster-randomised controlled trials had assessed the effect of FIFA injury prevention programmes compared with controls on the overall football injury incidence in recreational/subelite football. These studies included 2 specific exercise-based injury prevention programmes: FIFA 11 (2 studies) and FIFA 11+ (4 studies). The primary analysis showed a reduction in the overall injury risk ratio of 0.75 (95% CI 0.57 to 0.98), p=0.04, in favour of the FIFA injury prevention programmes. Secondary analyses revealed that when pooling the 4 studies applying the FIFA 11+ prevention programme, a reduction in the overall injury risk ratio (incidence rate ratio (IRR) 0.61; 95% CI 0.48 to 0.77, p<0.001) was present in favour of the FIFA 11+ prevention programme. No reduction was present when pooling the 2 studies including the FIFA 11 prevention programme (IRR 0.99; 95% CI 0.80 to 1.23, p=0.940). CONCLUSIONS An injury-preventing effect of the FIFA injury prevention programmes compared with controls was shown in football. This effect was induced by the FIFA 11+ prevention programme which has a substantial injury-preventing effect by reducing football injuries by 39%, whereas a preventive effect of the FIFA 11 prevention programme could not be documented. TRIAL REGISTRATION NUMBER PROSPERO CRD42015024120.
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Affiliation(s)
- Kristian Thorborg
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre Hospital, Copenhagen University, Hvidovre, Denmark.,Department of Physical Medicine and Rehabilitation-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University, Hvidovre, Denmark
| | - Kasper Kühn Krommes
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre Hospital, Copenhagen University, Hvidovre, Denmark.,Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ernest Esteve
- University School of Health and Sport Sciences, Universitat de Girona (EUSES-UdG), Carrer de Francesc Macia 65, Girona, Spain.,Sportclinic, Physiotherapy and Sports Training Center, Girona, Spain
| | - Mikkel Bek Clausen
- Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen N, Denmark
| | - Else Marie Bartels
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Michael Skovdal Rathleff
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.,Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
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Thorborg K, Krommes K, Esteve E, Clausen MB, Bartels EM, Rathleff MS. High Risk of Bias and Low Transparency in "How Effective are F-MARC Injury Prevention Programs for Soccer Players? A Systematic Review and Meta-Analysis". Sports Med 2015; 46:293-4. [PMID: 26712508 DOI: 10.1007/s40279-015-0458-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Kristian Thorborg
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. .,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Kasper Krommes
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ernest Esteve
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Sportclinic, Physiotherapy and Sports Training Center, Girona, Catalonia, Spain
| | - Mikkel Bek Clausen
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center-Copenhagen (SORC-C), Amager-Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Bachelor's Degree Programme in Physiotherapy, Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark
| | - Else Marie Bartels
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Michael Skovdal Rathleff
- Research Unit for General Practice in Aalborg, Clinical Institute, Aalborg University, Aalborg, Denmark.,Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
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Clausen MB, Tang L, Zebis MK, Krustrup P, Hölmich P, Wedderkopp N, Andersen LL, Christensen KB, Møller M, Thorborg K. Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football. Scand J Med Sci Sports 2015; 26:919-26. [PMID: 26179111 DOI: 10.1111/sms.12521] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2015] [Indexed: 12/25/2022]
Abstract
Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15-18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (< 80 points) were chosen as independent variables in the risk factor analyses. The study showed that self-reported previous knee injury significantly increased the risk of time-loss knee injury [relative risk (RR): 3.65, 95% confidence (CI) 1.73-7.68; P < 0.001]. Risk of time-loss knee injury was also significantly increased in players with low KOOS subscale scores (< 80 points) in Activities of Daily Living (RR: 5.0), Sport/Recreational (RR: 2.2) and Quality of Life (RR: 3.0) (P < 0.05). In conclusion, self-reported previous knee injury and low scores in three KOOS subscales significantly increase the risk of future time-loss knee injury in adolescent female football.
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Affiliation(s)
- M B Clausen
- Sports Orthopaedic Research Center - Copenhagen, Arthroscopic Center Amager, Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Amager-Hvidovre, Denmark.,Bachelor's Degree Programme in Physiotherapy, Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark
| | - L Tang
- Bachelor's Degree Programme in Physiotherapy, Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark.,CopenRehab, Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - M K Zebis
- Bachelor's Degree Programme in Physiotherapy, Department of Physiotherapy and Occupational Therapy, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark.,Gait Analysis Laboratory, Copenhagen University Hospital, Copenhagen, Hvidovre, Denmark
| | - P Krustrup
- Department of Nutrition, Exercise and Sports (NEXS), Section of Human Physiology, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark.,Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke's Campus, University of Exeter, Exeter, UK
| | - P Hölmich
- Sports Orthopaedic Research Center - Copenhagen, Arthroscopic Center Amager, Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Amager-Hvidovre, Denmark
| | - N Wedderkopp
- Sport Medicine Clinic, Orthopaedic Department, Hospital of Lillebaelt, Institute of Regional Health Service Research and Center for Research in Childhood Health, IOB, University of Southern Denmark, Odense, Denmark
| | - L L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - K B Christensen
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - M Møller
- Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, Denmark
| | - K Thorborg
- Sports Orthopaedic Research Center - Copenhagen, Arthroscopic Center Amager, Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Amager-Hvidovre, Denmark
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Clausen MB, Zebis MK, Møller M, Krustrup P, Hölmich P, Wedderkopp N, Andersen LL, Christensen KB, Thorborg K. High injury incidence in adolescent female soccer. Am J Sports Med 2014; 42:2487-94. [PMID: 24989492 DOI: 10.1177/0363546514541224] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous studies report varying rates of time-loss injuries in adolescent female soccer, ranging from 2.4 to 5.3 per 1000 athlete-exposures or 2.5 to 3.7 per 1000 hours of exposure. However, these studies collected data using traditional injury reports from coaches or medical staff, with methods that significantly underestimate injury rates compared with players' self-reports. PURPOSE The primary aim was to investigate the injury incidence in adolescent female soccer using self-reports via mobile telephone text messaging. The secondary aim was to explore the association between soccer exposure, playing level, and injury risk. STUDY DESIGN Descriptive epidemiology study and cohort study; Level of evidence, 2 and 3. METHODS During a full adolescent female soccer season in Denmark (February-June 2012), a population-based sample of 498 girls aged 15 to 18 years was included in the prospective registration of injuries. All players were enrolled on a team participating in Danish Football Association series. Soccer injuries and exposure were reported weekly by answers to standardized text message questions, followed by individual injury interviews. Soccer exposure and playing levels were chosen a priori as the only independent variables of interest in the risk factor analyses. Injury rates and relative risks were estimated using Poisson regression. Generalized estimation equations were used to take into account that players were clustered within teams. RESULTS There were 498 players who sustained a total of 424 soccer injuries. The incidence of injuries was 15.3 (95% CI, 13.1-17.8), the incidence of time-loss injuries was 9.7 (95% CI, 8.2-11.4), and the incidence of severe injuries was 1.1 (95% CI, 0.7-1.6) per 1000 hours of soccer exposure. Higher average exposure in injury-free weeks was associated with a lower injury risk (P value for trend <.001), and players with low exposure (≤1 h/wk) were 3 to 10 times more likely to sustain a time-loss injury compared with other players (P < .01). Playing level was not associated with the risk of time-loss injuries (P = .18). CONCLUSION The injury incidence in adolescent female soccer is high, and this includes many severe injuries. Players with low soccer participation (≤1 h/wk) have a significantly higher injury risk compared with players participating more frequently.
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Affiliation(s)
- Mikkel Bek Clausen
- Sports Orthopaedic Research Center-Copenhagen, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark School of Physiotherapy, Institute of Rehabilitation and Nutrition, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark
| | - Mette Kreutzfeldt Zebis
- Sports Orthopaedic Research Center-Copenhagen, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark School of Physiotherapy, Institute of Rehabilitation and Nutrition, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Denmark Gait Analysis Laboratory, Copenhagen University Hospital, Hvidovre, Denmark
| | - Merete Møller
- Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Peter Krustrup
- Section of Human Physiology, Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark Sport and Health Sciences, College of Life and Environmental Sciences, St Luke's Campus, University of Exeter, Exeter, UK
| | - Per Hölmich
- Sports Orthopaedic Research Center-Copenhagen, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Niels Wedderkopp
- Sport Medicine Clinic, Department of Orthopaedics, Hospital of Lillebaelt, Institute of Regional Health Service Research and Center for Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | | | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark
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