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Malisoux L, Gette P, Delattre N, Urhausen A, Theisen D. Gait asymmetry in spatiotemporal and kinetic variables does not increase running-related injury risk in lower limbs: a secondary analysis of a randomised trial including 800+ recreational runners. BMJ Open Sport Exerc Med 2024; 10:e001787. [PMID: 38196940 PMCID: PMC10773390 DOI: 10.1136/bmjsem-2023-001787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/11/2024] Open
Abstract
Objective To investigate asymmetry in spatiotemporal and kinetic variables in 800+ recreational runners, identify determinants of asymmetry, investigate if asymmetry is related to greater running injury risk and compare spatiotemporal and kinetic variables between the involved and uninvolved limb at baseline in runners having sustained an injury during follow-up. Methods 836 healthy recreational runners (38.6% women) were tested on an instrumented treadmill at their preferred running speed at baseline and followed up for 6 months. From ground reaction force recordings, spatiotemporal and kinetic variables were derived for each lower limb. The Symmetry Index was computed for each variable. Correlations and multiple regression analyses were performed to identify potential determinants of asymmetry. Cox regression analyses investigated the association between asymmetry and injury risk. Analysis of variance for repeated measures was used to compare the involved and uninvolved limbs in runners who had sustained injuries during follow-up. Results 107 participants reported at least one running-related injury. Leg length discrepancy and fat mass were the most common determinants of asymmetry, but all correlation coefficients were negligible (0.01-0.13) and explained variance was very low (multivariable-adjusted R2<0.01-0.03). Greater asymmetry for flight time and peak breaking force was associated with lower injury risk (HR (95% CI): 0.80 (0.64 to 0.99) and 0.96 (0.93 to 0.98), respectively). No between-limb differences were observed in runners having sustained an injury. Conclusion Gait asymmetry was not associated with higher injury risk for investigated spatiotemporal and kinetic variables. Trial registration number NCT03115437.
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Affiliation(s)
- Laurent Malisoux
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Paul Gette
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Nicolas Delattre
- Movement Sciences Department, Decathlon SportsLab Research and Development, Villeneuve d'Ascq, Nord, France
| | - Axel Urhausen
- Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- Luxembourg Institute of Research in Orthopedics Sports Medicine and Science, Luxembourg, Luxembourg
| | - Daniel Theisen
- ALAN – Maladies Rares Luxembourg, Luxembourg, Luxembourg
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Malisoux L, Gette P, Delattre N, Urhausen A, Theisen D. Spatiotemporal and Ground-Reaction Force Characteristics as Risk Factors for Running-Related Injury: A Secondary Analysis of a Randomized Trial Including 800+ Recreational Runners. Am J Sports Med 2022; 50:537-544. [PMID: 35049407 DOI: 10.1177/03635465211063909] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Running biomechanics may play a role in running-related injury development, but to date, only a few modifiable factors have been prospectively associated with injury risk. PURPOSE To identify risk factors among spatiotemporal and ground-reaction force characteristics in recreational runners and to investigate whether shoe cushioning modifies the association between running biomechanics and injury risk. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Recreational runners (N = 848) were tested on an instrumented treadmill at their preferred running speed in randomly allocated, standardized running shoes (with either hard or soft cushioning). Typical kinetic and spatiotemporal metrics were derived from ground-reaction force recordings. Participants were subsequently followed up for 6 months regarding running activity and injury. Cox regression models for competing risk were used to investigate the association between biomechanical risk factors and injury risk, including stratified analyses by shoe version. RESULTS In the crude analysis, greater injury risk was found for greater step length (subhazard rate ratio [SHR], 1.01; 95% CI, 1.00-1.02; P = .038), longer flight time (SHR, 1.00; 95% CI, 1.00-1.01; P = .028), shorter contact time (SHR, 0.99; 95% CI, 0.99-1.00; P = .030), and lower duty factor (defined as the ratio between contact time and stride time; SHR, 0.95; 95% CI, 0.91-0.98; P = .005). In the stratified analyses by shoe version, adjusted for previous injury and running speed, lower duty factor was associated with greater injury risk in those using the soft shoes (SHR, 0.92; 95% CI, 0.85-0.99; P = .042) but not in those using the hard shoes (SHR, 0.97; 95% CI, 0.91-1.04; P = .348). CONCLUSION Lower duty factor is an injury risk factor, especially for softer shoe use. Contrary to widespread beliefs, vertical impact peak, loading rate, and step rate were not injury risk factors in recreational runners. REGISTRATION NCT03115437 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport & Health Research Group, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Paul Gette
- Human Motion, Orthopaedics, Sports Medicine and Digital Methods, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Nicolas Delattre
- Decathlon Sports Lab, Movement Sciences Department, Villeneuve d'Ascq, France
| | - Axel Urhausen
- Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Grand-Duchy of Luxembourg
| | - Daniel Theisen
- ALAN-Maladies Rares Luxembourg, Grand-Duchy of Luxembourg, Luxembourg
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Malisoux L, Gette P, Backes A, Delattre N, Cabri J, Theisen D. Relevance of Frequency-Domain Analyses to Relate Shoe Cushioning, Ground Impact Forces and Running Injury Risk: A Secondary Analysis of a Randomized Trial With 800+ Recreational Runners. Front Sports Act Living 2021; 3:744658. [PMID: 34859204 PMCID: PMC8632264 DOI: 10.3389/fspor.2021.744658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/14/2021] [Indexed: 01/21/2023] Open
Abstract
Cushioning systems in running shoes are used assuming that ground impact forces relate to injury risk and that cushioning materials reduce these impact forces. In our recent trial, the more cushioned shoe version was associated with lower injury risk. However, vertical impact peak force was higher in participants with the Soft shoe version. The primary objective of this study was to investigate the effect of shoe cushioning on the time, magnitude and frequency characteristics of peak forces using frequency-domain analysis by comparing the two study groups from our recent trial (Hard and Soft shoe group, respectively). The secondary objective was to investigate if force characteristics are prospectively associated with the risk of running-related injury. This is a secondary analysis of a double-blinded randomized trial on shoe cushioning with a biomechanical running analysis at baseline and a 6-month follow-up on running exposure and injury. Participants (n = 848) were tested on an instrumented treadmill at their preferred running speed in their randomly allocated shoe condition. The vertical ground reaction force signal for each stance phase was decomposed into the frequency domain using the discrete Fourier transform. Both components were recomposed into the time domain using the inverse Fourier transform. An analysis of variance was used to compare force characteristics between the two study groups. Cox regression analysis was used to investigate the association between force characteristics and injury risk. Participants using the Soft shoes displayed lower impact peak force (p < 0.001, d = 0.23), longer time to peak force (p < 0.001, d = 0.25), and lower average loading rate (p < 0.001, d = 0.18) of the high frequency signal compared to those using the Hard shoes. Participants with low average and instantaneous loading rate of the high frequency signal had lower injury risk [Sub hazard rate ratio (SHR) = 0.49 and 0.55; 95% Confidence Interval (CI) = 0.25–0.97 and 0.30–0.99, respectively], and those with early occurrence of impact peak force (high frequency signal) had greater injury risk (SHR = 1.60; 95% CI = 1.05–2.53). Our findings may explain the protective effect of the Soft shoe version previously observed. The present study also demonstrates that frequency-domain analyses may provide clinically relevant impact force characteristics. Clinical Trial Registration:https://clinicaltrials.gov/, identifier: 9NCT03115437.
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Affiliation(s)
- Laurent Malisoux
- Department of Population Health, Physical Activity, Sport and Health Research Group, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Paul Gette
- Department of Population Health, Human Motion, Orthopedics, Sports Medicine and Digital Methods Research Group, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Anne Backes
- Department of Population Health, Physical Activity, Sport and Health Research Group, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Nicolas Delattre
- Decathlon Sports Lab, Movement Sciences Department, Decathlon SA, Villeneuve d'Ascq, France
| | - Jan Cabri
- Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science, Luxembourg, Luxembourg
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Motion-Control Shoes Reduce the Risk of Pronation-Related Pathologies in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial. J Orthop Sports Phys Ther 2021; 51:135-143. [PMID: 33306927 DOI: 10.2519/jospt.2021.9710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate whether motion-control shoes reduce the risk of pronation-related injuries in recreational runners. DESIGN Secondary analysis of a randomized controlled trial of the effect of shoes on running injuries. METHODS Three hundred seventy-two recreational runners were randomized to receive either standard neutral or motion-control shoes and were followed up for 6 months regarding running activity and injury. Running injuries that occurred during this period were registered and classified as pronation-related injuries (Achilles tendinopathy, plantar fasciopathy, exercise-related lower-leg pain, and anterior knee pain) or other running-related injuries. With the use of competing risk analysis, the relationship between pronation-related and other running-related injuries and shoe type was evaluated by estimating the cause-specific hazard, controlling for other possible confounders like age, sex, body mass index, previous injury, and sport participation pattern. RESULTS Twenty-five runners sustained pronation-related running injuries and 68 runners sustained other running-related injuries. Runners wearing the motion-control shoes had a lower risk of pronation-related running injuries compared with runners who wore standard neutral shoes (hazard ratio = 0.41; 95% confidence interval: 0.17, 0.98). There was no effect of shoe type (hazard ratio = 0.68; 95% confidence interval: 0.41, 1.10) on the risk of other running-related injuries. CONCLUSION Motion-control shoes may reduce the risk of pronation-related running injuries, but did not influence the risk of other running-related injuries. J Orthop Sports Phys Ther 2021;51(3):135-143. Epub 11 Dec 2020. doi:10.2519/jospt.2021.9710.
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Sommerfield LM, Harrison CB, Whatman CS, Maulder PS. A prospective study of sport injuries in youth females. Phys Ther Sport 2020; 44:24-32. [PMID: 32388016 DOI: 10.1016/j.ptsp.2020.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine sports and physical education (PE) injury rates in youth females during a school year and to investigate if an association exists between injury and phase of the menstrual cycle. DESIGN Prospective cohort. SETTING An online questionnaire was used to record training and competition exposure and self-reported injuries for 30-weeks. PARTICIPANTS 103 PE students (12-15 years) from a girls' secondary school. MAIN OUTCOME MEASURES Injury rates and prevalence of acute, gradual onset/overuse and substantial injuries. RESULTS On average, girls trained 3.4 h/week and competed 1 h/week. During the study, 74 participants reported 595 injuries. The average weekly prevalence of all injuries was 20.7% (95% CI: 20.0-21.3), of which 8.6% (95% CI: 8.3-9.0) were acute injuries and 12.0% (95% CI: 11.4-12.6) were gradual onset/overuse injuries. The overall rate of sport and PE injuries was 10.4 injuries/1000 h of exposure. The most common acute injury involved the ankle (35%) while the most common gradual onset/overuse injury involved the knee (51%). There was no significant association between the stage of the menstrual cycle and the likelihood of injury (P = 0.18). CONCLUSION The high number of injuries in this population of girls suggests preventative measures, particularly targeting the lower extremity, are needed.
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Affiliation(s)
- Lesley M Sommerfield
- Sports Performance Research Institute New Zealand, AUT University, 17 Antares Place, Mairangi Bay, Auckland, 0632, New Zealand.
| | - Craig B Harrison
- Sports Performance Research Institute New Zealand, AUT University, 17 Antares Place, Mairangi Bay, Auckland, 0632, New Zealand.
| | - Chris S Whatman
- Sports Performance Research Institute New Zealand, AUT University, 17 Antares Place, Mairangi Bay, Auckland, 0632, New Zealand.
| | - Peter S Maulder
- Sports Performance Research Institute New Zealand, AUT University, 17 Antares Place, Mairangi Bay, Auckland, 0632, New Zealand; Centre for Sport Science and Human Performance, Waikato Institute of Technology, Tristram Street, Whitiora, Hamilton, 3200, New Zealand.
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Malisoux L, Delattre N, Urhausen A, Theisen D. Shoe Cushioning Influences the Running Injury Risk According to Body Mass: A Randomized Controlled Trial Involving 848 Recreational Runners. Am J Sports Med 2020; 48:473-480. [PMID: 31877062 DOI: 10.1177/0363546519892578] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Shoe cushioning is expected to protect runners against repetitive loading of the musculoskeletal system and therefore running-related injuries. Also, it is a common belief that heavier runners should use footwear with increased shock absorption properties to prevent injuries. PURPOSE The aim of this study was to determine if shoe cushioning influences the injury risk in recreational runners and whether the association depends on the runner's body mass. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Healthy runners (n = 848) randomly received 1 of 2 shoe prototypes that only differed in their cushioning properties. Global stiffness was 61.3 ± 2.7 and 94.9 ± 5.9 N/mm in the soft and hard versions, respectively. Participants were classified as light or heavy according to their body mass using the median as a cut-off (78.2 and 62.8 kg in male and female runners, respectively). They were followed over 6 months regarding running activity and injury (any physical complaint reducing/interrupting running activity for at least 7 days). Data were analyzed through time-to-event models with the subhazard rate ratio (SHR) and their 95% confidence interval (CI) as measures of association. A stratified analysis was conducted to investigate the effect of shoe cushioning on the injury risk in lighter and heavier runners. RESULTS The runners who had received the hard shoes had a higher injury risk (SHR, 1.52 [95% CI, 1.07-2.16]), while body mass was not associated with the injury risk (SHR, 1.00 [95% CI, 0.99-1.01]). However, after stratification according to body mass, results showed that lighter runners had a higher injury risk in hard shoes (SHR, 1.80 [95% CI, 1.09-2.98]) while heavier runners did not (SHR, 1.23 [95% CI, 0.75-2.03]). CONCLUSION The injury risk was higher in participants running in the hard shoes compared with those using the soft shoes. However, the relative protective effect of greater shoe cushioning was found only in lighter runners. REGISTRATION NCT03115437 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Laurent Malisoux
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg
| | - Nicolas Delattre
- Movement Sciences Department, Decathlon SportsLab, Villeneuve d'Ascq, France
| | - Axel Urhausen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg.,Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Grand Duchy of Luxembourg
| | - Daniel Theisen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg.,ALAN-Maladies Rares Luxembourg, Bascharage, Grand Duchy of Luxembourg
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Rejeb A, Johnson A, Farooq A, Verrelst R, Pullinger S, Vaeyens R, Witvrouw E. Sports injuries aligned to predicted mature height in highly trained Middle-Eastern youth athletes: a cohort study. BMJ Open 2019; 9:e023284. [PMID: 30872539 PMCID: PMC6429725 DOI: 10.1136/bmjopen-2018-023284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 01/11/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To investigate the association of maturity status with injury incidence in Middle-Eastern youth athletes. DESIGN Prospective cohort study. SETTING Four consecutive seasons (2010-2014), Aspire Academy, Qatar. PARTICIPANTS Male athletes (age range: 11-18 years) representing four disciplines enrolled and grouped into two categories: individual sports and racquet sports. OUTCOME MEASURES Injury data collected over four seasons. Athletes' anthropometric characteristics assessed to calculate age at peak height velocity. Predicted mature heights (PMHs) collected and categorised into four quartiles. Athletes had wrist and hand radiographs for assessment of skeletal age (SA). Early and late maturers with an SA of >1 year older or younger than their chronological age (CA). RESULTS For the sample (n=67) across all groups, 43 (64%) athletes had one or more injuries: total of 212 injuries, 4.9 injuries per athlete across study. Survival analysis of maturity status using SA found early maturing athletes had two-fold greater injury risk compared with late maturers (HR 2.04, 95% CI 1.15 to 3.61, p=0.015). PMH associated with injury risk (HR 1.05, 95% CI 1.01 to 1.08, p=0.006).Athletes in fourth quartile (≥184 cm) had up to two-fold injury risk (HR 2.41, 95% CI 1.42 to 4.08, p=0.001). Racquet and individual sports involved similar injury risk (HR 1.14, 95% CI 0.86 to 1.52, p=0.37). CONCLUSION SA early maturity and PMH gradient were significant predictors of injury in youths.
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Affiliation(s)
- Abdallah Rejeb
- Aspire Academy Sports Medicine Center, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Rehabilitation Sciences and Physiotherapie, Universiteit Gent Faculteit Geneeskunde en Gezondheidswetenschappen, Gent, Belgium
| | - Amanda Johnson
- Aspire Academy Sports Medicine Center, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Abdulaziz Farooq
- Athlete Health and Performance Research, Aspetar, Orthopaedic and Sports Medicine Department, Doha, Qatar
| | - Ruth Verrelst
- Rehabilitation Sciences and Physiotherapie, Universiteit Gent Faculteit Geneeskunde en Gezondheidswetenschappen, Gent, Belgium
| | - Samuel Pullinger
- Department of Sports Sciences, ASPIRE Academy for Sports Excellence, Doha, Ad Dawhah, Qatar
| | - Roel Vaeyens
- Department of Movement and Sports Sciences, Universiteit Gent Faculteit Geneeskunde en Gezondheidswetenschappen, Gent, Belgium
| | - Erik Witvrouw
- Rehabilitation Sciences and Physiotherapie, Universiteit Gent Faculteit Geneeskunde en Gezondheidswetenschappen, Gent, Belgium
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Ristolainen L, Toivo K, Parkkari J, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Selänne H, Vasankari T, Kannas L, Villberg J, Kujala UM. Acute and overuse injuries among sports club members and non-members: the Finnish Health Promoting Sports Club (FHPSC) study. BMC Musculoskelet Disord 2019; 20:32. [PMID: 30660197 PMCID: PMC6339310 DOI: 10.1186/s12891-019-2417-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 01/11/2019] [Indexed: 12/19/2022] Open
Abstract
Background Physical activity in adolescence is promoted for its multi-dimensional health benefits. However, too intensive sports participation is associated with an increased injury risk. Our aim was to compare the occurrence of acute and overuse injuries in Finnish sports club members and non-members and to report training and competing habits associated with a higher injury risk in sports club members. Methods In this cross-sectional survey targeted at 14–16-year-old adolescents, a structured questionnaire was completed by 1077 sports club members and 812 non-members. The main outcome measures were self-reported acute and overuse injuries, their location and type. Results At least one acute injury in the past year was reported by 44.0% of sports club members and 19.8% of non-members (P < 0.001). The sex-adjusted odds ratio (OR) for acute injury in sports club members compared to non-members was 3.13 (95% confidence interval (95% CI) 2.54–3.87). Thirty-five percent of sports club members and 17.4% of non-members (P < 0.001) reported at least one overuse injury during the past year. The overuse injury OR for sports club members was 2.61 (95% CI 2.09–3.26). Sports club members who trained 7–14 h per week during training (OR 1.61, 95% CI 1.21–2.12, P = 0.001) or competition season (OR 1.55, 95% CI 1.18–2.06, P = 0.002) were more likely to report an injury compared to members who trained 3–6 h per week. Those sports club members who participated in forty competitions or more compared to 7–19 competitions per year were more likely to report an acute injury (OR 1.55, 95% CI 1.05–2.08, P = 0.028) or for an overuse injury (OR 1.53, 95% CI 1.02–2.30, P = 0.038). Conclusions Both acute and overuse injuries are common among youth sports club members, and the number increases along with increasing amounts of training and competitions. More effective injury prevention is needed both for adolescents engaging in sports club activities and for other adolescents. Electronic supplementary material The online version of this article (10.1186/s12891-019-2417-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L Ristolainen
- Orton Orthopaedic Hospital, Orton, Helsinki, Finland.
| | - K Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - J Parkkari
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - S Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - L Alanko
- Sports Medicine Clinic, Foundation for Sports and Exercise Clinic, Helsinki, Finland
| | - O J Heinonen
- Paavo Nurmi Centre & Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - R Korpelainen
- Oulu Deaconess Institute, Department of Sports and Exercise Medicine, Oulu, Finland.,Medical Research Center Oulu Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - K Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - H Selänne
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - T Vasankari
- UKK Institute of Health Promotion Research, Tampere, Finland
| | - L Kannas
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - J Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - U M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Fortington LV, van der Worp H, van den Akker-Scheek I, Finch CF. Reporting Multiple Individual Injuries in Studies of Team Ball Sports: A Systematic Review of Current Practice. Sports Med 2018; 47:1103-1122. [PMID: 27785773 PMCID: PMC5432578 DOI: 10.1007/s40279-016-0637-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. Objective The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and reported in prospective, long-term, injury studies in team ball sports. Data Sources A systematic search of three online databases for articles published before 2016. Study Selection Publications were included if (1) they collected prospective data on musculoskeletal injuries in individual participants; (2) the study duration was >1 consecutive calendar year/season; and (3) individuals were the unit of analysis. Data Extraction Key study features were summarised, including definitions of injury, how multiple individual injuries were reported and results relating to multiple injuries. Results Of the 71 publications included, half did not specifically indicate multiple individual injuries; those that did were largely limited to reporting recurrent injuries. Eight studies reported the number/proportion of athletes with more than one injury, and 11 studies presented the mean/number of injuries per athlete. Conclusions Despite it being relatively common to collect data on individuals across more than one season, the reporting of multiple injuries within individuals is much more limited. Ultimately, better addressing of multiple injuries will improve the accuracy of injury incidence studies and enable more precise targeting and monitoring of the effectiveness of preventive interventions. Electronic supplementary material The online version of this article (doi:10.1007/s40279-016-0637-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lauren V Fortington
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, VIC, 3353, Australia.
| | - Henk van der Worp
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Inge van den Akker-Scheek
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Caroline F Finch
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, VIC, 3353, Australia
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Räisänen AM, Parkkari J, Karhola L, Rimpelä A. Adolescent physical activity-related injuries in sports club, school sports and other leisure time physical activities. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1260786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Anu M. Räisänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland
| | - Lotta Karhola
- School of Medicine, University of Tampere, Tampere, Finland
| | - Arja Rimpelä
- School of Health Sciences and PERLA–Tampere Centre for Childhood, Youth and Family Research, University of Tampere, Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
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11
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Malisoux L, Chambon N, Urhausen A, Theisen D. Influence of the Heel-to-Toe Drop of Standard Cushioned Running Shoes on Injury Risk in Leisure-Time Runners: A Randomized Controlled Trial With 6-Month Follow-up. Am J Sports Med 2016; 44:2933-2940. [PMID: 27501833 DOI: 10.1177/0363546516654690] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Modern running shoes are available in a wide range of heel-to-toe drops (ie, the height difference between the forward and rear parts of the inside of the shoe). While shoe drop has been shown to influence strike pattern, its effect on injury risk has never been investigated. Therefore, the reasons for such variety in this parameter are unclear. PURPOSE The first aim of this study was to determine whether the drop of standard cushioned running shoes influences running injury risk. The secondary aim was to investigate whether recent running regularity modifies the relationship between shoe drop and injury risk. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Leisure-time runners (N = 553) were observed for 6 months after having received a pair of shoes with a heel-to-toe drop of 10 mm (D10), 6 mm (D6), or 0 mm (D0). All participants reported their running activities and injuries (time-loss definition, at least 1 day) in an electronic system. Cox regression analyses were used to compare injury risk between the 3 groups based on hazard rate ratios (HRs) and their 95% CIs. A stratified analysis was conducted to evaluate the effect of shoe drop in occasional runners (<6 months of weekly practice over the previous 12 months) versus regular runners (≥6 months). RESULTS The overall injury risk was not different among the participants who had received the D6 (HR, 1.30; 95% CI, 0.86-1.98) or D0 (HR, 1.17; 95% CI, 0.76-1.80) versions compared with the D10 shoes. After stratification according to running regularity, low-drop shoes (D6 and D0) were found to be associated with a lower injury risk in occasional runners (HR, 0.48; 95% CI, 0.23-0.98), whereas these shoes were associated with a higher injury risk in regular runners (HR, 1.67; 95% CI, 1.07-2.62). CONCLUSION Overall, injury risk was not modified by the drop of standard cushioned running shoes. However, low-drop shoes could be more hazardous for regular runners, while these shoes seem to be preferable for occasional runners to limit injury risk.
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Affiliation(s)
- Laurent Malisoux
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg
| | - Nicolas Chambon
- Movement Sciences Department, Decathlon, Villeneuve d'Ascq, France
| | - Axel Urhausen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg.,Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg
| | - Daniel Theisen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg
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Fabricant PD, Lakomkin N, Sugimoto D, Tepolt FA, Stracciolini A, Kocher MS. Youth sports specialization and musculoskeletal injury: a systematic review of the literature. PHYSICIAN SPORTSMED 2016; 44:257-62. [PMID: 27121730 DOI: 10.1080/00913847.2016.1177476] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Early sports specialization is being seen with increasing frequency in children and adolescents in an attempt to achieve elite performance status. This phenomenon has attracted negative medical and lay media attention due, in part, to the possibility of an increased risk of acute and overuse injuries. The purpose of this study was to systematically review available research on youth sport specialization and musculoskeletal injury. METHODS A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies evaluating sports specialization and injury rates in participants under age 18. Inclusion criteria were: (1) youth patient population (defined as <18 years of age), (2) peer-reviewed investigation of association(s) between sports specialization and incidence of injury, and (3) original research article (rather than a review, case report, or meta-analysis). Exclusion criteria were: (1) reliance on surrogate measure(s) of sports specialization (eg. hours of participation), (2) language other than English, and (3) not a clinically-based study. Rates of sport specialization, acute and overuse injuries, and frequency of organized training regimens were recorded. RESULTS Three studies met final inclusion and exclusion criteria. Of these studies two were retrospective cohort studies and one was a case-control study. All three studies reported an increased risk of overuse injures (OR range: 1.27-4.0; P < 0.05) which varied by sport and anatomic pathology. One study noted an increased rate of withdrawal from tennis matches (OR = 1.55, P < 0.05) in athletes who participated only in tennis compared to multisport athletes who competed in tennis. Based on the consistency of the results from included studies, the strength of recommendation grade for the current evidence against early sports specialization is "B" (recommendation based on limited-quality patient-oriented evidence). CONCLUSIONS The primary evidence that currently exists with regard to early sport specialization is scarce, retrospective, and shows only modest associations between early sports specialization and overuse injury. Further prospective research is needed to more definitively determine if early sports specialization in children is associated with increased injury risk. LEVEL OF EVIDENCE Systematic Review, Level III.
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Affiliation(s)
- Peter D Fabricant
- a Department of Orthopaedic Surgery , Boston Children's Hospital , Boston , MA , USA
| | - Nikita Lakomkin
- b School of Medicine, Vanderbilt University , Nashville , TN , USA
| | - Dai Sugimoto
- c Boston Children's Hospital Sports Medicine , The Micheli Center for Sports Injury Prevention , Waltham , MA , USA
| | - Frances A Tepolt
- a Department of Orthopaedic Surgery , Boston Children's Hospital , Boston , MA , USA
| | - Andrea Stracciolini
- c Boston Children's Hospital Sports Medicine , The Micheli Center for Sports Injury Prevention , Waltham , MA , USA.,d Harvard Medical School , Boston , MA , USA
| | - Mininder S Kocher
- a Department of Orthopaedic Surgery , Boston Children's Hospital , Boston , MA , USA.,d Harvard Medical School , Boston , MA , USA
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Malisoux L, Chambon N, Delattre N, Gueguen N, Urhausen A, Theisen D. Injury risk in runners using standard or motion control shoes: a randomised controlled trial with participant and assessor blinding. Br J Sports Med 2016; 50:481-7. [PMID: 26746907 PMCID: PMC4853529 DOI: 10.1136/bjsports-2015-095031] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 01/04/2023]
Abstract
Background/aim This randomised controlled trial investigated if the usage of running shoes with a motion control system modifies injury risk in regular leisure-time runners compared to standard shoes, and if this influence depends on foot morphology. Methods Recreational runners (n=372) were given either the motion control or the standard version of a regular running shoe model and were followed up for 6 months regarding running activity and injury. Foot morphology was analysed using the Foot Posture Index method. Cox regression analyses were used to compare injury risk between the two groups, based on HRs and their 95% CIs, controlling for potential confounders. Stratified analyses were conducted to evaluate the effect of motion control system in runners with supinated, neutral and pronated feet. Results The overall injury risk was lower among the participants who had received motion control shoes (HR=0.55; 95% CI 0.36 to 0.85) compared to those receiving standard shoes. This positive effect was only observed in the stratum of runners with pronated feet (n=94; HR=0.34; 95% CI 0.13 to 0.84); there was no difference in runners with neutral (n=218; HR=0.78; 95% CI 0.44 to 1.37) or supinated feet (n=60; HR=0.59; 95% CI 0.20 to 1.73). Runners with pronated feet using standard shoes had a higher injury risk compared to those with neutral feet (HR=1.80; 95% CI 1.01 to 3.22). Conclusions The overall injury risk was lower in participants who had received motion control shoes. Based on secondary analysis, those with pronated feet may benefit most from this shoe type.
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Affiliation(s)
- Laurent Malisoux
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Nicolas Chambon
- Decathlon, Movement Sciences Department, Villeneuve d'Ascq, France
| | - Nicolas Delattre
- Decathlon, Movement Sciences Department, Villeneuve d'Ascq, France
| | - Nils Gueguen
- Decathlon, Movement Sciences Department, Villeneuve d'Ascq, France
| | - Axel Urhausen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Daniel Theisen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg
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Malisoux L, Frisch A, Urhausen A, Seil R, Theisen D. Monitoring of sport participation and injury risk in young athletes. J Sci Med Sport 2013; 16:504-8. [DOI: 10.1016/j.jsams.2013.01.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 01/15/2013] [Accepted: 01/23/2013] [Indexed: 10/27/2022]
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