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Edouard P, Lahti J, Nagahara R, Samozino P, Navarro L, Guex K, Rossi J, Brughelli M, Mendiguchia J, Morin JB. Low Horizontal Force Production Capacity during Sprinting as a Potential Risk Factor of Hamstring Injury in Football. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7827. [PMID: 34360125 PMCID: PMC8345704 DOI: 10.3390/ijerph18157827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/18/2021] [Accepted: 07/06/2021] [Indexed: 01/09/2023]
Abstract
Clear decreases in horizontal force production capacity during sprint acceleration have been reported after hamstring injuries (HI) in football players. We hypothesized that lower FH0 is associated with a higher HI occurrence in football players. We aimed to analyze the association between sprint running horizontal force production capacities at low (FH0) and high (V0) velocities, and HI occurrence in football. This prospective cohort study included 284 football players over one season. All players performed 30 m field sprints at the beginning and different times during the season. Sprint velocity data were used to compute sprint mechanical properties. Players' injury data were prospectively collected during the entire season. Cox regression analyses were performed using new HI as the outcome, and horizontal force production capacity (FH0 and V0) was used at the start of the season (model 1) and at each measurement time point within the season (model 2) as explanatory variables, adjusted for individual players' (model 2) age, geographical group of players, height, body mass, and previous HI, with cumulative hours of football practice as the time scale. A total of 47 new HI (20% of all injuries) were observed in 38 out of 284 players (13%). There were no associations between FH0 and/or V0 values at the start of the season and new HI occurrence during the season (model 1). During the season, a total of 801 measurements were performed, from one to six per player. Lower measured FH0 values were significantly associated with a higher risk of sustaining HI within the weeks following sprint measurement (HR = 2.67 (95% CI: 1.51 to 4.73), p < 0.001) (model 2). In conclusion, low horizontal force production capacities at low velocity during early sprint acceleration (FH0) may be considered as a potential additional factor associated with HI risk in a comprehensive, multifactorial, and individualized approach.
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Affiliation(s)
- Pascal Edouard
- UJM-Saint-Etienne, Laboratory Interuniversity of Human Movement Sciences, University Lyon, EA 7424, F-42023 Saint-Etienne, France; (J.R.); (J.-B.M.)
- Sports Medicine Unity, Department of Clinical and Exercise Physiology, Faculty of Medicine, University Hospital of Saint-Etienne, CEDEX 2, F-42055 Saint-Etienne, France
| | - Johan Lahti
- LAMHESS, Université Côte d’Azur, F-06200 Nice, France;
| | - Ryu Nagahara
- Sports Research and Development Core, University of Tsukuba, Ibaraki 305-8574, Japan;
- Faculty of Sports and Budo Coaching Studies, National Institute of Fitness and Sports in Kanoya, Kagoshima 891-2393, Japan
| | - Pierre Samozino
- Laboratory Interuniversity of Human Movement Sciences, University Savoie Mont Blanc, EA 7424, F-73000 Chambéry, France;
| | - Laurent Navarro
- Mines Saint-Etienne, Centre CIS, Université de Lyon, Université Jean Monnet, INSERM, U 1059 Sainbiose, F-42023 Saint-Etienne, France;
| | - Kenny Guex
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland;
- Department of Sprints, Hurdles and Relays, Swiss Athletics, Haus des Sports, 3063 Ittigen, Switzerland
| | - Jérémy Rossi
- UJM-Saint-Etienne, Laboratory Interuniversity of Human Movement Sciences, University Lyon, EA 7424, F-42023 Saint-Etienne, France; (J.R.); (J.-B.M.)
| | - Matt Brughelli
- Sports Performance Research Institute New Zealand, Auckland University of Technology, 1010 Auckland, New Zealand;
| | - Jurdan Mendiguchia
- Department of Physical Therapy, Zentrum Rehabilitation and Performance Center, 31002 Pamplona, Spain;
| | - Jean-Benoît Morin
- UJM-Saint-Etienne, Laboratory Interuniversity of Human Movement Sciences, University Lyon, EA 7424, F-42023 Saint-Etienne, France; (J.R.); (J.-B.M.)
- LAMHESS, Université Côte d’Azur, F-06200 Nice, France;
- Sports Performance Research Institute New Zealand, Auckland University of Technology, 1010 Auckland, New Zealand;
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52
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Smith MD, Vicenzino B, Bahr R, Bandholm T, Cooke R, Mendonça LDM, Fourchet F, Glasgow P, Gribble PA, Herrington L, Hiller CE, Lee SY, Macaluso A, Meeusen R, Owoeye OBA, Reid D, Tassignon B, Terada M, Thorborg K, Verhagen E, Verschueren J, Wang D, Whiteley R, Wikstrom EA, Delahunt E. Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework-an international multidisciplinary consensus. Br J Sports Med 2021; 55:1270-1276. [PMID: 34158354 DOI: 10.1136/bjsports-2021-104087] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute lateral ankle sprain injuries. We aimed to develop a list of assessment items to address this gap. METHODS We used a three-round Delphi survey approach to develop consensus of opinion among 155 globally diverse health professionals working in elite field or court sports. This involved surveys that were structured in question format with both closed-response and open-response options. We asked panellists to indicate their agreement about whether or not assessment items should support the RTS decision after an acute lateral ankle sprain injury. The second and third round surveys included quantitative and qualitative feedback from the previous round. We defined a priori consensus being reached at >70% agree or disagree responses. RESULTS Sixteen assessment items reached consensus to be included in the RTS decision after an acute lateral ankle sprain injury. They were mapped to five domains with 98% panellist agreement-PAASS: Pain (during sport participation and over the last 24 hours), Ankle impairments (range of motion; muscle strength, endurance and power), Athlete perception (perceived ankle confidence/reassurance and stability; psychological readiness), Sensorimotor control (proprioception; dynamic postural control/balance), Sport/functional performance (hopping, jumping and agility; sport-specific drills; ability to complete a full training session). CONCLUSION Expert opinion indicated that pain severity, ankle impairments, sensorimotor control, athlete perception/readiness and sport/functional performance should be assessed to inform the RTS decision following an acute lateral ankle sprain injury. TRIAL REGISTRATION NUMBER ACTRN12619000522112.
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Affiliation(s)
- Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Roald Bahr
- Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway.,Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Thomas Bandholm
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy and Department of Clinical Research, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rosalyn Cooke
- English Institute of Sport, Manchester Institute for Health and Performance, Manchester, UK
| | - Luciana De Michelis Mendonça
- Physical Therapy Department, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.,Graduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - François Fourchet
- Physiotherapy Department, Hôpital de La Tour, Meyrin, Switzerland.,Laboratoire Interuniversitaire de Biologie de la Motricité, UJM-Saint-Etienne, University of Lyon, Lyon, France
| | - Philip Glasgow
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,School of Sport, Ulster University, Jordanstown, UK
| | - Phillip A Gribble
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Lee Herrington
- English Institute of Sport, Manchester Institute for Health and Performance, Manchester, UK.,Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
| | - Claire E Hiller
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Seoul, South Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Seoul, South Korea
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Roma, Italy.,Villa Stuart Sport Clinic, FIFA Medical Centre of Excellence, Roma, Italy
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Oluwatoyosi B A Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Saint Louis, Missouri, USA.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Duncan Reid
- Faculty of Health and Environmental Sciences, School of Clinical Sciences, AUT University, Auckland, New Zealand
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kristian Thorborg
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre University Hospital, Copenhagen, Denmark.,Physical Medicine Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre University Hospital, Copenhagen, Denmark
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, VUmc site, Amsterdam, Netherlands
| | - Jo Verschueren
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dan Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Rod Whiteley
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,School of Human Movement & Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Erik A Wikstrom
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - 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
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53
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Return to Play After a Hamstring Strain Injury: It is Time to Consider Natural Healing. Sports Med 2021; 51:2067-2077. [PMID: 34143413 DOI: 10.1007/s40279-021-01494-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 01/15/2023]
Abstract
Return to play (RTP) criteria after hamstring strain injuries (HSIs) help clinicians in deciding whether an athlete is ready to safely resume previous sport activities. Today, functional and sport-specific training tests are the gold standard in the decision-making process. These criteria lead to an average RTP time between 11 and 25 days after a grade 1 or 2 HSI. However, the high re-injury rates indicate a possible inadequacy of the current RTP criteria. A possible explanation for this could be the neglect of biological healing time. The present review shows that studies indicating time as a possible factor within the RTP-decision are very scarce. However, studies on biological muscle healing showed immature scar tissue and incomplete muscle healing at the average moment of RTP. Twenty-five percent of the re-injuries occur in the first week after RTP and at the exact same location as the index injury. This review supports the statement that functional recovery precedes the biological healing of the muscle. Based on basic science studies on biological muscle healing, we recommend a minimum period of 4 weeks before RTP after a grade 1 or 2 HSI. In conclusion, we advise a comprehensive RTP functional test battery with respect for the natural healing process. Before deciding RTP readiness, clinicians should reflect whether or not it is biologically possible for the injured tissue to have regained enough strength to withstand the sport-specific forces. In an attempt to reduce the detrimental injury-reinjury cycle, it is time to start considering (biological healing) time.
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Rodas G, Soler-Rich R, Rius-Tarruella J, Alomar X, Balius R, Orozco L, Masci L, Maffulli N. Effect of Autologous Expanded Bone Marrow Mesenchymal Stem Cells or Leukocyte-Poor Platelet-Rich Plasma in Chronic Patellar Tendinopathy (With Gap >3 mm): Preliminary Outcomes After 6 Months of a Double-Blind, Randomized, Prospective Study. Am J Sports Med 2021; 49:1492-1504. [PMID: 33783227 DOI: 10.1177/0363546521998725] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patellar tendinopathy is common. The success of traditional management, including isometric or eccentric exercises combined with shockwave therapy and even surgery, is limited. Therefore, it is important to determine whether biological treatments such as ultrasound-guided intratendinous and peritendinous injections of autologous expanded bone marrow mesenchymal stem cells (BM-MSCs) or leukocyte-poor platelet-rich plasma (Lp-PRP) improve clinical outcomes in athletic patients with patellar tendinopathy. STUDY DESIGN Randomized controlled trial; Level of evidence, 2. METHODS A prospective, double-blinded, randomized, 2-arm parallel group, active controlled, phase 1/2 single-center clinical study was performed in patients who had proximal patellar tendinopathy with a lesion >3 mm. A total of 20 participants (age 18-48 years) with pain for >4 months (mean, 23.6 months) and unresponsive to nonoperative treatments were randomized into 2 groups. Of these, 10 participants were treated with BM-MSC (20 × 106 cells) and 10 with Lp-PRP. Both groups performed the same postintervention rehabilitation protocol. Outcomes included the Victorian Institute of Sport Assessment for pain (VISA-P), self-reported tendon pain during activity (visual analog scale [VAS]), muscle function by dynamometry, tendon thickness and intratendinous vascularity by ultrasonographic imaging and Doppler signal, ultrasound tissue characterization (UTC) echo type changes, and magnetic resonance imaging (MRI) T2-weighted mapping changes. Participants were followed longitudinally for 6 months. RESULTS The average VAS scores improved in both groups at all time points, and there was a significant reduction in pain during sporting activities (P < .05). In both groups, the average mean VISA-P scores at 6 months were significantly increased compared with baseline (66 BM-MSC group and 72.90 Lp-PRP group), with no significant differences in VAS or VISA-P scores between the groups. There were statistically significant greater improvements in tendon structure on 2-dimensional ultrasound and UTC in the BM-MSC group compared with the Lp-PRP group at 6 months. Similarly, the BM-MSC group demonstrated significant evidence of restoration of tendon structure on MRI compared with the Lp-PRP group at 6 months. Only the participants in the BM-MSC group showed evidence of normalization of tendon structure, with statistically significant differences between the groups on T2-weighted, fat-saturated sagittal and coronal scans and hypersignal in T2-weighted on spin-echo T2-weighted coronal MRI scan. Both treatments were safe, and no significant adverse events were reported in either group. CONCLUSION Treatment with BM-MSC or Lp-PRP in combination with rehabilitation in chronic patellar tendinopathy is effective in reducing pain and improving activity levels in active participants. Participants who received BM-MSC treatment demonstrated greater improvement in tendon structure compared with those who received Lp-PRP. REGISTRATION 2016-001262-28 (EudraCT identifier); NCT03454737 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Gil Rodas
- Medical Department FC Barcelona, Barcelona, Spain.,Sports Medicine Unit, Clínic Hospital and Sant Joan de Déu Hospital, Barcelona, Spain
| | - Robert Soler-Rich
- Institut de Teràpia Regenerativa Tissular, Centro Médico Teknon, Barcelona, Spain
| | - Joan Rius-Tarruella
- Institut de Teràpia Regenerativa Tissular, Centro Médico Teknon, Barcelona, Spain
| | - Xavier Alomar
- Diagnóstico por la Imagen, Clínica Creu Blanca, Barcelona, Spain
| | - Ramon Balius
- Consell Català de l'Esport, Generalitat de Catalunya, Barcelona, Spain
| | - Lluís Orozco
- Institut de Teràpia Regenerativa Tissular, Centro Médico Teknon, Barcelona, Spain
| | - Lorenzo Masci
- Institute of Sports Exercise and Health (ISEH), London, UK
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine, Surgery and Dentistry, Salerno, Italy.,Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Staffordshire, UK
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55
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Exercise-Based Strategies to Prevent Muscle Injury in Male Elite Footballers: An Expert-Led Delphi Survey of 21 Practitioners Belonging to 18 Teams from the Big-5 European Leagues. Sports Med 2021; 50:1667-1681. [PMID: 32676903 PMCID: PMC7441050 DOI: 10.1007/s40279-020-01315-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Purpose To define based on expert opinion and practical experience using a systematic and scientific approach, (1) the perceived most effective exercise-based strategies to prevent muscle injury in elite footballers; and, (2) when and how these exercise programs are prescribed based on the number of days between games i.e. implementation strategy. Methods A Delphi survey obtained opinions and assessed for agreement. Delphi respondents consisted of 21 experienced sports practitioners (12 ± 5.3 years in elite football and with an academic background) belonging to 18 teams from the Big-5 European football leagues; England, France, Germany, Italy, Spain. Three teams were represented collaboratively by two experts. The Delphi process involves sequential rounds each evolving based on the responses from the previous. The number of rounds is not pre-defined and continues until an agreement is either achieved or it is clear that no agreement will be reached. Frequency of responses was recorded where the agreement was sought (i.e. in closed questions) and an agreement was achieved if ≥ 13/18 (70%) respondents agreed. For open-ended questions, a qualitative content analysis was performed to identify recurring themes and when themes were specified by ≥ 13 (70%), these were also considered as reaching an agreement. Practitioners had the opportunity to raise concerns if they disagreed with the ‘agreement from recurrent themes’. Results There were four Delphi rounds (100% response for each round). Sprinting and High-Speed Running (HSR) focused exercises were agreed as most effective (perceived) to prevent muscle injuries. Eccentric exercise was perceived as the next most effective. It was agreed that sprinting and HSR be integrated into coaches training, and target 100% of players worst-case match scenario (e.g. volume, intensity) based on individual maximum speeds. Eccentric exercise was recommended to be implemented according to the context of the main football session and planned/actual sprinting and HSR content. It was agreed that eccentrics can be performed before or after training, context dependent. The day to perform specific sprinting and HSR or eccentric exercises depended on the proximity of previous and upcoming matches. Other exercises reaching agreement as ‘somewhat effective’ included concentric and isometric, horizontal and vertical plyometrics, coordination, core and dynamic flexibility in addition to core stability. No agreement was reached for multi-joint, resisted sprinting, kicking or agility exercises nor simultaneous single-leg strength and stability. Finally, no agreement was reached regarding programming variables e.g. sets, repetitions as deemed too contextual. Conclusion Regarding exercise-based strategies, particular importance agreed by the Delphi expert group was to focus on sprinting, HSR and eccentric exercises, integrated with a variety of other exercise modes which also carry some level of effectiveness in a multidimensional programme. Context was agreed to be key and decision-making about when to undertake/ how to prescribe exercise strategies to be made according to the content of normal football training and the proximity of matches.
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56
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Jukic I, Calleja-González J, Cuzzolin F, Sampaio J, Cos F, Milanovic L, Krakan I, Ostojic S, Olmo J, Requena B, Njaradi N, Sassi R, Rovira M, Kocaoglu B. The 360° Performance System in Team Sports: Is It Time to Design a "Personalized Jacket" for Team Sports Players? Sports (Basel) 2021; 9:sports9030040. [PMID: 33802654 PMCID: PMC8002432 DOI: 10.3390/sports9030040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/21/2022] Open
Abstract
Elite performance in team sports attracts the attention of the general public. In particular, the best players became incredibly skilled and physically powerful, which is a fact that potentiates the delivery of a product that is considered attractive, exciting, and competitive. Not surprisingly, this is a very valuable product from an economic and social standpoint; thus, all sports professionals are extremely interested in developing new procedures to improve their sports performance. Furthermore, the great interests of the various stakeholders (owners, chief executive officers (CEOs), agents, fans, media, coaches, players, families, and friends) are one of the main reasons for this development under the sports science umbrella and the accompanying sports industry. All their personal performances should be coordinated and put into practice by the sports team. In this scientific and applied study, we primarily dealt with the individual treatment of players in order to improve their personal performance and, consequently, the team’s sporting performance.
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Affiliation(s)
- Igor Jukic
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Biotrening Ltd., 10000 Zagreb, Croatia
| | - Julio Calleja-González
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Faculty of Education and Sport, University of Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain
- Correspondence:
| | | | - Jaime Sampaio
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, 5001-801 Vila Real, Portugal;
| | - Francesc Cos
- National Institute of Physical Education (INEFC), University of Barcelona, 08038 Barcelona, Spain;
- Manchester City Football Club, Manchester M11 4TS, UK
| | - Luka Milanovic
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Biotrening Ltd., 10000 Zagreb, Croatia
| | - Ivan Krakan
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Biotrening Ltd., 10000 Zagreb, Croatia
| | - Sergej Ostojic
- Faculty of Physical Education and Sport, University of Novi Sad, 21000 Novi Sad, Serbia;
- Center for Health, Exercise and Sport Sciences, 11000 Belgrade, Serbia
| | - Jesús Olmo
- Football Science Institute, 18016 Granada, Spain; (J.O.); (B.R.)
| | - Bernardo Requena
- Football Science Institute, 18016 Granada, Spain; (J.O.); (B.R.)
| | - Nenad Njaradi
- Football Club Deportivo Alavés, 01007 Vitoria-Gasteiz, Spain;
| | | | - Mar Rovira
- Tecnocampus, Universitat Pompeu Fabra, Grup de recerca en Activitat Física, Rendiment i Salut (AFIRS), Av. d’Ernest Lluch, 32, 08302 Mataró, Spain;
| | - Baris Kocaoglu
- Faculty of Medicine, Acibadem University, Küçükbakkalköy, Kayışdağı Cd., 34755 Ataşehir/İstanbul, Turkey;
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Rüther J, Willauschus M, Hammer A, Schröder J, Bail HJ, Geßlein M. [Analysis of muscle injuries and return-to-training in elite Taekwondo athletes: results of a prospective cohort study over a period of five years]. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2021; 35:52-57. [PMID: 33572005 DOI: 10.1055/a-1262-2175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Muscle injuries frequently occur in sports involving explosive movement patterns, and they can cause considerable downtime. There is a lack of detailed data on muscle injuries in Olympic elite Taekwondo. METHODS All injuries sustained by 76 elite Taekwondo athletes from a national Olympic training centre during training and competition were prospectively recorded over a period of five years. Data on muscle injuries, including location and time elapsed until return-to-training, were extracted from medical records. Injuries were diagnosed by means of MRI and were classified according to the British Athletes Muscle Injury System. The relationship between MRI classification subgroups and time elapsed until return-to-training was assessed. RESULTS Mean age of athletes was 22.5 ± 3.2 (16-27) years with an average Taekwondo experience of 12.1 ± 4.0 (7-20) years. Hamstring muscles were most commonly injured (48.4 %), followed by quadriceps muscles (32.3 %) and calf muscles (9.6 %). The analysis of MRI injury subgroups showed grade 1 (32.2 %) and grade 2 (41.9 %) injuries in most cases. A positive correlation was found between injury groups and return-to-training (r = 0.56). The comparison between different injury groups and time elapsed until return-to-training also revealed significant differences (p < 0.0001). CONCLUSION Hamstring muscles are the most injured muscles in Taekwondo besides the quadriceps femoris muscle. Most injuries were mild to moderate (grade 1-2). The time needed for return-to-training increased significantly with the severity of injuries diagnosed by MRI.
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Affiliation(s)
- Johannes Rüther
- Universitätsklinik für Orthopädie und Unfallchirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - Maximilian Willauschus
- Universitätsklinik für Orthopädie und Unfallchirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - Alexander Hammer
- Universitätsklinik für Orthopädie und Unfallchirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
- Universitätsklinik für Neurochirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - Jörg Schröder
- Klinik für Unfallchirurgie und Orthopädie, Unfallkrankenhaus Berlin
| | - Hermann Josef Bail
- Universitätsklinik für Orthopädie und Unfallchirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| | - Markus Geßlein
- Universitätsklinik für Orthopädie und Unfallchirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
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58
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van de Hoef PA, Brink MS, van der Horst N, van Smeden M, Backx FJG. The prognostic value of the hamstring outcome score to predict the risk of hamstring injuries. J Sci Med Sport 2021; 24:641-646. [PMID: 33478885 DOI: 10.1016/j.jsams.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 08/25/2020] [Accepted: 01/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Hamstring injuries are common among soccer players. The hamstring outcome score (HaOS) might be useful to identify amateur players at risk of hamstring injury. Therefore the aims of this study were: To determine the association between the HaOS and prior and new hamstring injuries in amateur soccer players, and to determine the prognostic value of the HaOS for identifying players with or without previous hamstring injuries at risk of future injury. DESIGN Cohort study. METHODS HaOS scores and information about previous injuries were collected at baseline and new injuries were prospectively registered during a cluster-randomized controlled trial involving 400 amateur soccer players. Analysis of variance and t-tests were used to determine the association between the HaOS and previous and new hamstring injury, respectively. Logistic regression analysis indicated the prognostic value of the HaOS for predicting new hamstring injuries. RESULTS Analysis of data of 356 players indicated that lower HaOS scores were associated with more previous hamstring injuries (F=17.4; p=0.000) and that players with lower HaOS scores sustained more new hamstring injuries (T=3.59, df=67.23, p=0.001). With a conventional HaOS score cut-off of 80%, logistic regression models yielded a probability of hamstring injuries of 11%, 18%, and 28% for players with 0,1, or 2 hamstring injuries in the previous season, respectively. CONCLUSIONS The HaOS is associated with previous and future hamstring injury and might be a useful tool to provide players with insight into their risk of sustaining a new hamstring injury risk when used in combination with previous injuries.
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Affiliation(s)
- P A van de Hoef
- Utrecht University, University Medical Center, Division Brain, Department of Rehabilitation, Physical Therapy Science & Sports, Utrecht, The Netherlands.
| | - M S Brink
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | - N van der Horst
- FIFA Medical Center, Royal Netherlands Football Association, Zeist, The Netherlands
| | - M van Smeden
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - F J G Backx
- Utrecht University, University Medical Center, Division Brain, Department of Rehabilitation, Physical Therapy Science & Sports, Utrecht, The Netherlands
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SPRINT PERFORMANCE IN FOOTBALL (SOCCER) PLAYERS WITH AND WITHOUT A PREVIOUS HAMSTRING STRAIN INJURY: AN EXPLORATIVE CROSS-SECTIONAL STUDY. Int J Sports Phys Ther 2020; 15:947-957. [PMID: 33344011 DOI: 10.26603/ijspt20200947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Hamstring strain injuries are common in many sports. Following a hamstring injury, deficits in peak and explosive strength may persist after return to sport potentially affecting sprint performance. Assessment of repeated-sprint ability is recognized as an important part of the return to sport evaluation after a hamstring injury.Purpose: This purpose of this exploratory cross-sectional study was to compare sprinting performance obtained during a repeated-sprint test between football players with and without a previous hamstring strain injury. Methods Forty-four fully active sub-elite football players, 11 with a previous hamstring strain injury during the preceding 12 months (cases; mean age, SD: 25.6 ± 4.4) and 33 demographically similar controls (mean age, SD: 23.2 ± 3.7), were included from six clubs. All players underwent a repeated-sprint test, consisting of six 30-meter maximal sprints with 90 seconds of recovery between sprints. Sprint performance was captured using high-speed video-recording and subsequently assessed by a blinded tester to calculate maximal sprint velocity, maximal horizontal force, maximal horizontal power, and mechanical effectiveness. Results A significant between-group difference was seen in favor of players having a previous hamstring injury over 6 sprints for maximal velocity (mean difference: 0.457 m/s, 95% CI: 0.059-0.849, p = 0.025) and mechanical effectiveness (mean difference: 0.009, 95% CI: 0.001-0.016, p = 0.020). Conclusion Repeated-sprint performance was not impaired in football players with a previous hamstring strain injury; in fact, higher mean maximal sprinting velocity and better mechanical effectiveness were found in players with compared to without a previous hamstring injury. The higher sprinting velocity, which likely increases biomechanical load on the hamstring muscles, in previously injured players may increase the risk of recurrent injuries. Level of evidence 3b.
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The Effects of a Soccer-Specific Fitness Test on Eccentric Knee Flexor Strength. J Sport Rehabil 2020; 30:568-572. [PMID: 33217730 DOI: 10.1123/jsr.2019-0532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/07/2020] [Accepted: 08/22/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Physiological fitness testing, such as the Yo-Yo Intermittent Recovery Test (YYIR) is a key requirement of the Elite Player Performance Plan, introduced by the English Premier League. Eccentric hamstring strength has been identified as a risk factor for hamstring injuries in soccer players, with fatigue highlighted to further exasperate this issue. OBJECTIVE The aim of the current study was to examine the effect of the YYIR level 1 (YYIR1) on eccentric knee flexor strength assessed using the NordBord in youth soccer players. DESIGN Experimental design. SETTING Soccer club academy. PARTICIPANTS A total of 67 male academy soccer players (age = 16.58 [0.57] y; height = 175.45 [5.85] cm; mass = 66.30 [8.21] kg) volunteered to participate in the current study during the English competitive soccer season. MAIN OUTCOME MEASURES Participants conducted eccentric hamstring strength assessments using the NordBord prior to and immediately postcompletion of the YYIR1, with outcome measures of peak force and peak force relative to body mass recorded. RESULTS Paired t tests highlighted increased absolute eccentric knee flexor strength values (P < .001) immediately post-YYIR1 for both the dominant and nondominant limbs, with the same trend (P < .001) observed for eccentric strength relative to body mass. CONCLUSIONS The results of this study indicate that the YYIR1 does not induce eccentric knee flexor fatigue and as such is not a valid assessment method to assess the effects of fatigue on hamstring function. However, results do suggest that the NordBord may be considered a viable and more accessible alternative to detect pre-post fitness test/fatigue protocol differences in eccentric knee flexor peak strength while working in the field.
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Silvers-Granelli HJ, Cohen M, Espregueira-Mendes J, Mandelbaum B. Hamstring muscle injury in the athlete: state of the art. J ISAKOS 2020; 6:170-181. [PMID: 34006581 DOI: 10.1136/jisakos-2017-000145] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 08/16/2020] [Accepted: 09/26/2020] [Indexed: 11/03/2022]
Abstract
Hamstring injuries (HSI) are the source of significant impairment and disability for both professional and recreational athletes. The incidence and prevalence of HSIs has been well documented in the literature, as they are among the most common soft tissue injuries reported. The significant time loss due to injury and the inherent risk of reinjury pose a significant issue to the athlete, their career longevity and the success of their respective team. This review will deal predominantly with describing the prevalence and incidence of HSI in athletes, discuss risk factors and the mechanisms of injury for HSI, how to properly diagnose, image and prognosticate appropriate return to sport (RTS) for individuals who have sustained an HSI, prescribe treatment and prevention strategies and to discuss relevant options to decrease overall risk of primary and secondary recurrence of HSI.Current treatments of acute HSI necessitate a thorough understanding of the mechanism of injury, identifying muscle imbalances and/or weakness, inclusion of eccentric and concentric hamstring (HS) and hip extension (HE) exercises, evaluation of pathokinematic movement patterns and use non-surgical methods to promote healing and RTS. This methodology can be used prospectively to mitigate the overall risk of HSI. Injection therapies for HSI, including ultrasound-guided platelet-rich plasma and corticosteroids, may impart some short-term benefit, but the existing literature is largely inconclusive with respect to long-term functional outcomes. Future directions should prioritise injury prevention, early diagnosis and targeted interventions that combine both non-surgical and minimally invasive orthobiological approaches and identifying biomechanical risk factors prospectively to mitigate risk.
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Affiliation(s)
- Holly J Silvers-Granelli
- Musculoskeletal Research Center, Velocity Physical Therapy, Santa Monica, California, USA .,Medical Assessment Research Committee, Major League Soccer, New York, New York, USA
| | - Moises Cohen
- Orthopedic Department, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - João Espregueira-Mendes
- Dom Research Center, Clinica Espregueira Mendes, FIFA Medical Centre of Excellence, Porto, Portugal
| | - Bert Mandelbaum
- Medical Assessment Research Committee, Major League Soccer, New York, New York, USA.,Sports Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Improvements in Match-Related Physical Performance of Professional Soccer Players After the Application of an on-Field Training Program for Hamstring Injury Rehabilitation. J Sport Rehabil 2020; 29:1145-1150. [PMID: 31869814 DOI: 10.1123/jsr.2019-0033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 10/24/2019] [Accepted: 10/30/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Although there are multiple, validated return-to-play programs following hamstring strain injuries, no studies have evaluated their changes in match performance parameters. OBJECTIVES The aim of this study was twofold as follows: (1) to determine the changes in match-based physical performance parameters in professional soccer players before and after sustaining a hamstring strain injury and undergoing a soccer-specific rehabilitation program and (2) to observe the progress of these performance parameters 6 to 10 weeks after the player returned from injury. DESIGN Prospective, quasi-experimental longitudinal study. SETTING Soccer playing and training grounds. PARTICIPANTS Nineteen players suffering a hamstring strain injury from 2 male professional teams playing in the Spanish professional football league (La Liga) were followed during the 2015-2016, 2016-2017, and 2017-2018 seasons. INTERVENTION Participation in on-field training program following a hamstring injury. MAIN OUTCOME MEASURES Match global positioning system data were collected in the following stages: prior to injury (PRE), after return to play (RTP), program, and 6 to 10 weeks following RTP (C2). Peak velocities and distances ran at sprint velocities showed most likely improvements in C2 versus PRE, and very likely improvements in RTP versus PRE. RESULTS The distances ran at high and very high intensities, the average velocity, and work-to-rest ratio showed very likely improvements in C2 versus RTP and likely improvements in RTP versus PRE. Likely improvements were observed for all variables in C2 versus RTP. The authors' results showed an improvement of physical performance during competitive match after RTP, compared with PRE. There was a steady progression in the progress, and in 8 months following RTP, there was no injury reported in the players. CONCLUSIONS The current findings may indicate that the hamstring muscle complex not only recovered completely from the injury but could also withstand a greater training and match load reducing the risk of reinjury.
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Vermeulen R, Almusa E, Buckens S, Six W, Whiteley R, Reurink G, Weir A, Moen M, Kerkhoffs GMMJ, Tol JL. Complete resolution of a hamstring intramuscular tendon injury on MRI is not necessary for a clinically successful return to play. Br J Sports Med 2020; 55:bjsports-2019-101808. [PMID: 32561516 DOI: 10.1136/bjsports-2019-101808] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Clinical decision-making around intramuscular tendon injuries of the hamstrings is a controversial topic in sports medicine. For this injury, MRI at return to play (RTP) might improve RTP decision-making; however, no studies have investigated this. OBJECTIVE Our objectives were to describe MRI characteristics at RTP, to evaluate healing and to examine the association of MRI characteristics at RTP with reinjury for clinically recovered hamstring intramuscular tendon injuries. METHODS We included 41 athletes with hamstring intramuscular tendon injuries and an MRI at baseline and RTP. For both MRIs, we used a standardised scoring form that included intramuscular tendon injury characteristics. We recorded reinjuries during 1-year follow-up. RESULTS At RTP, 56% of the intramuscular tendons showed a partial or complete thickness tendon discontinuity. Regarding healing from injury to RTP, 18 of 34 (44% overall) partial-thickness tendon discontinuities became continuous and 6 out of 7 (15% overall) complete thickness tendon discontinuities became partial-thickness tendon discontinuities. Waviness decreased from 61% to 12%, and 88% of tendons became thickened. We recorded eight (20%) reinjuries within 1 year. Intramuscular tendon characteristics at RTP between participants with or without a reinjury were similar. CONCLUSION Complete resolution of an intramuscular tendon injury on MRI is not necessary for clinically successful RTP. From injury to RTP, the intramuscular tendon displayed signs of healing. Intramuscular tendon characteristics of those with or without a reinjury were similar.
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Affiliation(s)
- Robin Vermeulen
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Academic Center of Evidence Based Sports Medicine, Amsterdam UMC-Locatie AMC, Amsterdam, North Holland, The Netherlands
| | - Emad Almusa
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Stan Buckens
- Department of Radiology, Amsterdam UMC-Locatie AMC, Amsterdam, North Holland, The Netherlands
| | - Willem Six
- Department of Orthopaedic Surgery, Amsterdam UMC-Locatie AMC, Amsterdam, North Holland, The Netherlands
| | - Rod Whiteley
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Guus Reurink
- Academic Center of Evidence Based Sports Medicine, Amsterdam UMC-Locatie AMC, Amsterdam, North Holland, The Netherlands
- Department of Sports Medicine, OLVG, Amsterdam, Noord-Holland, The Netherlands
| | - Adam Weir
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Center for Groin Injuries, Department of Orthopaedics, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Maarten Moen
- Department of Sports Medicine, OLVG, Amsterdam, Noord-Holland, The Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, Amsterdam UMC-Locatie AMC, Amsterdam, North Holland, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports, Amsterdam, Netherlands
| | - Johannes L Tol
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Academic Center of Evidence Based Sports Medicine, Amsterdam UMC-Locatie AMC, Amsterdam, North Holland, The Netherlands
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Criteria-Based Return to Sport Decision-Making Following Lateral Ankle Sprain Injury: a Systematic Review and Narrative Synthesis. Sports Med 2020; 49:601-619. [PMID: 30747379 DOI: 10.1007/s40279-019-01071-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this systematic review was to identify prospective studies that used a criteria-based return to sport (RTS) decision-making process for patients with lateral ankle sprain (LAS) injury. DESIGN Systematic review and narrative synthesis. DATA SOURCES The PubMed (MEDLINE), Web of Science, PEDro, Cochrane Library, SPORTDiscus (EBSCO), ScienceDirect, and Scopus databases were searched to 23 November 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies were included if they prospectively applied a criteria-based RTS decision-making process for patients with LAS injury, but were excluded if they merely gathered outcome measures at the RTS time point. Studies were also excluded if patients were recovering from ankle fracture, high ankle sprain, medial ankle sprain, chronic ankle instability or complex ankle injury. RESULTS No studies were identified that used a criteria-based RTS decision-making process for patients with LAS injury. We were unable to conduct a quantitative synthesis or meta-analysis, therefore we provide a narrative synthesis of relevant questionnaires, as well as clinical and functional assessments commonly used in studies retrieved in the search. CONCLUSION There are currently no published evidence-based criteria to inform RTS decisions for patients with an LAS injury. Based on our narrative synthesis, we propose a number of variables that could be used to develop a criteria-based RTS decision paradigm. Future research should aim to reach consensus on these variables and apply them to actual RTS decisions within prospective study designs. Furthermore, we suggest that complex systems theory and the RTS continuum could be used to inform the development of an RTS decision-making paradigm for athletes with LAS injury.
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Dunlop G, Ardern CL, Andersen TE, Lewin C, Dupont G, Ashworth B, O'Driscoll G, Rolls A, Brown S, McCall A. Return-to-Play Practices Following Hamstring Injury: A Worldwide Survey of 131 Premier League Football Teams. Sports Med 2020; 50:829-840. [PMID: 31595453 PMCID: PMC7069905 DOI: 10.1007/s40279-019-01199-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Return-to-play (RTP) is an on-going challenge in professional football. Return-to-play related research is increasing. However, it is unknown to what extent the recommendations presented within research are being implemented by professional football teams, and where there are gaps between research and practice. The purposes of this study were (1) to determine if premier-league football teams worldwide follow a RTP continuum, (2) to identify RTP criteria used and (3) to understand how RTP decision-making occurs in applied practice. METHODS We sent a structured online survey to practitioners responsible for the RTP programme in 310 professional teams from 34 premier-leagues worldwide. The survey comprised four sections, based on hamstring muscle injury: (1) criteria used throughout RTP phases, (2) the frequency with which progression criteria were achieved, (3) RTP decision-making process and (4) challenges to decision-making. RESULTS One-hundred and thirty-one teams responded with a completed survey (42%). One-hundred and twenty-four teams (95%) used a continuum to guide RTP, assessing a combination of clinical, functional and psychological criteria to inform decisions to progress. One-hundred and five (80%) teams reported using a shared decision-making approach considering the input of multiple stakeholders. Team hierarchy, match- and player-related factors were common challenges perceived to influence decision-making. CONCLUSIONS General research recommendations for RTP and the beliefs and practices of practitioners appear to match with, the majority of teams assessing functional, clinical and psychological criteria throughout a RTP continuum to inform decision-making which is also shared among key stakeholders. However, specific criteria, metrics and thresholds used, and the specific involvement, dynamics and interactions of staff during decision-making are not clear.
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Affiliation(s)
- Gordon Dunlop
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
- Edinburgh Napier University, Sport Exercise and Health Science Research Group, School of Applied Sciences, Edinburgh, UK
| | - Clare L Ardern
- Department of Medical and Health Sciences, Division of Physiotherapy, Linkoping University, Linkoping, Sweden
| | - Thor Einar Andersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Centre, Oslo, Norway
| | | | - Gregory Dupont
- Medical Department, French Football Federation, Paris, France
| | - Ben Ashworth
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
| | - Gary O'Driscoll
- Performance Department, AC Sparta Prague Football Club, Prague, Czech Republic
| | - Andrew Rolls
- Sport Science and Medical Department, Bristol City Football Club, Bristol, UK
| | - Susan Brown
- Edinburgh Napier University, Sport Exercise and Health Science Research Group, School of Applied Sciences, Edinburgh, UK
| | - Alan McCall
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK.
- Edinburgh Napier University, Sport Exercise and Health Science Research Group, School of Applied Sciences, Edinburgh, UK.
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Psychometric Analysis and Effectiveness of the Psychological Readiness of Injured Athlete to Return to Sport (PRIA-RS) Questionnaire on Injured Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051536. [PMID: 32120951 PMCID: PMC7084929 DOI: 10.3390/ijerph17051536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 11/23/2022]
Abstract
The decision-making process about when an athlete may safely return to training and competition after an injury is a difficult decision. Safe return to training and competition is characterised by physical and psychological readiness to return to the sport. The objectives of this study are (1) to assess the measurement properties of the Psychological Readiness of Injured Athlete to Return to Sport questionnaire (PRIA-RS), and (2) to analyse the effectiveness which the PRIA-RS questionnaire possesses when applied during four consecutive seasons on professional soccer players. One hundred and nine male soccer players from the Albacete Soccer Club (Spain) were involved during four consecutive seasons for the current study: 2012–2013, 2013–2014, 2014–2015 and 2015–2016. Psychometric analysis (validity, reliability, internal consistency and effectiveness) and external psychometric analysis (evaluating measures of patient-reported outcomes (EMPRO)) were confirmed and supported. The main results of the study reveal that the psychometric properties of this questionnaire are optimum for their application in a professional sports context.
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Jiménez-Reyes P, Garcia-Ramos A, Párraga-Montilla JA, Morcillo-Losa JA, Cuadrado-Peñafiel V, Castaño-Zambudio A, Samozino P, Morin JB. Seasonal Changes in the Sprint Acceleration Force-Velocity Profile of Elite Male Soccer Players. J Strength Cond Res 2020; 36:70-74. [DOI: 10.1519/jsc.0000000000003513] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Effects of low-level laser therapy on hamstring strain injury rehabilitation: A randomized controlled trial. Phys Ther Sport 2020; 42:124-130. [PMID: 31991284 DOI: 10.1016/j.ptsp.2020.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate the effects of low-level laser therapy (LLLT) on functional rehabilitation following hamstring strain injury (HSI) in amateur athletes treated with an exercise-based rehabilitation program. DESIGN Randomized controlled trial. METHODS Male athletes (18-40 years old) who sustained HSI were randomized in LLLT or placebo groups. All patients were engaged in the same exercise-based rehabilitation program until they met specific criteria to return to sport. Hamstring muscles were treated with LLLT or placebo immediately after each rehabilitation session. The primary outcome was time-to-return to sport. Secondary outcomes were the number of rehabilitation sessions, hamstring flexibility, hamstring strength, and re-injury rate. RESULTS Twenty-four athletes began rehabilitation, and 22 (11 per group) completed the study schedule. Participants of LLLT and placebo groups had similar age, body size, injury characteristics, and baseline levels of hamstring flexibility and strength. The two groups increased flexibility and strength similarly throughout the rehabilitation program. Time-to-return to sport was the same for athletes treated with LLLT (23 ± 9 days) and placebo (24 ± 13 days). There were no re-injuries within 6 months after return to sport. CONCLUSION LLLT, as used in this study, did not optimize functional rehabilitation following HSI in amateur athletes treated with an exercise-based rehabilitation program.
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69
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Bisciotti GN, Volpi P, Alberti G, Aprato A, Artina M, Auci A, Bait C, Belli A, Bellistri G, Bettinsoli P, Bisciotti A, Bisciotti A, Bona S, Bresciani M, Bruzzone A, Buda R, Buffoli M, Callini M, Canata G, Cardinali D, Cassaghi G, Castagnetti L, Clerici S, Corradini B, Corsini A, D'Agostino C, Dellasette E, Di Pietto F, Enrica D, Eirale C, Foglia A, Franceschi F, Frizziero A, Galbiati A, Giammatei C, Landreau P, Mazzola C, Moretti B, Muratore M, Nanni G, Niccolai R, Orizio C, Pantalone A, Parra F, Pasta G, Patroni P, Pelella D, Pulici L, Quaglia A, Respizzi S, Ricciotti L, Rispoli A, Rosa F, Rossato A, Sannicandro I, Sprenger C, Tarantola C, Tenconi FG, Tognini G, Tosi F, Trinchese GF, Vago P, Zappia M, Vuckovich Z, Zini R, Trainini M, Chamari K. Italian consensus statement (2020) on return to play after lower limb muscle injury in football (soccer). BMJ Open Sport Exerc Med 2019; 5:e000505. [PMID: 31673400 PMCID: PMC6797382 DOI: 10.1136/bmjsem-2018-000505] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2019] [Indexed: 12/19/2022] Open
Abstract
Return to play (RTP) decisions in football are currently based on expert opinion. No consensus guideline has been published to demonstrate an evidence-based decision-making process in football (soccer). Our aim was to provide a framework for evidence-based decision-making in RTP following lower limb muscle injuries sustained in football. A 1-day consensus meeting was held in Milan, on 31 August 2018, involving 66 national and international experts from various academic backgrounds. A narrative review of the current evidence for RTP decision-making in football was provided to delegates. Assembled experts came to a consensus on the best practice for managing RTP following lower limb muscle injuries via the Delphi process. Consensus was reached on (1) the definitions of 'return to training' and 'return to play' in football. We agreed on 'return to training' and RTP in football, the appropriate use of clinical and imaging assessments, and laboratory and field tests for return to training following lower limb muscle injury, and identified objective criteria for RTP based on global positioning system technology. Level of evidence IV, grade of recommendation D.
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Affiliation(s)
| | - Piero Volpi
- Humanitas Clinical Institute, Rozzano, Milano, Italy.,FC Internazionale Milano, Milano, Milano, Italy
| | - Giampietro Alberti
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | | | | | - Alessio Auci
- UOS Angiografia e Radiologia Interventistica, Ospedale delle Apuane, Massa Carrara, Massa Carrara, Italy
| | | | | | | | | | | | | | - Stefano Bona
- Humanitas Clinical Institute, Rozzano, Milano, Italy
| | | | | | - Roberto Buda
- Dipartimento di Scienze Biomediche e Neuromotorie, Università Bologna, Bologna, Italy
| | | | | | - Gianluigi Canata
- Ospedale Koelliker, Torino, Italy.,Istituto di Medicina dello Sport di Torino, Torino, Italy
| | | | | | | | | | | | | | | | | | | | | | - Cristiano Eirale
- Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Paris St Germain FC, Paris, France
| | - Andrea Foglia
- Physiotherapy, Studio Riabilita, Civitanova Marche, Italy
| | | | | | | | | | | | | | - Biagio Moretti
- Dipartimento di Scienze Mediche di Base, Neuroscienze e Organi di Senso, Università di Bari, Bari, Italy
| | | | - Gianni Nanni
- FIFA Medical Centre of Excellence, Bologna, Isokinetic Medical Group, Bologna, Italy.,Bologna FC, Bologna, Italy
| | | | | | - Andrea Pantalone
- Universita degli Studi Gabriele d'Annunzio Chieti e Pescara, Chieti, Italy.,Ospedale SS Annunziata, Chieti, Italy
| | | | - Giulio Pasta
- Parma Calcio, Parma, Italy.,Studio Radiologico Pasta, Parma, Italy
| | | | | | - Luca Pulici
- FC Internazionale Milano, Milano, Milano, Italy
| | - Alessandro Quaglia
- Humanitas Clinical Institute, Rozzano, Milano, Italy.,FC Internazionale Milano, Milano, Milano, Italy
| | | | | | | | | | | | | | | | | | | | | | - Fabio Tosi
- FC Internazionale Milano, Milano, Milano, Italy
| | | | - Paola Vago
- Universita Cattolica del Sacro Cuore, Milano, Italy
| | | | | | - Raul Zini
- Villa Maria Cecilia, Cotignola, Italy
| | | | - Karim Chamari
- Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Research Lab, National Center of Science and Sports Medicine Tunis, Tunis, Tunisia
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Shanks MJ, McCrory P, Davis GA, Echemendia RJ, Gray AR, Sullivan SJ. Developing common demographic data elements to include in future editions of the SCAT and Child SCAT: a modified international Delphi study. Br J Sports Med 2019; 54:906-912. [PMID: 31604697 DOI: 10.1136/bjsports-2018-100482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Sport Concussion Assessment Tool (SCAT) and Child SCAT are the 'gold standard' assessment tools for a suspected sport-related concussion (SRC). A number of 'modifiers' (eg, previous history of concussion) of a SRC have been identified. These may influence how the SCAT/Child SCAT results should be interpreted. OBJECTIVES To achieve consensus, via an international panel of SRC experts, on which athlete/player and parent/caregiver demographic variables should be considered for inclusion in future editions of the SCAT/Child SCAT respectively. METHODS A two-round modified Delphi technique, overseen by a steering committee, invited 41 panellists to achieve expert consensus (≥80% agreement). The first round utilised open questions to generate demographic variables; the second round used a five-point ordinal item to rank the importance of including each variable in future editions of the SCAT/Child SCAT. RESULTS 15 experts participated in at least one Delphi round. 29 athlete/player and eight parent/caregiver variables reached consensus for inclusion in the SCAT, whereas two parent/caregiver variables reached consensus for exclusion. 28 athlete/player and four parent/caregiver variables reached consensus for the Child SCAT, whereas two parent/caregiver variables reached consensus for exclusion. Key categories of variables included the following: concussion/sport details, personal medical conditions and family medical history. CONCLUSION This study provides a list of athlete/player and parent/caregiver demographic variables that should be considered in future revisions of the SCAT/Child SCAT. By considering (and ultimately likely including) a wider and standard set of additional demographic variables, the Concussion in Sport experts will be able to provide clinicians and researchers with data that may enhance interpretation of the individual's data and the building of larger datasets.
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Affiliation(s)
- Maxine J Shanks
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Paul McCrory
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Gavin A Davis
- The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia.,Department of Neurosurgery, Austin and Cambrini Hospitals, Melbourne, Victoria, Australia
| | - Ruben J Echemendia
- University Orthopedic Center, Concussion Care Clinic, State College, Pennsylvania, USA
| | - Andrew R Gray
- Centre for Biostatistics, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - S John Sullivan
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Validity of an On-Field Readaptation Program Following a Hamstring Injury in Professional Soccer. J Sport Rehabil 2019; 28:jsr.2018-0203. [PMID: 30426832 DOI: 10.1123/jsr.2018-0203] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/07/2018] [Accepted: 10/14/2018] [Indexed: 11/18/2022]
Abstract
Context: Despite the presence of various injury prevention programs, the rate of hamstring injuries and reinjuries is increasing in soccer, warranting the need for a soccer-specific rehabilitation program. Objective: To develop and validate a new, functional on-field program for the rehabilitation and readaptation of soccer players after a hamstring strain injury through a panel of experts; and determine the usefulness of the program through its application in professional soccer players. Design: A 13-item program was developed, which was validated by a panel of experts and later applied to professional soccer players. Setting: Soccer training ground. Participants: Fifteen strength and conditioning and rehabilitation fitness coaches with a professional experience of 15.40 (1.57) years in elite clubs and national teams in Europe validated the program. The program was later applied to 19 professional soccer players of the Spanish First Division (La Liga). Interventions: Once a player sustained a clinically diagnosed injury, the player would first be subject to mobilization and strengthening exercises in the gym after undergoing treatment by percutaneous needle electrolysis. The player would then complete an on-field readaptation program consisting of 13 drills arranged in a progressive manner in terms of complexity. The drills integrated various aspects of repeated sprint abilities, retraining and reeducation of biomechanical patterns, and neuromuscular control of the core and lower limbs. Main Outcome Measures: Aiken’s V for each item of the program and number of days taken by the players to return to play. Results: The experts evaluated all items of the program very highly, as seen from Aiken’s V values between 0.78 and 0.98 (0.63–0.99) for all drills, while the return to play was in 22.42 (2.32) days. Conclusion: This program has the potential to help a player suffering from a hamstring strain injury to adapt to real-match conditions in the readaptation phase through the application of sports-specific drills that were very similar to the different injury mechanisms.
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72
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Taberner M, Allen T, Cohen DD. Infographic. Progressing rehabilitation after injury: consider the 'control-chaos continuum'. Br J Sports Med 2019; 54:116-117. [PMID: 31227494 PMCID: PMC6978561 DOI: 10.1136/bjsports-2019-100936] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Matt Taberner
- Performance Department, Everton Football Club, Liverpool, UK
| | - Tom Allen
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
| | - Daniel Dylan Cohen
- Faculty of Health Sciences, University of Santander, Bucaramanga, Colombia
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73
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Annear A, Sole G, Devan H. What are the current practices of sports physiotherapists in integrating psychological strategies during athletes' return-to-play rehabilitation? Mixed methods systematic review. Phys Ther Sport 2019; 38:96-105. [PMID: 31077961 DOI: 10.1016/j.ptsp.2019.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/24/2019] [Accepted: 04/24/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The primary aim was to identify the current practices of sports physiotherapists in implementing psychological strategies during athletes' return-to-play rehabilitation and, secondly, to explore their attitudes and challenges to do so. METHODS An electronic search of the PubMed, CINAHL, Scopus, Medline, Google Scholar, Cochrane Library, AMED, and PsycINFO databases was performed. Studies were considered eligible if they explored physiotherapists' implementation of psychological strategies during athletic rehabilitation. Methodological quality of included studies was assessed using the Guidelines for Critical Review Form. Data were synthesised using thematic analysis. RESULTS AND CONCLUSIONS Eleven studies involving 1440 sports physiotherapists were included: six were quantitative, three were qualitative, and two were mixed-method studies. Most sports physiotherapists recognised the importance of implementing psychological strategies during athletes' rehabilitation but were unsure whether it is within their scope. Common psychological strategies implemented included goal setting and encouraging positive self-thoughts. Barriers to implementing psychological strategies include lack of knowledge and training at undergraduate level, lack of postgraduate psychology courses available, and perceived stigma from athletes toward seeking psychological support. Strategies for sports physiotherapists to incorporate psychological strategies during athletes' return-to-play rehabilitation could include targeted professional development opportunities to gain confidence in implementing psychological strategies.
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Affiliation(s)
- Andrew Annear
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand; High Performance Sport, New Zealand.
| | - Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
| | - Hemakumar Devan
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand
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74
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Taberner M, Allen T, Cohen DD. Progressing rehabilitation after injury: consider the 'control-chaos continuum'. Br J Sports Med 2019; 53:1132-1136. [PMID: 30737202 PMCID: PMC6818668 DOI: 10.1136/bjsports-2018-100157] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/06/2019] [Accepted: 01/20/2019] [Indexed: 12/02/2022]
Affiliation(s)
- Matt Taberner
- Performance Department, Everton Football Club, Liverpool, UK.,School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, Merseyside, UK
| | - Tom Allen
- Performance and Research Department, Arsenal Football Club, London, UK
| | - Daniel Dylan Cohen
- Faculty of Health Sciences, University of Santander, Bucaramanga, Colombia
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75
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Hernández-Sanchez S, Korakakis V, Malliaropoulos N, Moreno-Perez V. Validation study of the Functional Assessment Scale for Acute Hamstring injuries in Spanish professional soccer players. Clin Rehabil 2018; 33:711-723. [DOI: 10.1177/0269215518815540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To cross-culturally adapt and validate the Functional Assessment Scale for acute hamstring injury for professional Spanish-speaking soccer players. Design: Clinical measurement study. Cross-cultural adaptation was conducted following international recommendations. Indicators of validity, reliability and responsiveness are provided. Subjects: The Spanish version of the Functional Assessment Scale for acute hamstring injury scale was administered to 165 participants: 45 professional soccer players with acute hamstring muscle injury diagnosis, 40 healthy subjects, 40 individuals at-risk for a hamstring muscle injury and 40 patients with injuries of the lower limb other than hamstring muscle injury. Main measures: The Functional Assessment Scale for acute hamstring injury. Reference measures: Spanish version of the Quality of Life Short-Form 36 questionnaire (SF-36) and the Lower Limb Functional Index (LLFI). Results: Cronbach’s alpha (internal consistency) for the Spanish version of the Functional Assessment Scale for acute hamstring injury scale was >0.8. The intraclass correlation coefficient using the two-way random model (ICC2,1) (test–retest) was 0.993 (95% confidence interval (CI): 0.991–0.995; P < 0.05). In the exploratory factor analysis, a one-factor solution explained 85% of the variance. Subjects with hamstring muscle injury scored significantly lower than the other groups in the Spanish version of the Functional Assessment Scale for acute hamstring injury scale ( P < 0.001). The Spanish version of the Functional Assessment Scale for acute hamstring injury scale score within the hamstring muscle injury group showed moderate and significant correlations with SF-36 physical components (Spearman’s rs > 0.6; P < 0.001), and LLFI score at baseline ( rs = 0.42; P < 0.01). The standard error of measurement (SEM) and minimum detectable change threshold (MDC95%) were 2.6 and 7.2 points, respectively. The responsiveness indicators have an effect size of 3.62, and the standardized response mean is 3.24. Conclusion: The Spanish version of the Functional Assessment Scale for acute hamstring injury scale showed satisfactory psychometric properties. It can be considered a reliable and valid instrument to assess the functional impact of acute hamstring muscle injury in professional Spanish-speaking football players.
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Affiliation(s)
- Sergio Hernández-Sanchez
- Centro de Investigación Traslacional en Fisioterapia and Department of Pathology and Surgery, Physiotherapy Area, Miguel Hernandez University, Sant Joan d’Alacant, Spain
| | | | - Nikos Malliaropoulos
- European SportsCare, London, UK
- Thessaloniki Sports and Exercise Medicine Clinic, Thessaloniki, Greece
- National Track and Field Centre, Sports Medicine Clinic of S.E.G.A.S., Thessaloniki, Greece
- Sports Clinic, Rheumatology Department, Barts Health NHS Trust, London, UK
- Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK
| | - Víctor Moreno-Perez
- Centro de Investigación Traslacional en Fisioterapia and Department of Pathology and Surgery, Physiotherapy Area, Miguel Hernandez University, Sant Joan d’Alacant, Spain
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76
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Edouard P, Mendiguchia J, Lahti J, Arnal PJ, Gimenez P, Jiménez-Reyes P, Brughelli M, Samozino P, Morin JB. Sprint Acceleration Mechanics in Fatigue Conditions: Compensatory Role of Gluteal Muscles in Horizontal Force Production and Potential Protection of Hamstring Muscles. Front Physiol 2018; 9:1706. [PMID: 30555346 PMCID: PMC6283907 DOI: 10.3389/fphys.2018.01706] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 11/13/2018] [Indexed: 12/28/2022] Open
Abstract
Aim: Hamstring muscle injury is the main injury related to sports requiring sprint acceleration. In addition, hamstring muscles have been reported to play a role in horizontal force production during sprint acceleration performance. The aim of the present study was to analyze (i) the determinants of horizontal force production and (ii) the role of hip extensors, and hamstring muscles in particular, for horizontal force production during repeated sprint-induced fatigue conditions. Method: In this experimental laboratory setting study including 14 sprint-trained male athletes, we analyzed (i) the changes in sprint mechanics, peak torque of the knee and hip extensors and flexors, muscle activity of the vastus lateralis, rectus femoris, biceps femoris, and gluteus, and sagittal plane lower limb motion, before and after twelve 6-s sprints separated by 44 s rest on an instrumented motorized treadmill, and (ii) the determinants of horizontal force production (FH ) during the sprint acceleration in a fatigue state (after 12 sprints). Results: The repeated-sprint protocol induced a decrease in maximal power output (Pmax) [-17.5 ± 8.9%; effect size (ES): 1.57, large] and in the contact-averaged horizontal force component (FH ) (-8.6 ± 8.4%; ES: 0.86, moderate) but not meaningful changes in the contact-averaged resultant (total) force (FTot ) (-3.4 ± 2.9%; ES: 0.55, small) and vertical force component (FV ) (-3.1 ± 3.2%; ES: 0.49, small). A decrease was found in concentric peak torque of the knee flexors and extensors and in gluteus and vastus lateralis muscle activity during entire swing and end-of-swing phase. An increase was found in contact time and swing time, while step frequency and knee speed before ground contact decreased. Muscular determinants associated with FH and its decrease after the repeated-sprint protocol were concentric peak torque of the hip extensors (p = 0.033) and a decrease in gluteus maximus activity at the end-of-swing (p = 0.007), respectively. Conclusion: Sprint-induced fatigue lead to changes in horizontal force production muscular determinants: hamstring muscle seems not to have the same role than in non-fatigue condition. Horizontal force production seems to be more dependent on the hip extensors and gluteus maximus function. Given the fatigue-induced decrease in hamstring muscle strength, we can hypothesize that muscle compensatory and kinematic strategies reported in a fatigued state could be an adaptation to allow/maintain performance and a protective adaptation to limit hamstring muscles constraints.
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Affiliation(s)
- Pascal Edouard
- Inter-University Laboratory of Human Movement Science (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint Etienne, France.,Department of Clinical and Exercise Physiology, Sports Medicine Unity, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Étienne, France.,Medical Commission, French Athletics Federation, Paris, France
| | - Jurdan Mendiguchia
- Department of Physical Therapy, ZENTRUM Rehab and Performance Center, Barañain, Spain
| | - Johan Lahti
- Université Côte d'Azur, LAMHESS, Nice, France.,Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Philippe Gimenez
- Laboratory Culture Sport Health Society (EA 4660), University of Bourgogne Franche-Comté, Besançon, France
| | - Pedro Jiménez-Reyes
- Faculty of Sport, Catholic University of San Antonio, Murcia, Spain.,Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
| | - Matt Brughelli
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Pierre Samozino
- Univ Savoie Mont Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Chambéry, France
| | - Jean-Benoit Morin
- Université Côte d'Azur, LAMHESS, Nice, France.,Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
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77
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Habets B, van den Broek AG, Huisstede BMA, Backx FJG, van Cingel REH. Return to Sport in Athletes with Midportion Achilles Tendinopathy: A Qualitative Systematic Review Regarding Definitions and Criteria. Sports Med 2018; 48:705-723. [PMID: 29249084 PMCID: PMC5808052 DOI: 10.1007/s40279-017-0833-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Midportion Achilles tendinopathy (AT) can cause long-term absence from sports participation, and shows high recurrence rates. It is important that the decision to return to sport (RTS) is made carefully, based on sharply delimited criteria. Lack of a well-defined definition and criteria hampers the decision to RTS among athletes with AT, and impedes comparison of RTS rates between different studies. Objective The aim of this study was to systematically review the literature for definitions of, and criteria for, RTS in AT research. Study Design Qualitative systematic review. Methods The PubMed, EMBASE, Cochrane, CINAHL, PEDro, and Scopus electronic databases were searched for articles that reported on the effect of a physiotherapeutic intervention for midportion AT. Article selection was independently performed by two researchers. Qualitative content analysis was used to analyze the included studies and extract definitions of, and criteria for, RTS. Results Thirty-five studies were included in the content analysis, showing large variety in both the definitions and criteria. Thirty-two studies reported a definition of RTS, but only 19 studies described the criteria for RTS. The content analysis revealed that ‘reaching pre-injury activity/sports level, with the ability to perform training and matches without limitations’, ‘absence of pain’, and ‘recovery’ were the main content categories used to define RTS. Regarding the criteria for RTS, eight different content categories were defined: (1) ‘level of pain’; (2) ‘level of functional recovery’; (3) ‘recovery of muscle strength’; (4) ‘recovery of range of motion’; (5) ‘level of endurance of the involved limb’; (6) ‘medical advice’; (7) ‘psychosocial factors’; and (8) ‘anatomical/physiological properties of the musculotendinous complex’. Many criteria were not clearly operationalized and lacked specific information. Conclusions This systematic review shows that RTS may be defined according to the pre-injury level of sports (including both training and matches), but also with terms related to the absence of pain and recovery. Multiple criteria for RTS were found, which were all related to level of pain, level of functional recovery, muscular strength, range of motion, endurance, medical advice, psychosocial factors, or anatomical/physiological properties of the Achilles tendon. For most of the criteria we identified, no clear operationalization was given, which limits their validity and practical usability. Further research on how RTS after midportion AT should be defined, and which criteria should be used, is warranted. PROSPERO Registration Number CRD42017062518. Electronic supplementary material The online version of this article (10.1007/s40279-017-0833-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bas Habets
- Papendal Sports Medical Centre, Papendallaan 7, 6816 VD, Arnhem, The Netherlands. .,Department of Rehabilitation, Physical Therapy Science and Sports, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Anke G van den Broek
- Department of Rehabilitation, Physical Therapy Science and Sports, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bionka M A Huisstede
- Department of Rehabilitation, Physical Therapy Science and Sports, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank J G Backx
- Department of Rehabilitation, Physical Therapy Science and Sports, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robert E H van Cingel
- Papendal Sports Medical Centre, Papendallaan 7, 6816 VD, Arnhem, The Netherlands.,Radboud University Medical Centre, Research Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands
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78
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Siddle J, Greig M, Weaver K, Page RM, Harper D, Brogden CM. Acute adaptations and subsequent preservation of strength and speed measures following a Nordic hamstring curl intervention: a randomised controlled trial. J Sports Sci 2018; 37:911-920. [PMID: 30369285 DOI: 10.1080/02640414.2018.1535786] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This randomised controlled trial investigated changes in eccentric hamstring strength, 10m sprint speed, and change-of-direction (COD) performance immediately post Nordic hamstring curl (NHC) intervention and following a 3-week detraining period. Fourteen male team sports athletes were randomised to a do-as-usual control group (CG; n = 7) or to a NHC intervention group (NHC; n = 7). Isokinetic dynamometry at 180°/s evaluated eccentric hamstring strength immediately post-intervention as the primary outcome measure. Secondary outcomes included 10 m sprint time and COD. Each outcome was measured, pre, immediately post-intervention and following a 3-week detraining period. Immediately post-intervention significant group differences were observed in the NHC group for eccentric hamstring strength (31.81 Nm-1 vs. 6.44 Nm-1, P = 0.001), COD (-0.12 s vs. 0.20 s; P = 0.003) and sprint (- 0.06 s vs. 0.05 s; P = 0.024) performance. Performance improvements were maintained following a detraining period for COD (-0.11 s vs. 0.20 s; P = 0.014) and sprint (-0.05 s vs. 0.03 s, P = 0.031) but not eccentric hamstring strength (15.67 Nm-1 vs. 6.44 Nm-1, P = 0.145) These findings have important implications for training programmes designed to reduce hamstring injury incidence, whilst enhancing physical qualities critical to sport.
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Affiliation(s)
- James Siddle
- a Sports Injuries Research Group, Department of Sport & Physical Activity , Edge Hill University , Ormskirk , UK
| | - Matt Greig
- a Sports Injuries Research Group, Department of Sport & Physical Activity , Edge Hill University , Ormskirk , UK
| | - Kristian Weaver
- a Sports Injuries Research Group, Department of Sport & Physical Activity , Edge Hill University , Ormskirk , UK
| | - Richard Michael Page
- a Sports Injuries Research Group, Department of Sport & Physical Activity , Edge Hill University , Ormskirk , UK
| | - Damian Harper
- b School of Sport , York St John University , York , UK
| | - Christopher Michael Brogden
- a Sports Injuries Research Group, Department of Sport & Physical Activity , Edge Hill University , Ormskirk , UK
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79
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Risberg MA, Steffen K, Nilstad A, Myklebust G, Kristianslund E, Moltubakk MM, Krosshaug T. Normative Quadriceps and Hamstring Muscle Strength Values for Female, Healthy, Elite Handball and Football Players. J Strength Cond Res 2018; 32:2314-2323. [PMID: 29794892 PMCID: PMC6092090 DOI: 10.1519/jsc.0000000000002579] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Risberg, MA, Steffen, K, Nilstad, A, Myklebust, G, Kristianslund, E, Moltubakk, MM, and Krosshaug, T. Normative quadriceps and hamstring muscle strength values for female, healthy, elite handball and football players. J Strength Cond Res 32(8): 2314–2323, 2018—This study presents normative values for isokinetic knee extension and flexion muscle strength tests in 350 elite, female, handball (n = 150) and football (n = 200) players. Isokinetic concentric muscle strength tests at 60°·sec−1 were recorded bilaterally using a dynamometer. Peak torque (in Newton meter [N·m]), body mass normalized peak torque (N·m·kg−1), and hamstring to quadriceps ratio (H:Q ratio) for dominant and nondominant legs were recorded. The female elite players were 20.9 ± 4.0 years, started playing at the elite level at the age of 18.2 ± 2.7 years, with a mean of 9.7 ± 2.2 hours of weekly in-season training. Handball players demonstrated greater quadriceps muscle strength compared with football players (11.0%) (p < 0.001), also when normalized to body mass (4.1%) (p = 0.012), but not for weight-adjusted hamstring muscle strength. The H:Q ratio was higher on the dominant compared with the nondominant leg for handball players only (p = 0.012).The H:Q ratio was significantly lower for handball players (0.58) compared with football players (0.60) (p < 0.02). These normative values for isokinetic knee extension and flexion torques of healthy, elite, female handball and football players can be used to set rehabilitation goals for muscle strength after injury and enable comparison with uninjured legs. Significantly greater quadriceps muscle strength was found for handball players compared with football players, also when normalized to body mass.
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Affiliation(s)
| | | | | | | | | | - Marie M Moltubakk
- Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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80
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Loose O, Achenbach L, Fellner B, Lehmann J, Jansen P, Nerlich M, Angele P, Krutsch W. Injury prevention and return to play strategies in elite football: no consent between players and team coaches. Arch Orthop Trauma Surg 2018; 138:985-992. [PMID: 29679206 DOI: 10.1007/s00402-018-2937-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Injuries are a common problem in football. To improve prevention strategies, the players' (p) and coaches' (c) views need to be disclosed as they have a strong impact on return to play decisions. The aim of this study is to reveal current opinions with regard to injury prevention and return to play strategies to introduce new strategies in elite football. MATERIALS AND METHODS In a retrospective data analysis of elite salaried football players (n = 486) and team coaches (n = 88), a detailed investigation by means of a standardized questionnaire was carried out. In a preseason period of the 2015/16 season and as part of a large interventional research project in elite salaried German football, a request about players' and team coaches' knowledge and opinions was performed. Topics such as injury prevention, return to play after injuries, the importance of screening tests, general problems of injuries in football, or the decision-making in terms of prevention and return to play in elite football were investigated. RESULTS The study revealed a high interest in injury prevention and screening tests among players and coaches (p 82.5%; c 99.1%). The participants of the study reported warm-up exercises (p 76.4%; c 74.7%), regeneration training (p 54.1%; c 56.3%), and core stability (p 53.8; c 70.1%) as the most important prevention methods, but the additional investigation of the teams' current daily training routine showed that the transfer is incomplete. Coaches are more familiar with scientific published warm-up programs like FIFA 11 + than players (42.5 vs. 12.6; p < 0.001). Knee injuries (p 90.7%; c 93.1%) and ACL injuries in particular were reported as the most severe and common problem in elite football. Players and coaches expressed different attitudes concerning return to play decisions. While players want to decide themselves (81.4%), team coaches consult medical advice ahead of the decision of return to play after injuries (83.5%; p < 0.001). Decisions against the doctor's recommendation are often made by both groups (p 64.4% vs. c 87.1%; p < 0.001). CONCLUSION The basic knowledge of prevention and injuries is sufficient in elite football, but the transfer from theoretical knowledge to practical routine is suboptimal. The study also shows possibilities to improve the prevention process and communication between players, coaches, doctors, and physiotherapists, while there is no consent between players and coaches regarding return to play decision.
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Affiliation(s)
- Oliver Loose
- Clinic of Pediatric Surgery, Clinic St. Hedwig Regensburg, Steinmetzstraße 1-3, 93049, Regensburg, Germany.
| | - Leonard Achenbach
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Birgit Fellner
- Institute of Sport Science, University of Regensburg, Regensburg, Germany
| | - Jennifer Lehmann
- Institute of Sport Science, University of Regensburg, Regensburg, Germany
| | - Petra Jansen
- Institute of Sport Science, University of Regensburg, Regensburg, Germany
| | - Michael Nerlich
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Peter Angele
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Werner Krutsch
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
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81
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Blandford L, McNeill W, Charvet I. Can we spread the risk? A demand-share perspective to sustained hamstring health. J Bodyw Mov Ther 2018; 22:766-779. [PMID: 30100311 DOI: 10.1016/j.jbmt.2018.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lincoln Blandford
- Movement Performance Solutions Ltd, The Quorum, Bond Street South, Bristol, BS1 3AE, UK.
| | | | - Ingrid Charvet
- Department of Civil, Environmental & Geomatic Engineering, University College London, WC1E 6BT, UK.
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82
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WITHDRAWN: Can we spread the risk? A demand-share perspective to sustained hamstring health. Biomaterials 2018. [DOI: 10.1016/j.biomaterials.2018.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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83
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Ardern CL, Ekås G, Grindem H, Moksnes H, Anderson AF, Chotel F, Cohen M, Forssblad M, Ganley TJ, Feller JA, Karlsson J, Kocher MS, LaPrade RF, McNamee M, Mandelbaum B, Micheli L, Mohtadi NG, Reider B, Roe JP, Seil R, Siebold R, Silvers-Granelli HJ, Soligard T, Witvrouw E, Engebretsen L. 2018 International Olympic Committee Consensus Statement on Prevention, Diagnosis, and Management of Pediatric Anterior Cruciate Ligament Injuries. Orthop J Sports Med 2018; 6:2325967118759953. [PMID: 29594177 PMCID: PMC5865521 DOI: 10.1177/2325967118759953] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In October 2017, the International Olympic Committee hosted an international expert group of physical therapists and orthopaedic surgeons who specialize in treating and researching pediatric anterior cruciate ligament (ACL) injuries. The purpose of this meeting was to provide a comprehensive, evidence-informed summary to support the clinician and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the following societies attended: American Orthopaedic Society for Sports Medicine; European Paediatric Orthopaedic Society; European Society for Sports Traumatology, Knee Surgery, and Arthroscopy; International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine; Pediatric Orthopaedic Society of North America; and Sociedad Latinoamericana de Artroscopia, Rodilla, y Deporte. Physical therapists and orthopaedic surgeons with clinical and research experience in the field and an ethics expert with substantial experience in the area of sports injuries also participated. This consensus statement addresses 6 fundamental clinical questions regarding the prevention, diagnosis, and management of pediatric ACL injuries. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision making with children and the potential long-term ramifications of the injury.
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Affiliation(s)
| | - Clare L. Ardern
- Clare L. Ardern, PT, PhD, Division of Physiotherapy, Linköping University, Linköping, Sweden (ORCID ID: 0000-0001-8102-3631) ()
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84
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Ardern CL, Ekås G, Grindem H, Moksnes H, Anderson AF, Chotel F, Cohen M, Forssblad M, Ganley TJ, Feller JA, Karlsson J, Kocher MS, LaPrade RF, McNamee M, Mandelbaum B, Micheli L, Mohtadi N, Reider B, Roe J, Seil R, Siebold R, Silvers-Granelli HJ, Soligard T, Witvrouw E, Engebretsen L. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. J ISAKOS 2018. [DOI: 10.1136/jisakos-2018-000200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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85
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Ardern CL, Ekås GR, Grindem H, Moksnes H, Anderson AF, Chotel F, Cohen M, Forssblad M, Ganley TJ, Feller JA, Karlsson J, Kocher MS, LaPrade RF, McNamee M, Mandelbaum B, Micheli L, Mohtadi N, Reider B, Roe J, Seil R, Siebold R, Silvers-Granelli HJ, Soligard T, Witvrouw E, Engebretsen L. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. Br J Sports Med 2018; 52:422-438. [PMID: 29478021 PMCID: PMC5867447 DOI: 10.1136/bjsports-2018-099060] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2018] [Indexed: 12/25/2022]
Abstract
In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
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Affiliation(s)
- Clare L Ardern
- Division of Physiotherapy, Linköping University, Linköping, Sweden.,School of Allied Health, La Trobe University, Melbourne, Australia
| | - Guri Ranum Ekås
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.,Oslo Sports Trauma Research Centre (OSTRC), Norwegian School of Sport Sciences, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hege Grindem
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Håvard Moksnes
- Oslo Sports Trauma Research Centre (OSTRC), Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Franck Chotel
- Department of Pediatric Orthopaedic Surgery, Hôpital Femme Mere Enfant, Lyon, France
| | - Moises Cohen
- Orthopedic Department, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Magnus Forssblad
- Stockholm Sports Trauma Research Center, Karolinska Institute, Stockholm, Sweden
| | - Theodore J Ganley
- Department of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Julian A Feller
- OrthoSport Victoria Research Unit, Epworth Healthcare, Melbourne, Australia.,College of Science, Health & Engineering, La Trobe University, Melbourne, Australia
| | - Jón Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Minider S Kocher
- Division of Sports Medicine, Boston Children's Hospital, Boston, USA.,Harvard Medical School, Boston, USA
| | - Robert F LaPrade
- Steadman Philippon Research Institute, Vail, USA.,The Steadman Clinic, Vail, USA
| | | | - Bert Mandelbaum
- Santa Monica Orthopaedic and Sports Medicine Group, Los Angeles, USA
| | - Lyle Micheli
- Division of Sports Medicine, Boston Children's Hospital, Boston, USA.,Harvard Medical School, Boston, USA.,The Micheli Center for Sports Injury Prevention, Waltham, USA
| | | | - Bruce Reider
- Department of Orthopaedics and Rehabilitation Medicine, University of Chicago, Chicago, USA
| | - Justin Roe
- North Sydney Orthopaedic & Sports Medicine Centre, Sydney, Australia
| | - Romain Seil
- Department of Orthopaedic Surgery, Centre Hospitalier Luxembourg, Luxembourg.,Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg
| | - Rainer Siebold
- Institute for Anatomy and Cell Biology, Ruprecht-Karls-University, Heidelberg, Germany.,HKF International Center for Hip, Knee, Foot Surgery and Sports Traumatology, ATOS Klinik, Heidelberg, Germany
| | | | - Torbjørn Soligard
- Medical & Scientific Department, International Olympic Committee, Chateau de Vidy, Lausanne, Switzerland.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Erik Witvrouw
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, Ghent University, Ghent, Belgium
| | - Lars Engebretsen
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.,Oslo Sports Trauma Research Centre (OSTRC), Norwegian School of Sport Sciences, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Medical & Scientific Department, International Olympic Committee, Chateau de Vidy, Lausanne, Switzerland
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86
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van der Horst N. Preventing hamstring injuries in football through enhanced exercise and RTP strategies. Br J Sports Med 2018; 52:684-685. [PMID: 29363495 DOI: 10.1136/bjsports-2017-098630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Nick van der Horst
- Sports Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
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87
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Navandar A, Veiga S, Torres G, Chorro D, Navarro E. A previous hamstring injury affects kicking mechanics in soccer players. J Sports Med Phys Fitness 2018; 58:1815-1822. [PMID: 29327823 DOI: 10.23736/s0022-4707.18.07852-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although the kicking skill is influenced by limb dominance and sex, how a previous hamstring injury affects kicking has not been studied in detail. Thus, the objective of this study was to evaluate the effect of sex and limb dominance on kicking in limbs with and without a previous hamstring injury. METHODS Forty-five professional players (males: N.=19, previously injured players=4, age=21.16±2.00 years; females: N.=19, previously injured players =10, age= 22.15±4.50 years) performed 5 kicks each with their preferred and non-preferred limb at a target 7m away, which were recorded with a three-dimensional motion capture system. Kinematic and kinetic variables were extracted for the backswing, leg cocking, leg acceleration and follow through phases. RESULTS A shorter backswing (20.20±3.49% vs. 25.64±4.57%), and differences in knee flexion angle (58±10º vs. 72±14º) and hip flexion velocity (8±0 rad/s vs. 10±2 rad/s) were observed in previously injured, non-preferred limb kicks for females. A lower peak hip linear velocity (3.50±0.84 m/s vs. 4.10±0.45 m/s) was observed in previously injured, preferred limb kicks of females. These differences occurred in the backswing and leg-cocking phases where the hamstring muscles were the most active. A variation in the functioning of the hamstring muscles and that of the gluteus maximus and iliopsoas in the case of a previous injury could account for the differences observed in the kicking pattern. CONCLUSIONS Therefore, the effects of a previous hamstring injury must be considered while designing rehabilitation programs to re-educate kicking movement.
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Affiliation(s)
- Archit Navandar
- Faculty of Sports Sciences, Universidad Politécnica de Madrid, Madrid, Spain -
| | - Santiago Veiga
- Faculty of Sports Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Gonzalo Torres
- Faculty of Sports Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - David Chorro
- Faculty of Sports Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Enrique Navarro
- Faculty of Sports Sciences, Universidad Politécnica de Madrid, Madrid, Spain
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88
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Ardern CL, Ekås G, Grindem H, Moksnes H, Anderson A, Chotel F, Cohen M, Forssblad M, Ganley TJ, Feller JA, Karlsson J, Kocher MS, LaPrade RF, McNamee M, Mandelbaum B, Micheli L, Mohtadi N, Reider B, Roe J, Seil R, Siebold R, Silvers-Granelli HJ, Soligard T, Witvrouw E, Engebretsen L. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. Knee Surg Sports Traumatol Arthrosc 2018; 26:989-1010. [PMID: 29455243 PMCID: PMC5876259 DOI: 10.1007/s00167-018-4865-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 02/05/2018] [Indexed: 12/11/2022]
Abstract
In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric anterior cruciate ligament (ACL) injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery and Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America, and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis, and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
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Affiliation(s)
- Clare L. Ardern
- 0000 0001 2162 9922grid.5640.7Division of Physiotherapy, Linköping University, Linköping, Sweden ,0000 0001 2342 0938grid.1018.8School of Allied Health, La Trobe University, Melbourne, Australia
| | - Guri Ekås
- 0000 0004 0389 8485grid.55325.34Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway ,0000 0000 8567 2092grid.412285.8Oslo Sports Trauma Research Centre (OSTRC), Norwegian School of Sport Sciences, Oslo, Norway ,0000 0004 1936 8921grid.5510.1Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hege Grindem
- 0000 0000 8567 2092grid.412285.8Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Håvard Moksnes
- 0000 0000 8567 2092grid.412285.8Oslo Sports Trauma Research Centre (OSTRC), Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Franck Chotel
- grid.414103.3Department of Pediatric Orthopaedic Surgery, Hôpital Femme Mere Enfant, Lyon, France
| | - Moises Cohen
- 0000 0001 0514 7202grid.411249.bOrthopedic Department, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Magnus Forssblad
- 0000 0004 1937 0626grid.4714.6Stockholm Sports Trauma Research Center, Karolinska Institute, Stockholm, Sweden
| | - Theodore J. Ganley
- 0000 0001 0680 8770grid.239552.aDepartment of Orthopaedics, Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Julian A. Feller
- 0000 0001 0459 5396grid.414539.eOrthoSport Victoria Research Unit, Epworth Healthcare, Melbourne, Australia ,0000 0001 2342 0938grid.1018.8College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Jón Karlsson
- 0000 0000 9919 9582grid.8761.8Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mininder S. Kocher
- 0000 0004 0378 8438grid.2515.3Division of Sports Medicine, Boston Children’s Hospital, Boston, USA ,000000041936754Xgrid.38142.3cHarvard Medical School, Boston, USA
| | - Robert F. LaPrade
- 0000 0001 0367 5968grid.419649.7Steadman Philippon Research Institute, Vail, USA ,0000 0001 0027 3736grid.419648.6The Steadman Clinic, Vail, USA
| | - Mike McNamee
- 0000 0001 0658 8800grid.4827.9College of Engineering, Swansea University, Swansea, UK
| | - Bert Mandelbaum
- Santa Monica Orthopaedic and Sports Medicine Group, Los Angeles, USA
| | - Lyle Micheli
- 0000 0004 0378 8438grid.2515.3Division of Sports Medicine, Boston Children’s Hospital, Boston, USA ,000000041936754Xgrid.38142.3cHarvard Medical School, Boston, USA ,The Micheli Center for Sports Injury Prevention, Waltham, USA
| | - Nicholas Mohtadi
- 0000 0004 1936 7697grid.22072.35University of Calgary Sports Medicine Centre, Calgary, Canada
| | - Bruce Reider
- 0000 0004 1936 7822grid.170205.1Department of Orthopaedics and Rehabilitation Medicine, University of Chicago, Chicago, USA
| | - Justin Roe
- 0000 0004 0382 8241grid.420075.4North Sydney Orthopaedic and Sports Medicine Centre, Sydney, Australia
| | - Romain Seil
- 0000 0004 0578 0421grid.418041.8Department of Orthopaedic Surgery, Centre Hospitalier Luxembourg, Luxembourg City, Luxembourg ,0000 0004 0621 531Xgrid.451012.3Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg City, Luxembourg
| | - Rainer Siebold
- 0000 0001 2190 4373grid.7700.0Institute for Anatomy and Cell Biology, Ruprecht-Karls-University, Heidelberg, Germany ,HKF International Center for Hip, Knee, Foot Surgery and Sportstraumatology, ATOS Klinik, Heidelberg, Germany
| | | | - Torbjørn Soligard
- 0000 0004 0626 1762grid.469323.9Medical and Scientific Department, International Olympic Committee, Chateau de Vidy, Lausanne, Switzerland ,0000 0004 1936 7697grid.22072.35Faculty of Kinesiology, Sports Injury Prevention Centre, University of Calgary, Calgary, Alberta Canada
| | - Erik Witvrouw
- 0000 0001 2069 7798grid.5342.0Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Healthscience, Ghent University, Ghent, Belgium
| | - Lars Engebretsen
- 0000 0004 0389 8485grid.55325.34Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway ,0000 0000 8567 2092grid.412285.8Oslo Sports Trauma Research Centre (OSTRC), Norwegian School of Sport Sciences, Oslo, Norway ,0000 0004 1936 8921grid.5510.1Institute of Clinical Medicine, University of Oslo, Oslo, Norway ,0000 0004 0626 1762grid.469323.9Medical and Scientific Department, International Olympic Committee, Chateau de Vidy, Lausanne, Switzerland
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89
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Whiteley R, van Dyk N, Wangensteen A, Hansen C. Clinical implications from daily physiotherapy examination of 131 acute hamstring injuries and their association with running speed and rehabilitation progression. Br J Sports Med 2017; 52:303-310. [DOI: 10.1136/bjsports-2017-097616] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 09/08/2017] [Accepted: 10/04/2017] [Indexed: 11/03/2022]
Abstract
AimTo investigate the association of daily clinical measures and the progression of rehabilitation and perceived running effort.MethodsA cohort of 131 athletes with an MRI-confirmed acute hamstring injury underwent a standardised criteria-based rehabilitation protocol. Descriptive and inferential statistics were used to investigate the association between daily clinical subjective and objective measures and both the progression of rehabilitation and perceived running effort. These measures included different strength, palpation, flexibility and functional tests. Inter-rater and intrarater reliability and minimal detectable change were established for the clinical measures of strength and flexibility by examining measures taken on consecutive days for the uninjured leg.ResultsThe progression of the daily measures was seen to be non-linear and varied according to the measure. Intra-rater reliability for the strength and flexibility measures were excellent (95% CI ≥0.85 for all measures). Strength (in the outer range position) and flexibility (in maximum hip flexion with active knee extension (MHFAKE) in supine) were best associated with rehabilitation progression and perceived running effort. Additionally, length of pain on palpation was usefully associated with rehabilitation progression. At lower perceived running effort there was a large variation in actual running speed.ConclusionDaily physical measures of palpation pain, outer range strength, MHFAKE and reported pain during daily activity are useful to inform the progression of rehabilitation.Trial registration numberNCT01812564 and NCT02104258.
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