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Teixeira E, Silva C, Romero F, Costa JP, Vicente A. The Quality of Life of Former Portuguese Football Players. Sports (Basel) 2024; 12:200. [PMID: 39195576 PMCID: PMC11360592 DOI: 10.3390/sports12080200] [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: 07/04/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND The demands of playing professional football can have an impact on an individual's quality of life (QoL), which may remain into retirement. Given limited evidence exists regarding the QoL in former football players, this study aimed to assess QoL among Portuguese former players according to career duration, career end period, competitive level, tactical-positional status, international status, academic qualifications, serious injuries in career, and current professional football connection. METHODS The study included 84 Portuguese former football players (48.8 ± 8.2 years old) who transitioned to retirement between 1988 and 2018. The WHOQOL-BREF questionnaire was used to assess QoL perceptions, and the Portuguese version was validated. RESULTS AND DISCUSSION The former players have positive QoL indicators, both in general and across the four domains, namely in terms of the physical, psychological, and social relationship and environment. There were no statistically significant differences in QoL between the defined categories for career end period, competitive level, tactical-positional status, international status, and current professional football connection. Likewise, there was no significant correlation between QoL and career duration. In contrast, there were significant differences in general QoL (p < 0.023) and in the physical domain (p < 0.001) between former players with different academic qualifications. A significant correlation was found between the number of severe injuries sustained in a career and QoL in the physical domain (R = -0.300, p = 0.006). CONCLUSIONS There are no concerning QoL results presented by former players. However, the number of severe injuries sustained during the career was associated with a lower QoL, while holding higher academic qualifications demonstrated higher general and physical QoL. Studies with larger samples should be conducted to confirm these trends.
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Affiliation(s)
- Eduardo Teixeira
- Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal; (C.S.); (F.R.); (J.P.C.)
- Life Quality Research Centre, Polytechnic Institute of Santarem, 2040-413 Rio Maior, Portugal
- SPRINT, Sport Physical Activity and Health Research & Innovation Center, 2040-413 Rio Maior, Portugal
- Faculty of Human and Social Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
| | - Carlos Silva
- Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal; (C.S.); (F.R.); (J.P.C.)
- SPRINT, Sport Physical Activity and Health Research & Innovation Center, 2040-413 Rio Maior, Portugal
| | - Félix Romero
- Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal; (C.S.); (F.R.); (J.P.C.)
- Life Quality Research Centre, Polytechnic Institute of Santarem, 2040-413 Rio Maior, Portugal
| | - João Paulo Costa
- Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal; (C.S.); (F.R.); (J.P.C.)
| | - António Vicente
- Faculty of Human and Social Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal;
- CIDESD, Research Center in Sports Sciences, Health Sciences and Human Development, 5001-801 Vila Real, Portugal
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Solie BS, Tollefson LV, Doney CP, O'Keefe JMJ, Thompson WC, LaPrade RF. Return to the Pre-Injury Level of Sport after Anterior Cruciate Ligament Reconstruction: A Practical Review with Medical Recommendations. Int J Sports Med 2024; 45:572-588. [PMID: 38527465 DOI: 10.1055/a-2270-3233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Returning to sport after anterior cruciate ligament reconstruction (ACLR) can be a challenging and complex process for the athlete, with the rate of return to the pre-injury level of sport observed to be less than athlete expectations. Of the athletes that do return to sport (RTS), knee re-injury rates remain high, and multiple studies have observed impaired athletic performance upon RTS after ACLR as well as reduced playing time, productivity, and career lengths. To mitigate re-injury and improve RTS outcomes, multiple RTS after ACLR consensus statements/clinical practice guidelines have recommended objective RTS testing criteria to be met prior to medical clearance for unrestricted sports participation. While the achievement of RTS testing criteria can improve RTS rates after ACLR, current criteria do not appear valid for predicting safe RTS. Therefore, there is a need to review the various factors related to the successful return to the pre-injury level of sport after ACLR, clarify the utility of objective performance testing and RTS criteria, further discuss safe RTS decision-making as well as present strategies to reduce the risk of ACL injury/re-injury upon RTS. This article provides a practical review of the current RTS after ACLR literature, as well as makes medical recommendations for rehabilitation and RTS decision-making after ACLR.
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Affiliation(s)
- Braidy S Solie
- Physical Therapy, Training HAUS, Twin Cities Orthopedics, Eagan, MN, United States
- Research, Twin Cities Orthopedics, Edina, MN, United States
| | | | - Christopher P Doney
- Physical Therapy, Training HAUS, Twin Cities Orthopedics, Eagan, MN, United States
| | - Jeremy M J O'Keefe
- Physical Therapy, Training HAUS, Twin Cities Orthopedics, Eagan, MN, United States
| | - Will C Thompson
- Sports Science, Training HAUS, Twin Cities Orthopedics, Eagan, MN, United States
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Bilgoe SC, Janse van Rensburg DC(C, Goedhart E, Orhant E, Kerkhoffs G, Gouttebarge V. Unmasking mental health symptoms in female professional football players: a 12-month follow-up study. BMJ Open Sport Exerc Med 2024; 10:e001922. [PMID: 38756700 PMCID: PMC11097812 DOI: 10.1136/bmjsem-2024-001922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2024] [Indexed: 05/18/2024] Open
Abstract
Objective To calculate the prevalence rates of mental health symptoms among female professional football players over a 12-month period and to explore the associations of severe injury and related surgery with mental health symptoms among female professional footballers. Methods An observational prospective cohort study was conducted over a 12-month follow-up period by distributing an electronic questionnaire three times. The questionnaire was based on validated screening tools for assessing mental health symptoms. Results A total of 74 female professional football players participated in this study. Mental health symptoms ranged from 1% for substance misuse to 65% for sport-psychological distress at baseline, from 6% for anxiety to 53% for sport-psychological distress 6 months postbaseline and from 3% for substance misuse to 55% for sport-psychological distress 12 months postbaseline. The prevalence of disordered eating remained between 15% and 20% over the 12-month period. Only one of the associations was statistically significant. Female professional football players were nearly twice as likely to report sport-related psychological distress following every surgery. Conclusions The substantial prevalence of mental health symptoms among female professional football players emphasises the need for increased attention, awareness and interventions. Additionally, female professional football players are nearly twice as likely to report sport-related psychological distress after each surgery. Sports medicine physicians and mental health professionals working in female football should provide standard care, which involves identifying, monitoring and implementing tailored interventions for mental health symptoms.
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Affiliation(s)
- Sharaisha Chanita Bilgoe
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam, Netherlands
| | | | - Edwin Goedhart
- Royal Netherlands Football Association (KNVB), FIFA Medical Center of Excellence, Zeist, Netherlands
| | - Emmanuel Orhant
- French Football Federation (FFF), Clairefontaine Medical Centre, FIFA Medical Center of Excellence, Clairefontaine, France
| | - Gino Kerkhoffs
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Ageing & Vitaly, Amsterdam, Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, Netherlands
| | - Vincent Gouttebarge
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam, Netherlands
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Ageing & Vitaly, Amsterdam, Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Amsterdam, Netherlands
- Football Players Worldwide (FIFPRO), Hoofddorp, Netherlands
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4
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Hendricks S, Amino N, van Wyk JP, Gouttenbarge V, Mellalieu S, Schlebusch R. Inside edge - prevalence and factors associated with symptoms of anxiety/depression in professional cricketers. Res Sports Med 2024; 32:524-536. [PMID: 36284499 DOI: 10.1080/15438627.2022.2139619] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/20/2022] [Indexed: 10/31/2022]
Abstract
The purpose of this study was to i) determine the prevalence of anxiety/depression symptoms in professional cricketers and ii) identify factors associated with symptoms of anxiety/depression. One-hundred and seventy-seven (n = 177, response rate of 76%) professional cricketers completed the General Health Questionnaire 12 (GHQ-12). Odd ratios (OR) for anxiety/depression symptoms were related to players' career, family and education. Prevalence of symptoms of anxiety/depression was 59% (n = 104/177). Anxiety/depression symptoms increased when players were contracted for more than 2 years (OR: 5.0; 95% CI: 1.2-21.3; p = 0.028) and if they played their last offseason overseas (OR: 3.5; 95% CI: 1.3-9.6; p = 0.013). Anxiety/depression symptoms decreased by 70% when players made "productive use" of their time in the offseason (OR: 0.3; 95% CI: 0.1-0.9; p = 0.036) and contracted for 2 years (OR: 0.3; 95% CI: 0.1-1.0; p = 0.049). These findings can be incorporated into cricket mental health literacy programmes to improve awareness and understanding, and to encourage early help-seeking.
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Affiliation(s)
- Sharief Hendricks
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Health through Physical Activity, Lifestyle and Sport (HPALS) Research Centre, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK
| | - Nur Amino
- Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - J P van Wyk
- South African Cricketers' Association, Cape Town, South Africa
| | - Vincent Gouttenbarge
- Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center, Amsterdam, Netherlands
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Stephen Mellalieu
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Ruan Schlebusch
- South African Cricketers' Association, Cape Town, South Africa
- Sportsthink 360, Claremont, Cape Town, South Africa
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Harøy J, Bache-Mathiesen LK, Andersen TE. Lower HAGOS subscale scores associated with a longer duration of groin problems in football players in the subsequent season. BMJ Open Sport Exerc Med 2024; 10:e001812. [PMID: 38685919 PMCID: PMC11057268 DOI: 10.1136/bmjsem-2023-001812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Groin injuries represent a considerable problem in football. Although the Adductor Strengthening Programme reduced groin injury risk, players can still experience groin symptoms throughout the season. This study aimed to determine whether preseason Copenhagen Hip and Groin Outcome Score (HAGOS) and a history of previous injury can identify individuals at risk of having a longer duration of groin problems the subsequent season, using an 'any physical complaint' definition of injury. Methods Preseason HAGOS score and weekly groin problems were registered with the Oslo Sports Trauma Research Center Overuse questionnaire during one full season in 632 male semiprofessional adult players. Results The prognostic model showed a decreased number of weeks with groin problems for each increase in HAGOS score for 'groin-related quality of life' (QOL) (IRR=0.99, p=0.003). A 10-point higher 'QOL' score predicted 10% fewer weeks of groin problems. Additionally, previous hip/groin injury was associated with a 74% increase in the number of weeks with symptoms (p<0.001). Conclusion The HAGOS questionnaire applied preseason can detect players at risk of getting more weeks with groin problems the following season. The 'QOL' subscale seems to be the superior subscale for estimating subsequent groin problem duration. While HAGOS appears promising in identifying players at risk, previous groin injury is the most robust indicator, showing a substantial 74% increase in weeks with symptoms.
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Affiliation(s)
- Joar Harøy
- Oslo Sports Trauma Research Center, Department of of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- The Norwegian Football Association's Sports Medicine Center, Oslo, Norway
| | - Lena Kristin Bache-Mathiesen
- Oslo Sports Trauma Research Center, Department of of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- The Norwegian Football Association's Sports Medicine Center, Oslo, Norway
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Durán-Custodio R, Castillo D, Raya-González J, Yanci J. Is a Maximal Strength-Training Program Effective on Physical Fitness, Injury Incidence, and Injury Burden in Semi-Professional Soccer Players? A Randomized Controlled Trial. Healthcare (Basel) 2023; 11:3195. [PMID: 38132085 PMCID: PMC10742471 DOI: 10.3390/healthcare11243195] [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: 10/30/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 12/23/2023] Open
Abstract
The aims of the study were to analyze the effects of a 12-week maximal strength- training program on injury incidence, injury burden, and physical fitness in semi-professional soccer players and to compare the perceived exertion load and well-being state between injured and non-injured soccer players. Twenty semi-professional male soccer players participated in this study. Participants were randomly allocated to an experimental group (EG, n = 10 players), who performed a maximal strength-training program, or to a control group (CG, n = 10 players), who only performed their regular soccer training. Physical fitness was measured at baseline and after the training program. In addition, the injury incidence, burden, training/match load, and the state of well-being of the players were recorded. The EG showed significant improvements in vertical jumps, change in direction ability, linear sprints, repeated sprint ability, isometric strength (p < 0.003; effect size = 1.78-11.86), and quadriceps-hamstring imbalance in both legs (p < 0.001; effect size = 2.37-3.71) in comparison to the CG. In addition, the EG players showed a significantly (p < 0.05) lower injury burden (p < 0.001, relative risk = 5.05, 95% confidence interval = 3.27-7.79). This study demonstrated the beneficial effects of a 12-week maximal strength-training program on physical fitness attributes and injury burden in semi-professional soccer players.
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Affiliation(s)
- Roberto Durán-Custodio
- Faculty of Education and Sport, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain;
- Faculty of Health Sciences, International University of La Rioja (UNIR), 26006 Logroño, Spain
| | - Daniel Castillo
- Valoración del Rendimiento Deportivo, Actividad Física y Salud y Lesiones Deportivas (REDAFLED), Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Education, University of Valladolid, 42004 Soria, Spain
| | | | - Javier Yanci
- Society, Sports and Physical Exercise Research Group (GIKAFIT), Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain;
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Liveris NI, Papageorgiou G, Tsepis E, Fousekis K, Tsarbou C, Xergia SA. Towards the Development of a System Dynamics Model for the Prediction of Lower Extremity Injuries. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2023; 16:1052-1065. [PMID: 37649464 PMCID: PMC10464767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Acute noncontact Lower Extremity (LE) injuries constitute a significant problem in team sports. Despite extensive research, current knowledge on the risk factors of LE injuries is limited to static simplistic models of instantaneous cause and effect relationships ignoring the time dimension and the embedded complexity of LE injuries. Even though complex systems approaches have been used in various cases to improve policy and intervention effectiveness, there is limited research on predicting and managing LE injuries. This creates an opportunity to fill the gap in the current literature by applying the System Dynamics (SD) methodology to model LE injuries. The proposed approach allows for synthesizing risk factors and examining their interaction. This paper makes the first step towards such an approach by developing a causal loop model revealing the etiology of LE injuries. A causal loop model for LE injuries is developed via an extensive literature review and brainstorming with experts. In contrast to the traditional static approaches, the proposed model reveals some of the complexity and nonlinear relationships of the various sports injury risk factors. The derived causal loop model may then be used to quantify these interactions and develop a simulation model. This will be achieved by operationalizing and incorporating the main risk factors that impact LE injuries in an integrated sports injury prediction model. In this way, plausible strategies for preventing LE injuries can be tested prior implementation and thereby achieve optimization of intervention programs.
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Affiliation(s)
- Nikolaos I Liveris
- Department of Physiotherapy School of Health Rehabilitation Sciences University of Patras, Rio, Achaia, GREECE
| | | | - Elias Tsepis
- Department of Physiotherapy School of Health Rehabilitation Sciences University of Patras, Rio, Achaia, GREECE
| | - Konstantinos Fousekis
- Department of Physiotherapy School of Health Rehabilitation Sciences University of Patras, Rio, Achaia, GREECE
| | - Charis Tsarbou
- Department of Physiotherapy School of Health Rehabilitation Sciences University of Patras, Rio, Achaia, GREECE
| | - Sofia A Xergia
- Department of Physiotherapy School of Health Rehabilitation Sciences University of Patras, Rio, Achaia, GREECE
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DiBartola AC, Magnussen RA, Everhart JS, Milliron E, Emery CF, Schiele SE, Harris KM, Schmitt L, Flanigan DC. Athletes and Nonathletes Show No Difference in Symptoms or Function Prior to Knee Surgery, but Those With Chronic Symptoms Show Increased Pain Catastrophizing and Kinesiophobia. Arthroscopy 2023; 39:1028-1034. [PMID: 36872027 DOI: 10.1016/j.arthro.2022.10.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 10/09/2022] [Accepted: 10/26/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To determine whether preoperative psychological status before outpatient knee surgery is influenced by athletic status, symptom chronicity, or prior surgical history. METHODS International Knee Documentation Committee subjective scores (IKDC-S), Tegner Activity Scale scores, and Marx Activity Rating Scale scores were collected. Psychological and pain surveys included the McGill pain scale, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia 11, Patient Health Questionnaire 9, Perceived Stress Scale, New General Self-Efficacy Scale, and Life Orientation Test-Revised for optimism. Linear regression was used to determine the effects of athlete status, symptom chronicity (>6 months or ≤6 months), and history of prior surgery on preoperative knee function, pain, and psychological status after matching for age, sex, and surgical procedure. RESULTS In total, 497 knee surgery patients (247 athletes, 250 nonathletes) completed a preoperative electronic survey. All patients were age 14 years and older and had knee pathology requiring surgical treatment. Athletes were younger than nonathletes on average (mean [SD], 27.7 [11.4] vs 41.6 [13.5] years; P < .001). The most frequently reported level of play among athletes was intramural or recreational (n = 110, 44.5%). Athletes had higher preoperative IKDC-S scores (mean [SE], 2.5 [1.0] points higher; P = .015) and lower McGill pain scores compared to nonathletes (mean [SE] 2.0 [0.85] points lower; P = .017). After matching for age, sex, athlete status, prior surgery, and procedure type, having chronic symptoms resulted in higher preoperative IKDC-S (P < .001), pain catastrophizing (P < .001), and kinesiophobia scores (P = .044). CONCLUSIONS Athletes demonstrate no difference in symptom/pain and function scores preoperatively when compared to nonathletes of similar age, sex, and knee pathology, as well as no difference in multiple psychological distress outcomes measures. Patients with chronic symptoms have more pain catastrophizing and kinesiophobia, while those who have had prior knee surgeries have slightly higher preoperative McGill pain score. LEVEL OF EVIDENCE Level III, cross-sectional analysis of prospective cohort study data.
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Affiliation(s)
- Alex C DiBartola
- Department of Orthopaedics, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Robert A Magnussen
- Department of Orthopaedics, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A; Department of Orthopaedics Sports Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | | | - Eric Milliron
- The Ohio State University College of Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Charles F Emery
- Department of Psychology, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Steve E Schiele
- Department of Psychology, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Kristie M Harris
- Department of Orthopaedics, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Laura Schmitt
- Division of Physical Therapy, School of Health and Rehabilitation Sciences, Ohio State University and Jameson Crane Sports Medicine Research Institute, Ohio State University, Columbus, Ohio, U.S.A
| | - David C Flanigan
- Department of Orthopaedics, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A; Department of Orthopaedics Sports Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A; Cartilage Restoration Program, Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
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Nawasreh ZH, Yabroudi MA, Darwish AA, Debes WA, Bashaireh KM. Player Sex and Playing Surface Are Individual Predictors of Injuries in Professional Soccer Players. PATHOPHYSIOLOGY 2022; 29:619-630. [PMID: 36412633 PMCID: PMC9680497 DOI: 10.3390/pathophysiology29040048] [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: 09/05/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 12/14/2022] Open
Abstract
Background: The factors contributing to soccer injuries and their influence on the occurrence of injury are controversial and inconclusive. This study aimed to determine the association between player characteristics and playing factors with injuries in professional soccer players. Methods: One hundred and fifty-two professional soccer players completed a self-administered questionnaire that asked about demographic information and injury profile, the type of playing surface on which they sustained their injury, medical treatment, and the time lost due to soccer injury at the end of the soccer season. Results: The injury rate was 44.74% (n = 68; males: 61.50% (n = 56), females: 19.70% (n = 12)). Players’ age (OR: 1.15, 95%CI: 1.05−1.25, p < 0.002) and BMI (OR: 1.21, 95%CI: 1.06−1.38, p < 0.003) were significantly associated with soccer injuries. After adjusting for age and BMI, players’ sex (OR: 5.39, 95%CI: 2.11−13.75, p < 0.001), previous soccer injury (OR: 3.308, 95%CI: 2.307−29.920, p < 0.001), and playing surfaces (OR: 11.07, 95%CI: 4.53−27.03, p < 0.001) were the significant predictors of soccer injuries. Conclusion: Players’ age, BMI, sex, previous soccer injury, and playing surface were associated with injuries among professional soccer players. Old male athletes with high BMI, previous soccer injuries, and playing on natural grass were more likely to sustain soccer injuries than young female players with low BMI who had no previous injuries and played on synthetic surfaces.
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Affiliation(s)
- Zakariya H. Nawasreh
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
- Correspondence: ; Tel.: +962-27201000 (ext. 26937)
| | - Mohammad A. Yabroudi
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Ahmad A. Darwish
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Wesam A. Debes
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Khaldoon M. Bashaireh
- Department of Special Surgery, College of Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, P.O. Box 63001, Irbid 22110, Jordan
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Yung KK, Ardern CL, Serpiello FR, Robertson S. A Framework for Clinicians to Improve the Decision-Making Process in Return to Sport. SPORTS MEDICINE - OPEN 2022; 8:52. [PMID: 35416633 PMCID: PMC9008084 DOI: 10.1186/s40798-022-00440-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/23/2022] [Indexed: 12/14/2022]
Abstract
Return-to-sport (RTS) decisions are critical to clinical sports medicine and are often characterised by uncertainties, such as re-injury risk, time pressure induced by competition schedule and social stress from coaches, families and supporters. RTS decisions have implications not only for the health and performance of an athlete, but also the sports organisation. RTS decision-making is a complex process, which relies on evaluating multiple biopsychosocial factors, and is influenced by contextual factors. In this narrative review, we outline how RTS decision-making of clinicians could be evaluated from a decision analysis perspective. To begin with, the RTS decision could be explained as a sequence of steps, with a decision basis as the core component. We first elucidate the methodological considerations in gathering information from RTS tests. Second, we identify how decision-making frameworks have evolved and adapt decision-making theories to the RTS context. Third, we discuss the preferences and perspectives of the athlete, performance coach and manager. We conclude by proposing a framework for clinicians to improve the quality of RTS decisions and make recommendations for daily practice and research.
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Affiliation(s)
- Kate K Yung
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Clare L Ardern
- Musculoskeletal and Sports Injury Epidemiology Centre, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden.,Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Fabio R Serpiello
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Sam Robertson
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Kilic Ö, Carmody S, Upmeijer J, Kerkhoffs GMMJ, Purcell R, Rice S, Gouttebarge V. Prevalence of mental health symptoms among male and female Australian professional footballers. BMJ Open Sport Exerc Med 2021; 7:e001043. [PMID: 34394952 PMCID: PMC8314730 DOI: 10.1136/bmjsem-2021-001043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2021] [Indexed: 11/03/2022] Open
Abstract
Objective Determining the prevalence of mental health symptoms (MHS) among Australian professional footballers compared with former players. A secondary aim was to assess whether MHS were associated with recent injury and psychological resilience. Methods This cross-sectional study included 149 male (mean age: 24 years) and 132 female (mean age: 23 years) Australian A-League and W-League professional footballers (study group) and 81 former male footballers (control group, mean age: 39 years) for analysis. MHS and psychological resilience were assessed through validated questionnaires. Severe injuries were assessed through a single question. The adjusted Wald method was used to assess the primary aim. Logistic regression analyses was used to assess the secondary aim. Results The most prevalent MHS among active footballers and former footballers was sport-related psychological distress (63%) and alcohol misuse (69%), respectively. Global psychological distress, sleep disturbance, alcohol misuse and substance misuse were significantly lower among active male footballers than among former players. Increased psychological resilience among active male footballers was associated with a decrease in symptoms of sport-related and global psychological distress, anxiety and depression of 9%, 14%, 23% and 20%, respectively. Increased psychological resilience among female players was associated with 10% decrease in symptoms of depression. Problem gambling and sleep disturbance was associated with injury in the previous 6 months among active male and female footballers, respectively. Conclusions MHS are prevalent among active and former professional footballers. Higher level of psychological resilience is associated with decreased reporting of MHS. Severe injury is associated with problem gambling and sleep disturbance.
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Affiliation(s)
- Özgür Kilic
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Sean Carmody
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands.,Medical Department, Chelsea Football Club, London, The Netherlands
| | - Judith Upmeijer
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands
| | - Gino M M J Kerkhoffs
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Academic Center for Evidence-Based Sports Medicine (ACES), Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Rosemary Purcell
- Orygen, Parkville, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Simon Rice
- Orygen, Parkville, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Vincent Gouttebarge
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Section Sports Medicine, University of Pretoria, Pretoria, South Africa.,Football Players Worldwide (FIFPRO), Hoofddorp, The Netherlands
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13
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Clemente FM, Afonso J, Costa J, Oliveira R, Pino-Ortega J, Rico-González M. Relationships between Sleep, Athletic and Match Performance, Training Load, and Injuries: A Systematic Review of Soccer Players. Healthcare (Basel) 2021; 9:healthcare9070808. [PMID: 34206948 PMCID: PMC8305909 DOI: 10.3390/healthcare9070808] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this systematic review was to summarize available evidence regarding the relationships between sleep and (i) athletic and match performance, (ii) training load, and (iii) injuries in soccer players. A systematic review of EBSCOhost (SPORTDiscus), PubMed, Cochrane Library, FECYT (Web of Sciences, CCC, DIIDW, KJD, MEDLINE, RSCI, and SCIELO) databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 297 titles were identified, of which 32 met the eligibility criteria. Results revealed that soccer players are no exception for sleep inadequacy. Although there was inconsistency in the findings, some studies suggested that sleep restrictions in soccer negatively affected athletic and match performance while also increasing the number and severity of musculoskeletal injuries. On the other hand, inconsistent results were found between sleep and athletic and match performance, and training load in soccer players. Physiological responses (and their intensity) during drill-based games were not influenced by changes in sleep. The available evidence is inconsistent; however, it appears to suggest that poor sleep affects soccer players' performance and increases the risk of injury. However, it remains important to study this complex relationship further.
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Affiliation(s)
- Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, 1049-001 Lisboa, Portugal
- Correspondence:
| | - José Afonso
- Centre for Research, Education, Innovation and Intervention in Sport, Faculty of Sport of the University of Porto, 4200-450 Porto, Portugal;
| | - Júlio Costa
- Portugal Football School, Portuguese Football Federation, FPF, 1495-433 Cruz Quebrada, Portugal;
| | - Rafael Oliveira
- Sports Science School of Rio Maior–Polytechnic Institute of Santarém, 2140-413 Rio Maior, Portugal;
- Life Quality Research Centre, 2140-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, 5001-801 Vila Real, Portugal
| | - José Pino-Ortega
- Faculty of Sports Sciences, University of Murcia, 30720 San Javier, Spain;
- BIOVETMED & SPORTSCI Research Group, University of Murcia, 30720 San Javier, Spain;
| | - Markel Rico-González
- BIOVETMED & SPORTSCI Research Group, University of Murcia, 30720 San Javier, Spain;
- Department of Physical Education and Sport, University of the Basque Country, UPV-EHU, Lasarte 71, 01007 Vitoria-Gasteiz, Spain
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14
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Chennaoui M, Vanneau T, Trignol A, Arnal P, Gomez-Merino D, Baudot C, Perez J, Pochettino S, Eirale C, Chalabi H. How does sleep help recovery from exercise-induced muscle injuries? J Sci Med Sport 2021; 24:982-987. [PMID: 34074604 DOI: 10.1016/j.jsams.2021.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 03/20/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Athletes and military personnel may experience sleep disturbances due to conditions of training and competitions or military missions/field operations. The risk of muscle injuries is greater for them when sleep duration decreases, and training load increases simultaneously, which can be exacerbated by fatigue. Accumulating evidence demonstrates that sleep extension improved performance, pain sensitivity and GH/IGF-I anabolic responses, which may be beneficial in accelerating recovery from muscle injuries. DESIGN & METHODS This narrative review describes the importance of sleep for the recovery/prevention of exercise-induced muscle injuries and provides perspectives on the transferability of currently available scientific evidence to the field. RESULTS The first part presents the role of sleep and its interaction with the circadian system for the regulation of hormonal and immune responses, and provides information on sleep in athletes and soldiers and its relationship to injury risk. The second part is an overview of muscle injuries in sport and presents the different phases of muscle regeneration and repair, i.e. degeneration, inflammation, regeneration, remodeling and maturation. Part three provides information on the deleterious effects of sleep deprivation on muscle tissue and biological responses, and on the benefits of sleep interventions. Sleep extension could potentially help and/or prevent recovery from exercise-induced muscle-injuries through increasing local IGF-I and controlling local inflammation. CONCLUSIONS Although the science of sleep applied to sport is still an emerging field, the current scientific literature shows many potential physiological pathways between sleep and exercise-related muscle injuries. More direct studies are needed to establish clear guidelines for medical personnel and coaches.
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Affiliation(s)
- Mounir Chennaoui
- French Armed Forces Biomedical Research Institute (IRBA), France; Paris University, VIgilance FAtigue SOMmeil unit (VIFASOM) EA 7330, France.
| | - Théo Vanneau
- French Armed Forces Biomedical Research Institute (IRBA), France; Paris University, VIgilance FAtigue SOMmeil unit (VIFASOM) EA 7330, France
| | - Aurélie Trignol
- French Armed Forces Biomedical Research Institute (IRBA), France; Paris University, VIgilance FAtigue SOMmeil unit (VIFASOM) EA 7330, France
| | | | - Danielle Gomez-Merino
- French Armed Forces Biomedical Research Institute (IRBA), France; Paris University, VIgilance FAtigue SOMmeil unit (VIFASOM) EA 7330, France
| | | | | | | | - Cristiano Eirale
- Paris Saint Germain FC, France; Aspetar Sports and Orthopedics Hospital, Qatar
| | - Hakim Chalabi
- Paris Saint Germain FC, France; Aspetar Sports and Orthopedics Hospital, Qatar.
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15
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Grobler H, du Plooy K, Kruger P, Ellis S. The prevalence of common mental disorders and its relationship with mental toughness in professional South African rugby players. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1177/00812463211009422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study explores the relationship between common mental disorders and mental toughness in professional South African rugby players. A cross-sectional survey design was used by administering a questionnaire and preliminary and bivariate analyses were conducted. The inclusion criteria were professional rugby players who are able to communicate in English. The results indicated that, in general, these players (N = 215) portray significant mental toughness ( M = 5.69) on a 7-point scale. Anxiety/depression and distress measured the lowest ( M = 1.65) of all the common mental disorders measured in this study. Furthermore, the results indicated a positive relationship between mental toughness and sound sleep ( r = .262). Negative relationships were found between mental toughness and all other common mental disorders with the highest relationship being with anxiety/depression positive2 ( r = –.423). Other significant relationships were found with anxiety/depression ( r = –.401), distress ( r = –.259), and common mental disorders problems in general ( r = –.220). The results indicated that the management of teams and clinicians need to look at specific aspects, such as alcohol consumption among players, the implications of alcohol use on performance, but also mental wellbeing in general.
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Affiliation(s)
- Herman Grobler
- Community Psychosocial Research (COMPRES), North-West University, South Africa
| | - Kobus du Plooy
- Institute of Psychology & Wellbeing, North-West University, South Africa
| | - Pieter Kruger
- Institute of Psychology & Wellbeing, North-West University, South Africa
| | - Suria Ellis
- Statistics, North-West University, South Africa
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16
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van den Noort D, Oltmans E, Aoki H, Kerkhoffs GMMJ, Gouttebarge V. Clinical Hip Osteoarthritis in Current and Former Professional Footballers and Its Effect on Hip Function and Quality of Life. JOURNAL OF SPORTS SCIENCE AND MEDICINE 2021; 20:284-290. [PMID: 34211321 DOI: 10.52082/jssm.2021.284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/28/2021] [Indexed: 12/20/2022]
Abstract
The objective of the study was to establish the prevalence of clinical hip osteoarthritis in current and former professional footballers and to explore its consequences on hip function and health-related quality of life (HRQoL). A cross-sectional study by means of questionnaire was conducted among current and former professional footballers fulfilling the following inclusion criteria: (1) male (2) active or retired professional footballer (3) member of FIFPRO (Football Players Worldwide) (4) between 18 and 50 years old (5) could read and understand texts in French, Spanish, or English. Controls (matched for: gender, age, body weight and height) were also recruited. The main outcome measures were clinical hip osteoarthritis, hip function and HRQoL. Questionnaires were sent to 2,500 members of which 1,401 participated (1,000 current and 401 former professional footballers). Fifty-two controls were recruited. Prevalence of hip osteoarthritis was 2% among current and 8% among former professional footballers. Hip function was significantly (p ≤ 0.001) lower in both types of footballers with hip osteoarthritis than in footballers without hip osteoarthritis and controls. Current and former professional footballers with hip osteoarthritis reported significantly lower physical health scores (p = 0.032, p = 0.002) than those without. Hip osteoarthritis led to a significantly lower score in the physical (p = 0.004) and mental (p = 0.014) component of HRQoL in former footballers compared to the controls, while in current footballers only the physical component was significantly (p = 0.012) lower compared to the controls. Hip osteoarthritis has a higher prevalence in former than in current professional footballers and impacts hip function and HRQoL negatively.
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Affiliation(s)
- Dennie van den Noort
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Emmeline Oltmans
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands
| | - Haruhito Aoki
- St. Marianna University School of Medicine, Kawasaki, Japan.,Yokohama City Sports Medical Center, Yokohama, Japan
| | - Gino M M J Kerkhoffs
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands.,Academic Center for Evidence based Sports medicine (ACES), Amsterdam, the Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, the Netherlands
| | - Vincent Gouttebarge
- Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, the Netherlands.,Academic Center for Evidence based Sports medicine (ACES), Amsterdam, the Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, the Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.,FIFPRO (Football Players Worldwide), Hoofddorp, the Netherlands
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17
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Bush E, Cupery T, Turner RW, Sonnega A, Weir D, Whitfield KE, Jackson JS. The Price of Playing Through Pain: The Link Between Physical and Behavioral Health in Former NFL Athletes. Am J Mens Health 2020; 14:1557988320975541. [PMID: 33251947 PMCID: PMC7705796 DOI: 10.1177/1557988320975541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Over the past decade, media outlets have drawn attention to some of the health consequences of playing in the National Football League (NFL), including how wear-and-tear and injuries accumulated during athletes’ playing years can affect their physical, emotional, and behavioral health after retirement from professional sports. Through a secondary analysis of a cross-sectional telephone survey of former NFL athletes, this study estimated logistic regression models to assess the relationship between several forms of physical pain and anger attacks, controlling for binge drinking, signs of depression, functional limitations, NFL career duration, religious service attendance, and demographic characteristics (age, marital status, race, education, income, and wealth). The analytic sample included 1030 former NFL players. Neck pain, lower back pain, headaches/migraines, and the number of sites of pain were positively and significantly related to anger attacks. There was no significant association between joint pain and anger attacks. NFL career duration was negatively associated with anger attacks, as was religious service attendance. Future research should focus on factors that protect against affective aggression in former professional athletes and how protective factors can be adapted to the broader population.
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Affiliation(s)
- Evelyn Bush
- Department of Sociology and Anthropology, Fordham University, Bronx, NY, USA
| | - Tim Cupery
- Department of Sociology, College of Social Sciences, California State University, Fresno, CA, USA
| | - Robert W Turner
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Amanda Sonnega
- Survey Research Center of the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - David Weir
- Survey Research Center of the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - James S Jackson
- Department of Psychology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor, MI, USA
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18
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Kilic Ö, Hopley P, Kerkhoffs GMMJ, Lambert M, Verhagen E, Viljoen W, Wylleman P, Gouttebarge V. Impact of concussion and severe musculoskeletal injuries on the onset of mental health symptoms in male professional rugby players: a 12-month study. BMJ Open Sport Exerc Med 2019; 5:e000693. [PMID: 31908840 PMCID: PMC6937054 DOI: 10.1136/bmjsem-2019-000693] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2019] [Indexed: 01/10/2023] Open
Abstract
Objective This study explored the association between concussion or musculoskeletal injuries, and the onset of mental health symptoms (MHS) in male professional rugby players over a 12-month period. Methods Observational prospective cohort study with three measurements over a follow-up period of 12 months. At baseline, 573 participants provided informed consent. A total of 327 male professional rugby players (62% forwards, 38% backs) completed all follow-up assessments at baseline, 6 months and 12 months. The mean (±SD) age, height and weight of the participants at baseline was 25.9 (±4.4) years, 184.9 (±8.7) cm and 101.5 (±14.6) kg, respectively. Number of musculoskeletal injuries and number of confirmed concussions were assessed through single questions. Symptoms of distress, anxiety/depression, sleep disturbance, adverse alcohol use and eating disorders were assessed using validated questionnaires. Results Professional rugby players who sustained a concussion within 12 months of baseline were more likely to develop MHS with ORs ranging from 1.5 (95% CI 1.0 to 2.1) for distress to 2.0 (1.2 to 3.6) for adverse alcohol use. Players who sustained a severe injury within 12 months of baseline were more likely to develop symptoms anxiety/depression with an OR of 1.5 (1.1 to 2.0). There was no significant association in both groups for other MHS. Conclusions Rugby players who sustained concussion or severe injuries are up to two times more likely to develop symptoms of distress, adverse alcohol use or anxiety/depression.
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Affiliation(s)
- Özgür Kilic
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Noord-Holland, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands
| | - Phil Hopley
- Cognacity, London, United Kingdom.,Institute of Sport and Exercise Health, London, United Kingdom.,Division of Surgery, UCL, London, United Kingdom
| | - Gino M M J Kerkhoffs
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Noord-Holland, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Academic Center for Evidence based Sports medicine (ACES), Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Mike Lambert
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, The Netherlands
| | - Wayne Viljoen
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.,South African Rugby Union (SARU), Cape Town, South Africa
| | | | - Vincent Gouttebarge
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, Noord-Holland, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC IOC Research Center of Excellence, Amsterdam, The Netherlands.,Academic Center for Evidence based Sports medicine (ACES), Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
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19
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Gouttebarge V, Castaldelli-Maia JM, Gorczynski P, Hainline B, Hitchcock ME, Kerkhoffs GM, Rice SM, Reardon CL. Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis. Br J Sports Med 2019; 53:700-706. [PMID: 31097451 PMCID: PMC6579497 DOI: 10.1136/bjsports-2019-100671] [Citation(s) in RCA: 174] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives To present an overview of the existing epidemiological evidence regarding the occurrence of mental health symptoms and disorders among current and former elite athletes. Design Systematic review and meta-analysis. Data sources Five electronic databases were searched from inception to November 2018: PubMed (MEDLINE), SportDiscus via EBSCO, PSycINFO via ProQuest, Scopus and Cochrane. Eligibility criteria for selecting studies We included original quantitative studies that were written in English, were conducted exclusively among current or former elite athletes, and presented incidence or prevalence rates of symptoms of mental disorders. Results Twenty-two relevant original studies about mental health symptoms and disorders among current elite athletes were included: they presented data especially on symptoms of distress, sleep disturbance, anxiety/depression and alcohol misuse. Meta-analyses comprising 2895 to 5555 current elite athletes showed that the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression. Fifteen relevant original studies about mental health symptoms and disorders among former elite athletes were included: they similarly presented data especially about symptoms of distress, sleep disturbance, anxiety/depression and alcohol misuse. Meta-analyses comprising 1579 to 1686 former elite athletes showed that the prevalence of mental health symptoms and disorders ranged from 16% for distress to 26% for anxiety/depression. Conclusions Our meta-analyses showed that the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression for current elite athletes, and from 16% for distress to 26% for anxiety/depression for former elite athletes.
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Affiliation(s)
- Vincent Gouttebarge
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands .,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center of Excellence, Amsterdam, The Netherlands
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil.,Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
| | - Paul Gorczynski
- Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - Mary E Hitchcock
- Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Gino M Kerkhoffs
- Amsterdam UMC, Univ of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center of Excellence, Amsterdam, The Netherlands.,Amsterdam Center for Evidence-based Sports Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Simon M Rice
- Research and Translation, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,University Health Services, University of Wisconsin, Madison, Wisconsin, USA
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20
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Hainline B, Reardon CL. Breaking a taboo: why the International Olympic Committee convened experts to develop a consensus statement on mental health in elite athletes. Br J Sports Med 2019; 53:665-666. [PMID: 31097449 DOI: 10.1136/bjsports-2019-100681] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Brian Hainline
- Sport Science Institute, National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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21
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Mental health in elite athletes: International Olympic Committee consensus statement (2019). Br J Sports Med 2019; 53:667-699. [DOI: 10.1136/bjsports-2019-100715] [Citation(s) in RCA: 349] [Impact Index Per Article: 69.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 11/03/2022]
Abstract
Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.
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22
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Jansen P, Lehmann J, Fellner B, Huppertz G, Loose O, Achenbach L, Krutsch W. Relation of injuries and psychological symptoms in amateur soccer players. BMJ Open Sport Exerc Med 2019; 5:e000522. [PMID: 31205744 PMCID: PMC6540317 DOI: 10.1136/bmjsem-2019-000522] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives The first main goal of this study was to investigate the prevalence of depression and anxiety as well as self-compassion in a heterogeneous sample of male amateur soccer players. The second main goal of this study was the examination of the relationship between injuries and psychological factors in amateur soccer players. Methods Players were recruited from German amateur soccer clubs of the fourth to seventh league. 419 soccer players with the mean age of 22.88 years participated in the psychological and the injury assessment at the beginning of the season and at the end, 9 months later. For the psychological assessment, depression and anxiety rate as well as self-compassion was analysed. Furthermore, the frequencies of injuries were registered. Results The results showed that players of the highest amateur league, the fourth league in German soccer, showed significantly higher anxiety values than players from a lower league (p=0.013). There were no differences in depression values dependent on the league. Furthermore, players who suffered from an injury before the start of the season demonstrated higher anxiety values (p=0.027). This result was independent of the respective league. Conclusion The results of this study demonstrate that even in higher amateur soccer the anxiety level of the players varies between soccer players of different leagues. Because an injury before the start of the season influenced the anxiety level, a psychological treatment during injury should be considered.
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Affiliation(s)
- Petra Jansen
- Faculty of Psychology, Pedagogy and Sports Science, University of Regensburg, Regensburg, Bavaria, Germany
| | - Jennifer Lehmann
- Faculty of Psychology, Pedagogy and Sports Science, University of Regensburg, Regensburg, Bavaria, Germany
| | - Birgit Fellner
- Faculty of Psychology, Pedagogy and Sports Science, University of Regensburg, Regensburg, Bavaria, Germany
| | - Gunnar Huppertz
- Centerof Clinical Studies, University Medical Centre Regensburg, Regensburg, Bavaria, Germany
| | - Oliver Loose
- Clinic of Pediatric Surgery, Clinic St. Hedwig, Regensburg, Bavaria, Germany
| | - Leonard Achenbach
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Bavaria, Germany
| | - Werner Krutsch
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Bavaria, Germany
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23
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Stillman MA, Glick ID, McDuff D, Reardon CL, Hitchcock ME, Fitch VM, Hainline B. Psychotherapy for mental health symptoms and disorders in elite athletes: a narrative review. Br J Sports Med 2019; 53:767-771. [DOI: 10.1136/bjsports-2019-100654] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 11/03/2022]
Abstract
BackgroundAthletes, like non-athletes, suffer from mental health symptoms and disorders that affect their lives and their performance. Psychotherapy, either as the sole treatment or combined with other non-pharmacological and pharmacological strategies, is a pivotal component of management of mental health symptoms and disorders in elite athletes. Psychotherapy takes the form of individual, couples/family or group therapy and should address athlete-specific issues while being embraced as normative by athletes and their core stakeholders.Main findingsThis narrative review summarises controlled and non-controlled research on psychotherapy for elite athletes with mental health symptoms and disorders. In summary, treatment is similar to that of non-athletes—although with attention to issues that are athlete-specific. Challenges associated with psychotherapy with elite athletes are discussed, including diagnostic issues, deterrents to help-seeking and expectations about services. We describe certain personality characteristics sometimes associated with elite athletes, including narcissism and aggression, which could make psychotherapy with this population more challenging. The literature regarding psychotherapeutic interventions in elite athletes is sparse and largely anecdotal.
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Claudino JG, J Gabbet T, de Sá Souza H, Simim M, Fowler P, de Alcantara Borba D, Melo M, Bottino A, Loturco I, D'Almeida V, Carlos Amadio A, Cerca Serrão J, P Nassis G. Which parameters to use for sleep quality monitoring in team sport athletes? A systematic review and meta-analysis. BMJ Open Sport Exerc Med 2019; 5:e000475. [PMID: 30729029 PMCID: PMC6340585 DOI: 10.1136/bmjsem-2018-000475] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2018] [Indexed: 02/03/2023] Open
Abstract
Background Sleep quality is an essential component of athlete's recovery. However, a better understanding of the parameters to adequately quantify sleep quality in team sport athletes is clearly warranted. Objective To identify which parameters to use for sleep quality monitoring in team sport athletes. Methods Systematic searches for articles reporting the qualitative markers related to sleep in team sport athletes were conducted in PubMed, Scopus, SPORTDiscus and Web of Science online databases. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. For the meta-analysis, effect sizes with 95% CI were calculated and heterogeneity was assessed using a random-effects model. The coefficient of variation (CV) with 95% CI was also calculated to assess the level of instability of each parameter. Results In general, 30 measuring instruments were used for monitoring sleep quality. A meta-analysis was undertaken on 15 of these parameters. Four objective parameters inferred by actigraphy had significant results (sleep efficiency with small CV and sleep latency, wake episodes and total wake episode duration with large CV). Six subjective parameters obtained from questionnaires and scales also had meaningful results (Pittsburgh Sleep Quality Index (sleep efficiency), Likert scale (Hooper), Likert scale (no reference), Liverpool Jet-Lag Questionnaire, Liverpool Jet-Lag Questionnaire (sleep rating) and RESTQ (sleep quality)). Conclusions These data suggest that sleep efficiency using actigraphy, Pittsburgh Sleep Quality Index, Likert scale, Liverpool Jet-Lag Questionnaire and RESTQ are indicated to monitor sleep quality in team sport athletes. PROSPERO registration number CRD42018083941.
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Affiliation(s)
- João Gustavo Claudino
- School of Physical Education and Sport-Laboratory of Biomechanics, University of São Paulo, São Paulo, Brazil.,LOAD CONTROL, Contagem, Brazil
| | - Tim J Gabbet
- Gabbett Performance Solutions, Brisbane, Australia.,Institute for Resilient Regions, University of Southern Queensland, Ipswich, Brisbane, Australia
| | - Helton de Sá Souza
- Department of Psychobiology, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil
| | - Mário Simim
- Institute of Physical Education and Sports, Universidade Federal do Ceará, Ceará, Brazil
| | - Peter Fowler
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Queensland University of Technology, Queensland, Brisbane, Australia
| | | | - Marco Melo
- Department of Physiology, São Paulo Futebol Clube, São Paulo, Brazil
| | - Altamiro Bottino
- Department of Physiology, São Paulo Futebol Clube, São Paulo, Brazil
| | - Irineu Loturco
- NAR-Nucleus of High Performance in Sport, São Paulo, Brazil
| | - Vânia D'Almeida
- Department of Psychobiology, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil
| | - Alberto Carlos Amadio
- School of Physical Education and Sport-Laboratory of Biomechanics, University of São Paulo, São Paulo, Brazil
| | - Julio Cerca Serrão
- School of Physical Education and Sport-Laboratory of Biomechanics, University of São Paulo, São Paulo, Brazil
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Souter G, Lewis R, Serrant L. Men, Mental Health and Elite Sport: a Narrative Review. SPORTS MEDICINE-OPEN 2018; 4:57. [PMID: 30569248 PMCID: PMC6300449 DOI: 10.1186/s40798-018-0175-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 12/03/2018] [Indexed: 12/19/2022]
Abstract
Mental health in elite sport is receiving more publicity due to an increase in male athletes sharing their personal experiences. Sports injury is recognised as the major risk factor for psychological distress amongst male athletes, although anecdotally this may be that athletes are more likely to discuss their emotional wellbeing when related to the injury they are experiencing. Stress can be amplified within elite sport and the pressure they experience in relation to competition and performance can be exacerbated by adverse life events. This ongoing stress does not end when their sporting career does, it can follow them into retirement. The physical and psychological demands placed upon them by the sporting environment may predispose athletes to developing depression. As an athlete’s symptoms of mental illness intensify, their performance can be negatively affected leaving them vulnerable and exposed to further symptoms of common mental disorders. The pressure of performance can also expose male athletes to overtraining syndrome which can be difficult to distinguish from depression. Male athletes are more vulnerable to eating disorders compared with males in the general population and they do have anxieties, particularly around their bodies, but find it difficult to disclose their concerns. In addition to this, male athletes are more likely to use substances, including opioids to improve both sport and non-sport performance. Despite the prevalence of common mental disorders in male athletes, stigma still exists, and although some athletes discuss their issues publicly after their career has ended, the majority of athletes prefer to remain silent. There remains a view that athletes who seek help for psychological problems may be seen as weak. Although there is an improvement in help-seeking attitudes within elite sport, further research and education is needed to encourage men to talk about their mental health, share their experiences and to enjoy a greater sense of emotional wellbeing.
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Affiliation(s)
- Gary Souter
- Sheffield Hallam University, Faculty of Health & Wellbeing, F426 Robert Winston Building, 11-15 Broomhall Road, Sheffield, S10 2BP, UK.
| | - Robin Lewis
- Sheffield Hallam University, Faculty of Health & Wellbeing, M104 Mundella House, 34 Collegiate Crescent, Sheffield, S10 2BP, UK
| | - Laura Serrant
- Manchester Metropolitan University, Brooks Building Manchester Campus, Manchester, UK
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Abstract
Background Elite athletes can experience a diverse range of symptoms following post-concussive injury. The impact of sport-related concussion on specific mental health outcomes is unclear in this population. Objective The aim was to appraise the evidence base regarding the association between sport-related concussion and mental health outcomes in athletes competing at elite and professional levels. Methods A systematic search of PubMed, EMBASE, SPORTDiscus, PsycINFO, Cochrane, and Cinahl databases was conducted. Results A total of 27 studies met inclusion criteria for review. Most of the included studies (67%, n = 18) were published in 2014 or later. Study methodology and reporting varied markedly. The extant research has been conducted predominantly in North America (USA, n = 23 studies; Canada, n = 3), often in male only (44.4%, n = 12) and college (70.4%, n = 19) samples. Depression is the most commonly studied mental health outcome (70.4%, n = 19 studies). Cross-sectional retrospective studies and studies including a control comparison tend to support an association between concussion exposure and depression symptoms, although several studies report that these symptoms resolved in the medium term (i.e. 1 month) post-concussion. Evidence for anxiety is mixed. There are insufficient studies to draw conclusions for other mental health domains. Conclusion Consistent with current recommendations to assess mood disturbance in post-concussive examinations, current evidence suggests a link between sports-related concussion and depression symptoms in elite athletes. Causation cannot be determined at this stage of enquiry because of the lack of well-designed, prospective studies. More research is required that considers a range of mental health outcomes in diverse samples of elite athletes/sports. Electronic supplementary material The online version of this article (10.1007/s40279-017-0810-3) contains supplementary material, which is available to authorized users.
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Gouttebarge V, Aoki H, Kerkhoffs GMMJ. Lower extremity osteoarthritis is associated with lower health-related quality of life among retired professional footballers. PHYSICIAN SPORTSMED 2018. [PMID: 29527975 DOI: 10.1080/00913847.2018.1451718] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of the current study was to explore whether retired professional footballers suffering from lower extremity OA have a lower health-related quality of life than those without OA or current professional footballers. METHODS An observational study based on a cross-sectional design by means of questionnaires was conducted. Participants were retired and current professional footballers recruited by the World Players' Union (FIFPro). Information about lower extremity OA (clinically diagnosed by a medical professional) was gathered, while health-related quality of life (Global Physical Health and Global Mental Health scores) was assessed through a validated scale. RESULTS A total of 396 retired and 361 current professional footballers were included in the analyses (response rate of 54%). The group of retired professional footballers was on average 36 years old, and they had competed in professional football for 11 years (retired for 5 years). The group of current professional footballers was on average 25 years old, and they had been active in professional football for 7 years. Within the group of retired professional footballers, prevalence of lower extremity OA was 33%. Both Global Physical Health and Global Mental Health scores among retired professional footballers with lower extremity OA were significantly lower than among retired players without OA and current players, but these scores were nearly similar to the norm for the general population (regardless the presence of OA or not). CONCLUSIONS Health-related quality of life among retired professional footballers with lower extremity OA was significantly lower than among retired players without OA and current players but nearly similar to the norm for the general population (regardless the presence of OA or not). A rational recommendation is that a support measure such as the After Career Consultation should be introduced among retired professional footballers in order to empower their sustainable health and quality of life, focussing especially on the prevention of the occurrence or worsening of lower extremity OA.
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Affiliation(s)
- Vincent Gouttebarge
- a World Players' Union (FIFPro) , Hoofddorp , The Netherlands.,b Department of Orthopaedic Surgery, Academic Medical Center , University of Amsterdam, Amsterdam Movement Sciences , Amsterdam , The Netherlands.,c Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,d Amsterdam Collaboration on Health & Safety in Sports (ACHSS) , AMC/VUmc IOC Research Center , Amsterdam , The Netherlands.,e Division of Exercise Science and Sports Medicine , University of Cape Town , Cape Town , South Africa
| | - Haruhito Aoki
- f St. Marianna University School of Medicine , Kawasaki , Japan.,g Yokohama City Sports Medical Center , Yokohama , Japan
| | - Gino M M J Kerkhoffs
- b Department of Orthopaedic Surgery, Academic Medical Center , University of Amsterdam, Amsterdam Movement Sciences , Amsterdam , The Netherlands.,c Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,d Amsterdam Collaboration on Health & Safety in Sports (ACHSS) , AMC/VUmc IOC Research Center , Amsterdam , The Netherlands
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Gouttebarge V, Aoki H, Kerkhoffs GMMJ. Knee osteoarthritis in professional football is related to severe knee injury and knee surgery. Inj Epidemiol 2018; 5:26. [PMID: 29911282 PMCID: PMC6004342 DOI: 10.1186/s40621-018-0157-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/07/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND As a consequence of severe knee injuries, knee osteoarthritis (OA) seems prevalent in retired professional footballers. However, some epidemiological data remain missing, for instance whether knee OA is also prevalent in current professional footballers, whether knee OA is associated with knee injuries and surgeries, and whether knee OA leads to a lower level of functioning. Therefore, three research questions were answered: (i) what is the prevalence of knee osteoarthritis (OA) among current and retired professional footballers? (ii) is severe knee injury or knee surgery associated with knee OA among current and retired professional footballers? (iii) what are the consequences of knee OA on physical knee function among current and retired professional footballers? METHODS An observational study based on a cross-sectional design by means of questionnaires was conducted. Participants were current and retired professional footballers recruited by the World Players' Union (FIFPro). Information about severe knee injury and knee OA was gathered (medical record or team doctor), while physical knee function was assessed through a validated scale. RESULTS A total of 1360 participants (964 current and 396 retired professional footballers) were enrolled in the study (response rate of 54%). Prevalence of knee OA was 13% among current players and 28% among retired players (p < 0.01), being higher among older players. Current and retired professional footballers were nearly twice as likely to suffer from knee OA by every additional severe knee injury and by every additional knee surgery (risk ratio: 1.72-1.96; p < 0.01). Current and retired professional footballers with knee OA reported a lower level of physical knee function than current and retired players without OA (p < 0.01), their physical knee function being also lower than reference values (adult population, young athletic population and amateur footballers). CONCLUSION The prevalence of knee OA was higher among retired than among current professional footballers and reached up to 40%, leading to negative consequences for their physical knee function. Current and retired professional footballers were nearly twice as likely to suffer from knee OA by every additional severe knee injury and by every additional knee surgery incurred during their career. Management of knee OA should be prioritized among professional footballers, especially to prevent the worsening of the condition during their retirement years.
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Affiliation(s)
- Vincent Gouttebarge
- World Players' Union (FIFPro), Scorpius 161, 2132 LR, Hoofddorp, The Netherlands. .,Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands. .,Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands. .,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands. .,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.
| | - Haruhito Aoki
- St. Marianna University School of Medicine, Kawasaki, Japan.,Yokohama City Sports Medical Center, Yokohama, Japan
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
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Kilic Ö, Johnson U, Kerkhoffs GMMJ, Rosier P, Gouttebarge V. Exposure to physical and psychosocial stressors in relation to symptoms of common mental disorders among European professional football referees: a prospective cohort study. BMJ Open Sport Exerc Med 2018; 4:e000306. [PMID: 29629180 PMCID: PMC5884364 DOI: 10.1136/bmjsem-2017-000306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2018] [Indexed: 12/22/2022] Open
Abstract
Objectives The study aim was to explore the association of physical and psychosocial stressors (severe injuries, surgeries, recent life events, social support) with one-season onset of symptoms of common mental disorders (CMDs) among European professional football referees. Methods An observational prospective cohort study over a follow-up period of one season (2015-2016) was conducted among professional football referees from Belgium, Finland, France, Germany, Norway, Russia, Scotland and Sweden. Based on physical and psychosocial stressors as well as symptoms of CMD, an electronic questionnaire in English and French was set up and distributed by eight football federations involved. Results The prevalence of symptoms of CMD ranged from 5.9% for distress to 19.2% for eating disorders. A higher number of severe injuries and a lower degree of satisfaction about social support were significantly related to the occurrence of symptoms of CMD with an OR of 2.63 and an OR of 1.10, respectively. Conclusion A higher number of severe injuries and a lower degree on satisfaction about social support were found to be significantly associated with the onset of symptoms of CMD among European professional football referees. Referees suffering from severe injuries were nearly three times more likely to report symptoms of anxiety and depression. Referees who reported a low satisfaction of social support were significantly more likely to report symptoms of eating disorder.
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Affiliation(s)
- Özgür Kilic
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | | | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Philippe Rosier
- Royal Belgian Football Association, Brussels, Belgium.,Centre de Recherche Appliquée en Psychopédagogie de la Perception, University Fernando Pessoa, Porto, Portugal
| | - Vincent Gouttebarge
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
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Severe musculoskeletal time-loss injuries and symptoms of common mental disorders in professional soccer: a longitudinal analysis of 12-month follow-up data. Knee Surg Sports Traumatol Arthrosc 2018; 26:946-954. [PMID: 28698928 PMCID: PMC5847204 DOI: 10.1007/s00167-017-4644-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 07/07/2017] [Indexed: 10/31/2022]
Abstract
PURPOSE Psychological factors have shown to be predictors of injury in professional football. However, it seems that this is a two-way relationship, as severe musculoskeletal time-loss injuries have shown to be associated with the onset of symptoms of common mental disorders (CMD). There is no longitudinal study performed exploring this interaction between symptoms of CMD and injuries. The purpose of this study was to explore the interaction between severe musculoskeletal time-loss injuries and symptoms of CMD in professional football players over a 12-month period. METHODS Players were recruited by their national players' unions in five European countries. Symptoms of CMD included in the study were related to distress, anxiety/depression, sleep disturbance and adverse alcohol use. RESULTS A total of 384 professional football players were enrolled in the study, of whom 262 (68%) completed the 12-month follow-up period. The mean age of the participants at baseline was 27 ± 5 years, and they had played professional football for 8 ± 5 years on average. Symptoms of CMD at baseline were not associated with the onset of severe musculoskeletal time-loss injuries during the follow-up period with relative risks (and 95% CI) ranging from 0.6 (0.3-1.0) to 1.0 (0.5-2.2). In contrast, severe musculoskeletal time-loss injuries reported at baseline were associated with the onset of symptoms of CMD during the follow-up period with relative risks ranging from 1.8 (0.8-3.7) to 6.9 (4.0-11.9). CONCLUSION No relationship was found between symptoms of CMD and the onset of severe musculoskeletal time-loss injuries. However, professional football players who suffered from severe musculoskeletal time-loss injuries are likely to develop subsequent symptoms of CMD. This study emphasizes the need for an interdisciplinary medical approach, which not only focuses on the physical but also on the mental health of professional football players. An early identification of players at risk of symptoms of CMD, such as those suffering from severe musculoskeletal injuries, creates the opportunity for an interdisciplinary clinical medical team to treat the players timely and adequately. LEVEL OF EVIDENCE Prospective cohort study, Level II.
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Foskett RL, Longstaff F. The mental health of elite athletes in the United Kingdom. J Sci Med Sport 2017; 21:765-770. [PMID: 29289498 DOI: 10.1016/j.jsams.2017.11.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/03/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the prevalence of signs of anxiety/depression and distress among a sample of elite athletes in the United Kingdom (UK). A secondary aim was to identify the variables associated with signs of anxiety/depression and distress in the same sample. DESIGN A cross-sectional survey was distributed to a sample of elite athletes in the UK. METHODS A total of 143 elite athletes completed an online survey that consisted of demographic questions, the Greenhaus Scale assessing career satisfaction, the 12-Item General Health Questionnaire assessing signs of anxiety/depression and a distress screener based on the Four-Dimensional Symptom Questionnaire. RESULTS 47.8% of the overall sample met the cut-off for signs of anxiety/depression and 26.8% met the cut-off for signs of distress. A significant association was found between gender and signs of distress (x2=8.64, df=1, p=0.003). Career dissatisfaction was a significant independent predictor of signs of anxiety/depression (OR=0.836, p=0.001) and distress (OR=0.849, p=0.003). CONCLUSIONS The percentage of a sample of elite athletes in the UK showing signs of anxiety/depression and distress indicate that further cross-sectional research is required to understand the prevalence of mental health issues in the elite athlete population in the UK. Findings indicate that screening elite athletes for career dissatisfaction may support the early detection of signs of anxiety/depression and/or distress. Emphasis should be placed on understanding and improving the mental health of elite athletes in the UK.
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Gouttebarge V, Jonkers R, Moen M, Verhagen E, Wylleman P, Kerkhoffs G. A prospective cohort study on symptoms of common mental disorders among Dutch elite athletes. PHYSICIAN SPORTSMED 2017; 45:426-432. [PMID: 28826314 DOI: 10.1080/00913847.2017.1370987] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Scientific knowledge about symptoms of common mental disorders in elite sports is scarce. Consequently, the objectives of the study were to (i) establish the 12-month incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, adverse alcohol use, eating disorders) among Dutch elite athletes and (ii) explore their potential association with several stressors (being injured, recent life events, career dissatisfaction). METHODS A prospective cohort study with a 12-month follow-up period was conducted. The study used validated questionnaires to assess symptoms of common mental disorders (thus not clinically diagnosed) as well as several stressors; an electronic questionnaire was set up and repeatedly distributed. RESULTS A total of 203 elite athletes gave their written informed consent to participate in the study, from which 143 completed the 12-month follow-up period (follow-up rate of 70%). Incidence of symptoms of CMD ranged from 6% for adverse alcohol use to 57% for symptoms of anxiety/depression. Over the follow-up period, around 17% of the participants reported two simultaneous symptoms of CMD, and around 19% reported three simultaneous symptoms of CMD. Inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant. CONCLUSIONS Substantial 12-month incidence rates of symptoms of CMD (self-reported and not clinically diagnosed) were found among Dutch elite athletes (especially for anxiety/depression), appearing similar to the ones found among athletes from other sports disciplines and the Dutch general population. Also, inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve awareness and psychological resilience of athletes, which would likely improve their performance and quality-of-life.
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Affiliation(s)
- Vincent Gouttebarge
- a Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,b Amsterdam Collaboration for Health & Safety in Sports (ACHSS) , Academic Medical Center, VU University medical center , Amsterdam , The Netherlands.,c Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands.,d Division of Exercise Science and Sports Medicine , University of Cape Town , Cape Town , South Africa
| | | | - Maarten Moen
- f Elite Sports department , Nederlands Olympisch Comité en Nederlandse Sport Federatie (NOC*NSF) , Arnhem , The Netherlands.,g The Sportsphysician Group , Onze Lieve Vrouw Gasthuis , Amsterdam , The Netherlands
| | - Evert Verhagen
- b Amsterdam Collaboration for Health & Safety in Sports (ACHSS) , Academic Medical Center, VU University medical center , Amsterdam , The Netherlands.,d Division of Exercise Science and Sports Medicine , University of Cape Town , Cape Town , South Africa.,h Department of Public & Occupational Health and EMGO+ Institute , VU University Medical Center , Amsterdam , The Netherlands.,i Australian Centre for Research into Injury in Sport and its Prevention (ACRISP) , Federation University Australia , Australia
| | - Paul Wylleman
- f Elite Sports department , Nederlands Olympisch Comité en Nederlandse Sport Federatie (NOC*NSF) , Arnhem , The Netherlands.,j Department of Sports Policy and Management , Vrije Universiteit Brussel , Brussel , Belgium
| | - Gino Kerkhoffs
- a Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,b Amsterdam Collaboration for Health & Safety in Sports (ACHSS) , Academic Medical Center, VU University medical center , Amsterdam , The Netherlands.,c Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands
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Schuring N, Kerkhoffs G, Gray J, Gouttebarge V. The mental wellbeing of current and retired professional cricketers: an observational prospective cohort study. PHYSICIAN SPORTSMED 2017; 45:463-469. [PMID: 28952405 DOI: 10.1080/00913847.2017.1386069] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Scientific knowledge about symptoms of common mental disorders in professional cricket is non-existent. Consequently, the aims of the study were to determine the prevalence and the 6 months incidence of symptoms of common mental disorders (CMD: distress, anxiety/depression, sleep disturbance, adverse alcohol use) among current and former professional cricketers and to explore the association of potential stressors (significant injury, surgery, adverse life events, career dissatisfaction) and CMD. METHODS An observational prospective cohort study with a follow-up period of 6 months was conducted among current and former professional cricketers from South Africa. Using validated questionnaires to assess symptoms of common mental disorders as well as several stressors, an electronic questionnaire was set up and distributed by the South African Cricketers Association (SACA). RESULTS A total of 116 participants enrolled at baseline (overall response rate of 33%) and 76 of those participants completed the 6 month follow-up (follow up rate of 66%). The prevalence of symptoms of CMD in current professional cricketers was 38% for distress, 38% for sleep disturbance, 37% for anxiety/depression and 26% for adverse alcohol use. Among former professional cricketers, baseline prevalence as was 26% for distress, 24% for anxiety/depression, 21% for sleep disturbance and 22% for adverse alcohol use. Career dissatisfaction led to an increased risk of distress, anxiety/depression and sleep disturbance in current professional cricketers. Surgeries and adverse life events led to an increase in reported symptoms of distress and anxiety/depression in current professional cricketers. CONCLUSIONS It was concluded that symptoms of CMD are prevalent in both current and former professional cricketers and the association with surgery, adverse life events and cricket career dissatisfaction may provide some insight into possible mechanisms.
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Affiliation(s)
- Nannet Schuring
- a Academic Medical Center , Academic Center for Evidence based Sports medicine (ACES) , Amsterdam , The Netherlands.,b Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands
| | - Gino Kerkhoffs
- a Academic Medical Center , Academic Center for Evidence based Sports medicine (ACES) , Amsterdam , The Netherlands.,b Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands.,c Amsterdam Collaboration for Health & Safety in Sports (ACHSS), Academic Medical Center , VU University medical center , Amsterdam , The Netherlands
| | - Janine Gray
- d Division of Exercise Science and Sports Medicine , University of Cape Town , Cape Town , South Africa.,e Cricket South African (CSA) , Johannesburg , South Africa
| | - Vincent Gouttebarge
- a Academic Medical Center , Academic Center for Evidence based Sports medicine (ACES) , Amsterdam , The Netherlands.,b Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands.,c Amsterdam Collaboration for Health & Safety in Sports (ACHSS), Academic Medical Center , VU University medical center , Amsterdam , The Netherlands.,d Division of Exercise Science and Sports Medicine , University of Cape Town , Cape Town , South Africa
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Kilic Ö, Aoki H, Haagensen R, Jensen C, Johnson U, Kerkhoffs GMMJ, Gouttebarge V. Symptoms of common mental disorders and related stressors in Danish professional football and handball. Eur J Sport Sci 2017; 17:1328-1334. [PMID: 28961069 DOI: 10.1080/17461391.2017.1381768] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of the study was twofold, namely (i) to determine the prevalence of symptoms of common mental disorders (CMDs) among current and retired professional football and handball players and (ii) to explore the relationship of psychosocial stressors with the outcome measures under study. A total of 1155 players were enrolled in an observational study based on a cross-sectional design. Questionnaires based on validated scales were set up and distributed among current and retired professional football and handball players by the Danish football and handball players' union. In professional football, the highest prevalence (4 weeks) of symptoms of CMDs was 18% and 19% for anxiety/depression among current and retired players, respectively. In professional handball, the highest prevalence (4 weeks) of symptoms of CMDs was 26% and 16% for anxiety/depression among current and retired players, respectively. For both the current and retired professional football and handball players, a higher number of severe injuries and recent adverse life events (LE) were related to the presence of symptoms of CMD. Players exposed to severe injuries and/or recent adverse LE were 20-50% times more likely to report symptoms of CMD. The results suggest that it is possible to recognize the population of professional athletes that are more likely to develop symptoms of CMD. This could create the opportunity to intervene preventively on athletes that suffered from severe injury and/or recent adverse LE that could lead to a faster and safer recovery and psychological readiness to return to play.
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Affiliation(s)
- Özgür Kilic
- a Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center , Amsterdam , Netherlands
| | - Haruhito Aoki
- b St. Marianna University School of Medicine , Kawasaki , Japan
| | | | - Claus Jensen
- d Department of Sport Management , University College Nordjylland , Aalborg , Denmark
| | | | - Gino M M J Kerkhoffs
- a Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center , Amsterdam , Netherlands.,f Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , Netherlands.,g Amsterdam Collaboration for Health & Safety in Sports (ACHSS) , Academic Medical Center/VU University Medical Center , Amsterdam , Netherlands
| | - Vincent Gouttebarge
- a Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center , Amsterdam , Netherlands.,f Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , Netherlands.,h Division of Exercise Science and Sports Medicine , University of Cape Town , Cape Town , South Africa.,i World Players' Union (FIFPro) , Hoofddorp , Netherlands
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Gouttebarge V, Johnson U, Rochcongar P, Rosier P, Kerkhoffs G. Symptoms of common mental disorders among professional football referees: a one-season prospective study across Europe. PHYSICIAN SPORTSMED 2017; 45:11-16. [PMID: 27741403 DOI: 10.1080/00913847.2017.1248796] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The primary aim of this study was to determine the prevalence and one-season incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, eating disorders, adverse alcohol use) among European professional football referees. A secondary aim was to explore the view of European professional football referees on consequences, support and needs related to these symptoms. METHODS An observational prospective cohort study with three measurements over a follow-up period of one season (2015-2016) was conducted among central or assistant professional football referees from Belgium, Finland, France, Germany, Norway, Russia, Scotland and Sweden. Using validated questionnaires to assess symptoms of CMD (self-reported and not clinically diagnosed), an electronic questionnaire in English and French was set up and distributed by the eight football federations involved. RESULTS A total of 391 referees (mean age of 33 years old; mean career duration of 7 years) were enrolled, of which 292 completed the follow-up period. Baseline 4-week prevalence rates were 6% for distress, 12% for anxiety/depression, 9% for sleep disturbance, 19% for eating disorders and 17% for adverse alcohol use. The one-season incidence of symptoms of CMD was 10% for distress, 16% for anxiety/depression, 14% for sleep disturbance, 29% for eating disorders and 8% for adverse alcohol use. CONCLUSION While symptoms of CMD occur among professional football referees and can influence negatively refereeing performances, the development of specific support measures for referees are needed in order to manage properly these symptoms of CMD.
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Affiliation(s)
- Vincent Gouttebarge
- a Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,b Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands.,c Division of Exercise Science and Sports Medicine , University of Cape Town , Cape Town , South Africa
| | | | - Pierre Rochcongar
- e Fédération Française de Football , Paris , France.,f Centre National de Football (FIFA Medical Centres of Excellence) , Clairefontaine , France
| | - Philippe Rosier
- g Royal Belgian Football Association , Brussels , Belgium.,h Centre de Recherche Appliquée en Psychopédagogie de la Perception , University Fernando Pessoa , Porto , Portugal
| | - Gino Kerkhoffs
- a Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,b Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands.,i Amsterdam Collaboration for Health & Safety in Sports (ACHSS) , Academic Medical Center /VU Medical Center , Amsterdam , The Netherlands
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Schuring N, Aoki H, Gray J, Kerkhoffs GMMJ, Lambert M, Gouttebarge V. Osteoarthritis is associated with symptoms of common mental disorders among former elite athletes. Knee Surg Sports Traumatol Arthrosc 2017; 25:3179-3185. [PMID: 27488101 PMCID: PMC5603643 DOI: 10.1007/s00167-016-4255-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/27/2016] [Indexed: 01/15/2023]
Abstract
PURPOSE The primary aim was to establish the association between osteoarthritis (OA) and the occurrence and comorbidity of symptoms of common mental disorders (CMD: distress, anxiety/depression, sleep disturbance, adverse alcohol use) in a group of former elite athletes (rugby, football, ice hockey, Gaelic sports and cricket). A secondary aim was to explore this association in the subgroups of sports. METHODS Cross-sectional analysis was performed on the baseline questionnaires from five prospective cohort studies conducted between April 2014 and January 2016 in former elite athletes of rugby, football, ice hockey, Gaelic sports and cricket. The presence of OA (diagnosed by a medical professional) was examined with a single question, and symptoms of CMD were evaluated through multiple validated questionnaires (4DSQ, GHQ-12, PROMIS, AUDIT-C). RESULTS There was a significant association between OA and symptoms of distress (OR 1.7, 95 % CI 1.2-2.6), sleep disturbance (OR 1.6, 95 % CI 1.1-2.3), adverse alcohol use (OR 1.8, 95 % CI 1.2-2.6) and a comorbidity of symptoms of CMD (OR 1.5, 95 % CI 1.0-2.1) in former elite athletes. CONCLUSION OA might be a risk factor for developing symptoms of CMD in former elite athletes. The clinical relevance of this study is that an interdisciplinary approach to the clinical care and support of former elite athletes after their careers is advocated as the interaction between the physical and mental health issues occurring on the long term is complex. Monitoring OA among former elite athletes should be empowered while strategies to prevent symptoms worsening should be developed and implemented. The self-awareness, prevention and care of mental health problems that might occur after a professional sports career should also be addressed. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Nannet Schuring
- Academic Center for Evidence-based Sports medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands
| | - Haruhito Aoki
- St. Marianna University School of Medicine, Kawasaki, Japan
| | - Janine Gray
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
| | - Gino M. M. J. Kerkhoffs
- Academic Center for Evidence-based Sports medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands ,Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands ,Amsterdam Collaboration for Health & Safety in Sports (ACHSS), Academic Medical Center/VU Medical Center, Amsterdam, The Netherlands
| | - Mike Lambert
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa ,EMGO + Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Academic Center for Evidence-based Sports medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands. .,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa. .,Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands. .,Amsterdam Collaboration for Health & Safety in Sports (ACHSS), Academic Medical Center/VU Medical Center, Amsterdam, The Netherlands. .,World Players' Union (FIFPro), Scorpius 161, 2132 LR, Hoofddorp, The Netherlands.
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Gouttebarge V, Jonkers R, Moen M, Verhagen E, Wylleman P, Kerkhoffs G. The prevalence and risk indicators of symptoms of common mental disorders among current and former Dutch elite athletes. J Sports Sci 2016; 35:2148-2156. [PMID: 27894209 DOI: 10.1080/02640414.2016.1258485] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The aim of the study was to determine the prevalence and comorbidity of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance, eating disorders, adverse alcohol use) among current and former Dutch elite athletes, and to explore the inference between potential risk indicators (severe injury, surgery, life events, sport career dissatisfaction, social support) and the outcomes measures under investigation. Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among 203 current and 282 former elite Dutch athletes (response rate: 28% among current athletes and 95% among former athletes). Based on validated scales, an electronic questionnaire was set up and distributed. Prevalence (4-week) ranged from 6% for adverse alcohol use to 45% for anxiety/depression among current elite athletes, and from 18% for distress to 29% for anxiety/depression among former elite athletes. A higher number of past severe injuries, higher number of past surgeries, higher number of recent life events, higher level of career dissatisfaction and lower level of social support were related to the occurrence of symptoms of common mental disorders among both current and former elite athletes. On average, the 4-week prevalence of common mental disorders as shown in our study among current and former Dutch elite athletes were similar to the ones found among athletes from other sports disciplines and does compare with the lifetime prevalence estimates in the general population of the Netherlands.
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Affiliation(s)
- Vincent Gouttebarge
- a Academic Center for Evidence based Sports Medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,b Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands.,c Division of Exercise Science and Sports Medicine (ESSM) , University of Cape Town , Cape Town , South Africa
| | | | - Maarten Moen
- e Elite Sports Department , Nederlands Olympisch Comité en Nederlandse Sport Federatie (NOC*NSF) , Arnhem , The Netherlands.,f The Sportsphysician Group , Onze Lieve Vrouw Gasthuis , Amsterdam , The Netherlands
| | - Evert Verhagen
- c Division of Exercise Science and Sports Medicine (ESSM) , University of Cape Town , Cape Town , South Africa.,g Department of Public & Occupational Health and EMGO+ Institute , VU University Medical Center , Amsterdam , The Netherlands.,h Amsterdam Collaboration for Health & Safety in Sports (ACHSS), IOC Research Center , Academic Medical Center/VU Medical Center , Amsterdam , The Netherlands.,i Australian Centre for Research into Injury in Sport and its Prevention (ACRISP) , Federation University Australia , Ballarat , Australia
| | - Paul Wylleman
- e Elite Sports Department , Nederlands Olympisch Comité en Nederlandse Sport Federatie (NOC*NSF) , Arnhem , The Netherlands.,j Department of Sports Policy and Management , Vrije Universiteit Brussel , Brussel , Belgium
| | - Gino Kerkhoffs
- a Academic Center for Evidence based Sports Medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,b Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands.,h Amsterdam Collaboration for Health & Safety in Sports (ACHSS), IOC Research Center , Academic Medical Center/VU Medical Center , Amsterdam , The Netherlands
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Gouttebarge V, Aoki H, Verhagen E, Kerkhoffs G. Are Level of Education and Employment Related to Symptoms of Common Mental Disorders in Current and Retired Professional Footballers? Asian J Sports Med 2016; 7:e28447. [PMID: 27625749 PMCID: PMC5003303 DOI: 10.5812/asjsm.28447] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 08/28/2015] [Accepted: 09/06/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Mental disorders have become a topic of increasing interest in research due to their serious consequences for quality of life and functioning. OBJECTIVES The objective of this study was to explore the relationship of level of education, employment status and working hours with symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance, adverse alcohol behaviour, smoking, adverse nutritional behaviour) among current and retired professional footballers. MATERIALS AND METHODS Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among current and retired professional footballers. Based on validated scales, an electronic questionnaire was set up and distributed by players' unions in 11 countries across three continents. RESULTS A total of 607 current professional footballers (mean age of 27 years) and 219 retired professional footballers (mean age of 35 years) were involved in the study. Among retired professional footballers, statistically significant negative correlations were found between employment status and symptoms of distress and anxiety/depression (P < 0.05), as well as between number of working hours and symptoms of anxiety/depression (P < 0.05). No other statistically significant associations were found among retired players. Among current professional footballers, level of education was not associated with symptoms of common mental disorders. CONCLUSIONS Among retired professional footballers, employment status as well as a higher number of working hours was weakly correlated to symptoms of distress and anxiety/depression. Combining a football career with sustainable attention for educational and career planning might be important and of high priority.
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Affiliation(s)
- Vincent Gouttebarge
- World Players’ Union (FIFPro), Hoofddorp, The Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Academic Medical Center / VU University Medical Center, Amsterdam, The Netherlands
- Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands
- Corresponding author: Vincent Gouttebarge, World Players’ Union (FIFPro), Hoofddorp, The Netherlands, Tel: +31-621547499, E-mail:
| | - Haruhito Aoki
- St. Marianna University School of Medicine, Kawasaki, Japan
| | - Evert Verhagen
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Academic Medical Center / VU University Medical Center, Amsterdam, The Netherlands
- Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Gino Kerkhoffs
- Academic Center for Evidence Based Sports Medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands
- Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Academic Medical Center / VU University Medical Center, Amsterdam, The Netherlands
- Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands
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Gouttebarge V, Tol JL, Kerkhoffs GMMJ. Epidemiology of symptoms of common mental disorders among elite Gaelic athletes: a prospective cohort study. PHYSICIAN SPORTSMED 2016; 44:283-9. [PMID: 27149248 DOI: 10.1080/00913847.2016.1185385] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Scientific knowledge about symptoms of common mental disorders among elite Gaelic athletes is lacking. Consequently, this study aimed to (i) determine the prevalence, comorbidity and 6-month incidence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance, adverse alcohol use) among elite Gaelic athletes and (ii) evaluate their association with potential stressors (severe musculoskeletal injuries, surgeries, recent life events, career dissatisfaction). METHODS An observational prospective cohort study by means of questionnaires was conducted over six months among elite Gaelic athletes (N=204). Using validated questionnaires to assess symptoms of common mental disorders as well as several stressors, an electronic questionnaire was set up and distributed by the Gaelic Players' Association. RESULTS Prevalence ranged from 23% for adverse alcohol use to 48% for anxiety/depression. Around 24% of the participants reported at baseline two symptoms. Six-month incidence ranged from 11% for sleep disturbance to 21% for anxiety/depression. Severe musculoskeletal injury, surgery, recent life events and career dissatisfaction led to an increased risk for common mental disorders. CONCLUSION Our findings indicate that raising the self-awareness of all stakeholders in Gaelic sports about common mental disorders should be prioritized, as well as the evidence-based development and application of adequate preventive and supportive measures.
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Affiliation(s)
- Vincent Gouttebarge
- a Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,b Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Academic Medical Center , VU University Medical Center , Amsterdam , The Netherlands.,c Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands.,d World Players' Union (FIFPro), Players' Services , Hoofddorp , The Netherlands
| | - Johannes L Tol
- a Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,e Sports Physician Group , OLVG , Amsterdam , The Netherlands
| | - Gino M M J Kerkhoffs
- a Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,b Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Academic Medical Center , VU University Medical Center , Amsterdam , The Netherlands.,c Department of Orthopaedic Surgery , Academic Medical Center , Amsterdam , The Netherlands
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Gouttebarge V, Backx FJG, Aoki H, Kerkhoffs GMMJ. Symptoms of Common Mental Disorders in Professional Football (Soccer) Across Five European Countries. J Sports Sci Med 2015; 14:811-818. [PMID: 26664278 PMCID: PMC4657424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 10/08/2015] [Indexed: 06/05/2023]
Abstract
Evidence on the prevalence of symptoms related to distress, anxiety/depression or substance abuse/dependence, - typically referred to as symptoms of common mental disorders (CMD) - is lacking in European professional football (soccer). The aims of the present study were to investigate the prevalence of symptoms related to CMD (distress, anxiety/depression, sleeping disturbance, adverse alcohol behaviour, and adverse nutrition behaviour) in professional footballers from five European countries, and to explore associations of the outcome measures under study with life events and career dissatisfaction. A cross-sectional design was used. Questionnaires were distributed among professional footballers by the national players' unions in Finland, France, Norway, Spain and Sweden. The highest prevalence of symptoms related to common mental disorders were 18% for distress (Sweden), 43% for anxiety/depression (Norway), 33% for sleeping disturbance (Spain), 17% for adverse alcohol behaviour (Finland), and 74% for adverse nutrition behaviour (Norway). In Finland, France and Sweden, both life events and career dissatisfaction were associated with distress, anxiety/depression, adverse alcohol behaviour, and adverse nutrition behaviour. Results suggest the need for self-awareness in professional football about common mental disorders and a multidisciplinary approach by the medical team. Key pointsThe highest prevalence of symptoms related to common mental disorders were 18% for distress (Sweden), 43% for anxiety/depression (Norway), 33% for sleeping disturbance (Spain), 17% for adverse alcohol behaviour (Finland), and 74% for adverse nutrition behaviour (Norway).In Finland, France and Sweden, both life events and career dissatisfaction were associated with distress, anxiety/depression, adverse alcohol behaviour, and adverse nutrition behaviour.Our results suggest the need for self-awareness in professional football about common mental disorders and a multidisciplinary approach by the medical team.Further research based on longitudinal design should be conducted in order to acquire an insight into the causal relationship between symptoms related to common mental disorders and risk factors.
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Affiliation(s)
- Vincent Gouttebarge
- World Players' Union (FIFPro) , Hoofddorp, The Netherlands ; Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center , Amsterdam ; Amsterdam Collaboration for Health & Safety in Sports (ACHSS), Academic Medical Center / VU University Medical Center , Amsterdam, The Netherlands ; Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam , The Netherlands
| | - Frank J G Backx
- Department of Rehabilitation, Nursing Science and Sports, University Medical Center , Utrecht, The Netherlands
| | - Haruhito Aoki
- St. Marianna University School of Medicine , Kawasaki, Japan
| | - Gino M M J Kerkhoffs
- Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center , Amsterdam ; Amsterdam Collaboration for Health & Safety in Sports (ACHSS), Academic Medical Center / VU University Medical Center , Amsterdam, The Netherlands ; Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam , The Netherlands
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