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Valentin S, Linton L, Sculthorpe NF. Effect of supervision and athlete age and sex on exercise-based injury prevention programme effectiveness in sport: A meta-analysis of 44 studies. Res Sports Med 2024; 32:705-724. [PMID: 37283040 DOI: 10.1080/15438627.2023.2220059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/23/2023] [Indexed: 06/08/2023]
Abstract
We aimed to evaluate the influence of supervision, athlete age and sex and programme duration and adherence on exercise-based injury prevention programme effectiveness in sport. Databases were searched for randomized controlled trials evaluating exercise-based injury prevention programme effectiveness compared to "train-as-normal". A random effects meta-analysis for overall effect and pooled effects by sex and supervision and meta-regression for age, intervention duration and adherence were performed. Programmes were effective overall (risk ratio (RR) 0.71) and equally beneficial for female-only (0.73) and male-only (0.65) cohorts. Supervised programmes were effective (0.67), unlike unsupervised programmes (1.04). No significant association was identified between programme effectiveness and age or intervention duration. The inverse association between injury rate and adherence was significant (β=-0.014, p = 0.004). Supervised programmes reduce injury by 33%, but there is no evidence for the effectiveness of non-supervised programmes. Females and males benefit equally, and age (to early middle age) does not affect programme effectiveness.
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Affiliation(s)
- Stephanie Valentin
- Sport and Physical Activity Research Institute, University of the West of Scotland, Blantyre, UK
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Linda Linton
- Edinburgh Sports Medicine Research Network & UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), Institute for Sport, PE and Health Sciences, FASIC Sport and Exercise Medicine Clinic, University of Edinburgh, Edinburgh, UK
| | - Nicholas F Sculthorpe
- Sport and Physical Activity Research Institute, University of the West of Scotland, Blantyre, UK
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Hameed I, Farooq N, Haq A, Aimen I, Shanley J. Role of strengthening exercises in management and prevention of overuse sports injuries of lower extremity: a systematic review. J Sports Med Phys Fitness 2024; 64:807-815. [PMID: 38470015 DOI: 10.23736/s0022-4707.23.15470-3] [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: 03/13/2024]
Abstract
INTRODUCTION Overuse injuries are common in sports involving jumping, running, and landing, due to the repetitive nature of these activities and the strain they place on the lower extremity. The objective of the study was to determine the role of strengthening exercises in the management of overuse sports injuries of lower extremity and its effects on prevention of injury recurrence. EVIDENCE ACQUISITION This study employed a systematic review design. The author extracted and reviewed the papers for this study in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, and then used the PEDro scale to rate the articles' quality. For the most recent and well-developed primary data, several electronic databases including Google Scholar, PubMed Central, MEDLINE, Cochrane Library, and PEDro were exhaustively searched. Inclusion criteria were based on PICO (T) model and included study population, intervention nature, outcome measures, time period, methodological quality, and linguistic extent. EVIDENCE SYNTHESIS The data synthesis involved analyzing randomized control/clinical trials on strengthening exercises for lower extremity overuse sports injuries in athletes, considering outcomes including muscle strength, pain scores, return to sports, and injury prevention. CONCLUSIONS The methodological quality of the recruited articles ranged from excellent to fair on PEDro scale. Three included studies investigated the effects of strengthening exercises on management of lower extremity injuries of athletes. Four studies evaluated its role on prevention from recurrence of injuries. This study has concluded that strength training plays a fundamental role in management and prevention of overuse injuries. It not only improves the muscle performance, fitness level, speed and agility in sports but also decreases the pain, and aids in early recovery from an injury.
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Affiliation(s)
- Iqra Hameed
- Postgraduate Course in Advancing Physiotherapy Practice, Coventry University, Coventry, UK -
| | - Nawal Farooq
- Department of Physical Therapy, Riphah International University, Lahore, Pakistan
| | - Ayesha Haq
- Department of Physical Therapy, Riphah International University, Lahore, Pakistan
| | - Ifra Aimen
- Department of Physical Therapy, Riphah International University, Lahore, Pakistan
| | - Jackie Shanley
- Postgraduate Course in Advancing Physiotherapy Practice, Coventry University, Coventry, UK
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3
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Qin Z, Qin Y, Wang J. Neuromuscular Training Effects on Athletes' Jumping and Lower Limb Injury: A Systematic Review. J Mot Behav 2024:1-14. [PMID: 38967242 DOI: 10.1080/00222895.2024.2369699] [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: 02/06/2024] [Accepted: 06/09/2024] [Indexed: 07/06/2024]
Abstract
This study assessed the impact of integrated neuromuscular training (INT) on athletes' jumping performance and lower limb injury prevention. A thorough search across multiple databases, including PubMed, Web of Science, Science Direct, and the Cochrane Library, identified a sample of 19,805 athletes aged between 8.5 and 27.7 years. Results showed that INT led to a significant improvement in jumping ability (SMD = 0.45, 95% CI 0.30-0.60, P = 0.000) and a reduction in lower limb injuries (SMD = 0.68, 95% CI 0.62-0.74, P = 0.000). The most effective interventions lasted at least 25 minutes, conducted 2-5 times per week, for a minimum of 9 weeks. This approach was particularly beneficial for children and adolescents, as it enhanced their countermovement jump (CMJ) ability and helped in the prevention of injuries.
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Affiliation(s)
- Zhikai Qin
- Capital University of Physical Education and Sports, Beijing, China
| | | | - Junsheng Wang
- Capital University of Physical Education and Sports, Beijing, China
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Silvers-Granelli H, Silverman R, Bizzini M, Thorborg K, Brophy RH. The 11+ injury prevention programme decreases rate of hamstring strain injuries in male collegiate soccer players. Br J Sports Med 2024; 58:701-708. [PMID: 38599679 DOI: 10.1136/bjsports-2023-107323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES To investigate if the 11+ injury prevention programme decreases the risk of hamstring injury and improves recovery time and determine whether compliance with the 11+ affects hamstring injury risk. METHODS This study is a secondary analysis from a prospective cluster randomised controlled trial that included 65 National Collegiate Athletic Association (NCAA) division I and II men's soccer teams over the fall 2012 season. Thirty-one teams were randomised to the intervention group that were using the 11+ as their warm-up and 35 teams to the control group that continued to use their traditional warm-up. Each certified athletic trainer (ATC) collected data on demographics, hamstring injury (HSI), mechanism of injury, position, playing surface, time lost due to injury and compliance to the 11+ programme. RESULTS The 11+ decreased the risk of HSI by 63% compared with the control group (RR=0.37, 95% CI 0.21 to 0.63). Difference in return to play after HSI between the control (9.4±11.2 days) and intervention groups (10.2±11.3 days) was not significant (p=0.8). High compliance (>2 or more doses on average per week) reduced the risk of HSI by 78% (RR=0.22, 95% CI 0.06 to 0.87) compared with low compliance (<1 dose on average per week), and moderate compliance (1 to <2 doses on average per week) decreased the risk of HSI by 67% (RR=0.33, 95% CI 0.11 to 0.97) compared with low compliance. There was no significant difference between high and moderate compliance. CONCLUSION The 11+ decreased the risk of HSI by 63% but did not improve recovery time. High to moderate compliance is essential and makes the programme more effective at reducing HSI.
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Affiliation(s)
- Holly Silvers-Granelli
- Velocity Physical Therapy, Santa Monica, California, USA
- Research, Major League Soccer, New York, New York, USA
| | - Richard Silverman
- Washington University in St Louis School of Medicine, Saint Louis, Missouri, USA
| | - Mario Bizzini
- Research, Schulthess Klinik Human Performance Lab, Zurich, Switzerland
- Swiss Sport Physiotherapy Association, Leukerbad, VS, Switzerland
| | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark, Hvidovre Hospital, Hvidovre, Denmark
| | - Robert H Brophy
- Orthopaedic Surgery, Washington University in Saint Louis School of Medicine, Chesterfield, Missouri, USA
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Abdelnour P, Zhao KY, Babouras A, Corban JPAH, Karatzas N, Fevens T, Martineau PA. Comparing the Drop Vertical Jump Tracking Performance of the Azure Kinect to the Kinect V2. SENSORS (BASEL, SWITZERLAND) 2024; 24:3814. [PMID: 38931598 PMCID: PMC11207603 DOI: 10.3390/s24123814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
Traditional motion analysis systems are impractical for widespread screening of non-contact anterior cruciate ligament (ACL) injury risk. The Kinect V2 has been identified as a portable and reliable alternative but was replaced by the Azure Kinect. We hypothesize that the Azure Kinect will assess drop vertical jump (DVJ) parameters associated with ACL injury risk with similar accuracy to its predecessor, the Kinect V2. Sixty-nine participants performed DVJs while being recorded by both the Azure Kinect and the Kinect V2 simultaneously. Our software analyzed the data to identify initial coronal, peak coronal, and peak sagittal knee angles. Agreement between the two systems was evaluated using the intraclass correlation coefficient (ICC). There was poor agreement between the Azure Kinect and the Kinect V2 for initial and peak coronal angles (ICC values ranging from 0.135 to 0.446), and moderate agreement for peak sagittal angles (ICC = 0.608, 0.655 for left and right knees, respectively). At this point in time, the Azure Kinect system is not a reliable successor to the Kinect V2 system for assessment of initial coronal, peak coronal, and peak sagittal angles during a DVJ, despite demonstrating superior tracking of continuous knee angles. Alternative motion analysis systems should be explored.
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Affiliation(s)
- Patrik Abdelnour
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de la Montagne, Montreal, QC H3G 2M1, Canada; (P.A.); (K.Y.Z.); (N.K.)
| | - Kevin Y. Zhao
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de la Montagne, Montreal, QC H3G 2M1, Canada; (P.A.); (K.Y.Z.); (N.K.)
- Division of Orthopaedic Surgery, McGill University Health Centre, 1650 Cedar Ave, Montreal, QC H3G 1A4, Canada;
| | - Athanasios Babouras
- Department of Experimental Surgery, McGill University, 845 Sherbrooke St W, Montreal, QC H3A 0G4, Canada;
| | | | - Nicolaos Karatzas
- Faculty of Medicine and Health Sciences, McGill University, 3605 Rue de la Montagne, Montreal, QC H3G 2M1, Canada; (P.A.); (K.Y.Z.); (N.K.)
| | - Thomas Fevens
- Department of Computer Science and Software Engineering, Concordia University, 1455 De Maisonneuve Blvd. W., Montreal, QC H3G 1M8, Canada;
| | - Paul Andre Martineau
- Division of Orthopaedic Surgery, McGill University Health Centre, 1650 Cedar Ave, Montreal, QC H3G 1A4, Canada;
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Crotti M, Heering T, Lander N, Fox A, Barnett LM, Duncan MJ. Extrinsic Risk Factors for Primary Noncontact Anterior Cruciate Ligament Injury in Adolescents Aged between 14 and 18 years: A Systematic Review. Sports Med 2024; 54:875-894. [PMID: 38236505 DOI: 10.1007/s40279-023-01975-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Adolescents present a high incidence of ACL injury compared with other age groups. Examining the risk factors that predispose adolescents to primary noncontact ACL injury is a key strategy to decrease the number of injuries in this population. OBJECTIVE The aim of this systematic review was to summarise the existing literature investigating extrinsic risk factors that have been linked with primary noncontact ACL injury risk (identified either using ACL injury occurrence or using screening tests measuring biomechanical mechanisms for noncontact ACL injury) in adolescents including research investigating: (1) the association between extrinsic risk factors and primary noncontact ACL injury risk; and (2) whether primary noncontact ACL injury risk was different in populations or groups exposed to different extrinsic risk factors in adolescents. METHODS The same search strategy was used in MEDLINE, SPORTDiscus, CINAHL, PubMed and Embase. Articles were included if: written in English; published in peer-reviewed journals; investigating and discussing primary noncontact ACL injury risk associated with extrinsic risk factors; they were original research articles with an observational design; and participants presented a mean age ranging between 14 and 18 years. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies (QATOCCS) was used to assess the quality and risk of bias of the articles included in this systematic review. RESULTS The systematic review included 16 eligible articles published up to August 2022 about extrinsic risk factors for primary noncontact ACL injury including: sport (8 studies); sport exposure amount (5); sport level (3); sport season (1); environment (2); equipment (1). Differences in biomechanical risk factors predisposing to ACL injury were reported by sport in female adolescents playing basketball and soccer; however, no good evidence of differences in primary noncontact ACL injury rate by sport was reported in both male and female adolescents. There was contrasting evidence about associations between sport exposure and biomechanical and neuromuscular risk factors predisposing to ACL injury or primary noncontact ACL injury rate in both male and female adolescent players from different sports. There was weak evidence of differences in biomechanical risk factors predisposing to ACL injury by environmental condition in both male and female adolescents playing soccer and season phase in male adolescents playing basketball. Lastly, few good-quality articles suggested that higher sport level might be associated with increased primary noncontact ACL injury rate in female adolescents playing basketball and floorball and that bracing might not prevent primary noncontact ACL injuries in both male and female adolescent players from different sports. DISCUSSION The findings emphasise the need for further research to clarify the evidence about extrinsic risk factors and primary noncontact ACL injury in adolescents to develop ACL injury prevention guidelines that would help practitioners and researchers identify adolescents at risk and design future interventions. Future epidemiological studies should collect data about extrinsic factors as well as data about primary noncontact injury separately from secondary injuries or contact injuries to better inform primary noncontact ACL injury prevention in adolescents. REGISTRATION https://doi.org/10.17605/OSF.IO/VM82F (11/08/2021).
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Affiliation(s)
- Matteo Crotti
- Centre for Physical Activity, Sport and Exercise Science, Coventry University, Coventry, UK.
| | - Theresa Heering
- Centre for Physical Activity, Sport and Exercise Science, Coventry University, Coventry, UK
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Natalie Lander
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Aaron Fox
- School of Exercise and Nutrition Science, Deakin University, Melbourne, VIC, Australia
| | - Lisa M Barnett
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Michael J Duncan
- Centre for Physical Activity, Sport and Exercise Science, Coventry University, Coventry, UK
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7
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Magaña-Ramírez M, Gallardo-Gómez D, Álvarez-Barbosa F, Corral-Pernía JA. What exercise programme is the most appropriate to mitigate anterior cruciate ligament injury risk in football (soccer) players? A systematic review and network meta-analysis. J Sci Med Sport 2024; 27:234-242. [PMID: 38395699 DOI: 10.1016/j.jsams.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 12/29/2023] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES To examine the effectiveness of different exercise-based interventions to mitigate the risk of anterior cruciate ligament injury in football players, and to determine which is the most appropriate for them, specifically for female football players. DESIGN Four databases were accessed in July 2023 using the keywords football, soccer, athletic injuries, anterior cruciate ligament, knee injuries, injury prevention, exercise-based programme, and risk factor. METHODS Randomised controlled trials that evaluated any exercise-based injury prevention intervention compared with a control group on the prevention of anterior cruciate ligament injury in football players were included. RESULTS Eleven studies were included. Data were presented as logarithm hazard ratio, credible intervals and standard deviation. FIFA 11+ was the most effective in reducing anterior cruciate ligament injury risk in football players (logarithm hazard ratio = -1.23 [95% credible intervals: -2.20, -0.35]; SD = 0.47), followed by the Knäkontroll programme (logarithm hazard ratio = -0.76 [95% credible intervals: -1.60, -0.03]; standard deviation = 0.42). For females, only Knäkontroll had a significant impact on reducing the risk of anterior cruciate ligament injury (logarithm hazard ratio = -0.62 [95% credible intervals: -1.71, 0.62]; standard deviation = 0.58). CONCLUSIONS Our results support the use of FIFA 11+ and Knäkontroll to mitigate injury incidence at overall level. However, the effectiveness of these interventions changed when adjusting for females. Knäkontroll is postulated as the programme with the greatest preventive nature, although these results should be interpreted with caution due to the lack of the sample.
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Affiliation(s)
- Manuel Magaña-Ramírez
- University of Seville, Faculty of Education Sciences, Spain. https://twitter.com/manuemaga
| | - Daniel Gallardo-Gómez
- University of Seville, Faculty of Education Sciences, Spain. https://twitter.com/DanielG12754470
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8
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Mohr M, Federolf P, Heinrich D, Nitschke M, Raschner C, Scharbert J, Koelewijn AD. An 8-week injury prevention exercise program combined with change-of-direction technique training limits movement patterns associated with anterior cruciate ligament injury risk. Sci Rep 2024; 14:3115. [PMID: 38326644 PMCID: PMC10850483 DOI: 10.1038/s41598-024-53640-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/03/2024] [Indexed: 02/09/2024] Open
Abstract
Knee ligament sprains are common during change-of-direction (COD) maneuvers in multidirectional team sports. This study aimed to compare the effects of an 8-week injury prevention exercise program containing COD-specific exercises and a similar program containing linear sprint exercises on injury- and performance-related variables during a 135° COD task. We hypothesized that the COD-specific training would lead to (H1) stronger reductions in biomechanical variables associated with anterior cruciate ligament (ACL) injury risk during COD, i.e. knee abduction moment and angle, hip internal rotation angle and lateral trunk lean, and (H2) more effective improvements in COD performance according to the COD completion time, executed angle, ground contact time, and approach speed. Twenty-two sports science students (40% female) completed biomechanical assessments of COD movement strategies before and after participating in two supervised 25-min training sessions per week over 8 weeks. We observed significant 'training x group' interaction effects in support of H1: the COD-specific training but not the linear sprint training led to reduced peak knee abduction moments (interaction, p = 0.027), initial knee abduction (interaction, p < 0.001), and initial lateral trunk lean angles (interaction, p < 0.001) compared to baseline. Although the COD-specific training resulted in sharper executed angles (interaction, p < 0.001), the sprint-specific training group showed reduced COD completion (interaction, p = 0.037) and ground contact times (interaction, p < 0.001). In conclusion, a combination of generic and COD-specific injury prevention training resulted in COD technique adaptations that can help to avoid ACL injury-prone COD movements but may negatively affect COD speed.
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Affiliation(s)
- M Mohr
- Department of Sport Science, Universität Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria.
| | - P Federolf
- Department of Sport Science, Universität Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - D Heinrich
- Department of Sport Science, Universität Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - M Nitschke
- Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - C Raschner
- Department of Sport Science, Universität Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - J Scharbert
- Department of Sport Science, Universität Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - A D Koelewijn
- Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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9
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Ochiai D. Editorial Commentary: Hip Range of Motion Is Greater in Women. Arthroscopy 2024; 40:513-514. [PMID: 38296449 DOI: 10.1016/j.arthro.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/24/2023] [Indexed: 02/08/2024]
Abstract
Hip range of motion is greater in women. Notably, flexion and internal rotation are significantly greater in women than men. Having a sense of normal variances between female and male range of motion characteristics can help clinicians better identify pathologic findings, which can lead to more prompt treatment for our patients and has implications for injury prevention and activity modification recommendations. A broader understanding of differences between men and women can help with not only treating individual patients but treating large populations of patients.
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10
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Muramoto Y, Iwamoto W, Iida S, Sasagawa K, Kobayashi H, Ishibuchi S, Murakami J, Maehara Y, Tanaka N, Wagatsuma K, Kuruma H. Effectiveness of warm-up and dynamic balance training in preventing anterior cruciate ligament injuries in college gymnasts: a 3-year prospective study for one team. J Sports Med Phys Fitness 2024; 64:167-174. [PMID: 38093642 DOI: 10.23736/s0022-4707.23.15539-3] [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: 01/24/2024]
Abstract
BACKGROUND The effect of trunk stability and dynamic balance warm-up exercises on physical functional improvement remains unelucidated. This study examined whether exercises could prevent anterior cruciate ligament (ACL) injury and improve trunk muscle activation and dynamic balance in gymnasts. METHODS This comparison study, involving gymnastics practice sessions, included 31 university gymnasts and was conducted in two periods: 1 year of observation followed by 2 years of intervention. Participants performed a trunk and dynamic balance warm-up exercise program during the intervention. The effect of exercise on the incidence of ACL injury was evaluated. In addition, the paired t-test was used to compare the Y-balance distance and the changes in muscle thickness associated with trunk muscle activation at rest and during plank. RESULTS ACL injury risk during the intervention was significantly lower, with a relative risk of 0.23 (P=0.02, 95% CI: 0.06-0.88). Changes in muscle thickness with activation of the transversus abdominis (P<0.01, mean difference 4.1, 95% CI: 9.97-28.07, Cohen's d=0.52), internal oblique (P<0.01, mean difference 5.2, 95% CI: 9.72-21.55, Cohen's d=0.65), and external oblique (P<0.01, mean difference 5.5, 95% CI: 20.44-39.09, Cohen's d=0.71) muscles were significantly higher during the intervention. The Y-balance distance was also significantly greater in the posterior medial reach (P<0.01, mean difference 3.3, 95% CI: 1.56-6.26, Cohen's d=0.46) during the intervention. CONCLUSIONS Exercise-based warm-up programs may decrease ACL injuries. It can improve physical functions, such as the rate of change in trunk muscle thickness and the posterior medial distance during Y balance.
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Affiliation(s)
- Yuki Muramoto
- Institute for Integrated Sports Medicine, School of Medicine, Keio University, Tokyo, Japan -
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan -
| | - Wtataru Iwamoto
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | - Syota Iida
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | - Kaoru Sasagawa
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | | | | | | | - Yuko Maehara
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | - Naoki Tanaka
- Faculty of Health Care and Medical Sports, Teikyo Heisei University, Chiba, Japan
| | - Koji Wagatsuma
- Department of Sports Medicine, Edogawa Hospital, Tokyo, Japan
| | - Hironobu Kuruma
- Department of Physical Therapy Science, Tokyo Metropolitan University Graduate School of Human Health Sciences, Tokyo, Japan
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11
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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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12
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Jiménez-Rubio S, Raya-González J, Lobo-Triviño D, García-Calvo T. The impact of a multicomponent training program on physical fitness and joint injuries in Spanish male professional soccer players. J Sports Sci 2023; 41:1934-1943. [PMID: 38258651 DOI: 10.1080/02640414.2024.2307780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
This study aimed to assess the effects of a multicomponent training program (ProSAS) on selected measures of physical fitness and joint injuries in Spanish male professional soccer players. Twenty-six professional soccer players (age: 25.2 ± 3.1 years) were randomly assigned to either the experimental (EG; n = 16) or control group (CG; n = 10). Y-balance test (YBT), Single leg countermovement jump (SLCMJ), Single leg hop for distance test (SLH), Side-hop test (SH), Speedy jump test (SpJ), Agility T-test (TT) and Lower extremity functional test (LEFT) were performed before and after an 8-weeks training period. Additionally, any joint injury occurring during the intervention period were recorded. Significant improvements in the EG in all tests (p = 0.001 to p = 0.014), except for SLCMJ (p = 0.632) with the dominant leg were observed. CG displayed decreases in SLCMJ with the non-dominant leg (p = 0.014), SH for both legs (p = 0.001 to p = 0.050), TT (p = 0.005), and LEFT (p = 0.001). Inter-groups differences revealed better results for the EG in all variables (p = 0.001 to p = 0.008) except from SLCMJd (p = 0.555). Moreover, the EG exhibited lower joint injury incidence and burden compared to the CG (p < 0.05). These findings suggest that the ProSAS is an effective multicomponent program to improve variables related to risk of joint injuries, and consequently, to reduce the incidence and burden of these injuries in professional soccer players.
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Di Paolo S, Grassi A, Tosarelli F, Crepaldi M, Bragonzoni L, Zaffagnini S, Della Villa F. Two-Dimensional and Three-Dimensional Biomechanical Factors During 90° Change of Direction are Associated to Non-Contact ACL injury in Female Soccer Players. Int J Sports Phys Ther 2023; 18:887-897. [PMID: 37547837 PMCID: PMC10399106 DOI: 10.26603/001c.84308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Background The two-dimensional (2D) video-analysis of the change of direction (COD) technique has never been used to attempt to predict the risk of ACL injury in female football players. Hypothesis/Purpose The purpose of the present pilot study was to prospectively investigate the biomechanical predictors of ACL injury during a COD task in female football players using both gold standard 3D motion capture and a qualitative scoring system based on 2D video-analysis. Study Design Prospective cohort study. Methods Sixteen competitive female football (soccer) players (age 21.4 ± 4.3) performed a series of pre-planned 90° COD tasks. 3D motion data was recorded through 10 stereophotogrammetric cameras and a force platform. 2D frontal and transverse plane joint kinematics were computed through video-analysis from three high-speed cameras. A scoring system based on five criteria was adopted: limb stability, pelvis stability, trunk stability, shock absorption, and movement strategy. The players were prospectively followed for the next two consecutive football seasons and the occurrence of severe knee injuries was registered. Results Four players (25%) experienced an ACL injury. In 3D analysis, ACL-injured players showed greater knee valgus, knee internal rotation, and lower knee flexion (p= 0.017 - 0.029). Lower hip flexion coupled with greater external rotation (p= 0.003 - 0.042), ankle eversion, and contralateral pelvic drop (p<0.001) were also noted. In 2D analysis, ACL-injured players showed greater internal foot rotation, contralateral pelvic drop, lower knee flexion, and contralateral trunk tilt (moderate-to-large effect size). Pelvis stability and trunk stability showed the highest predictive value towards ACL injury. Total score was significantly lower in ACL-injured players with a moderate effect size (d=0.45). Conclusions Both 3D and 2D methodologies depicted biomechanical risk factors and offered predictive insights towards the ACL injury risk. Awareness should rise in women's football regarding the high risk of ACL injury and the strategies to assess and mitigate it. Level of Evidence 3©The Author(s).
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Affiliation(s)
| | - Alberto Grassi
- 2nd Orthopaedic and Traumatologic Clinic Istituto Ortopedico Rizzoli
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Obërtinca R, Hoxha I, Meha R, Lama A, Bimbashi A, Kuqi D, Shabani B, Meyer T, der Fünten KA. Efficacy of Multi-Component Exercise-Based Injury Prevention Programs on Injury Risk Among Footballers of All Age Groups: A Systematic Review and Meta-analysis. Sports Med 2023; 53:837-848. [PMID: 36752977 PMCID: PMC10036279 DOI: 10.1007/s40279-022-01797-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Playing football is associated with a high risk of injury. Injury prevention is a priority as injuries not only negatively impact health but also potentially performance. Various multi-component exercise-based injury prevention programs for football players have been examined in studies. OBJECTIVE We aimed to investigate the efficacy of multi-component exercise-based injury prevention programs among footballers of all age groups in comparison to a control group. METHODS We conducted a systematic review and meta-analysis of randomized and cluster-randomized controlled trials. CINAHL, Cochrane, PubMed, Scopus, and Web of Science databases were searched from inception to June 2022. The following inclusion criteria were used for studies to determine their eligibility: they (1) include football (soccer) players; (2) investigate the preventive effect of multi-component exercise-based injury prevention programs in football; (3) contain original data from a randomized or cluster-randomized trial; and (4) investigate football injuries as the outcome. The risk of bias and quality of evidence were assessed using the Cochrane Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), respectively. The outcome measures were the risk ratio (RR) between the intervention and the control group for the overall number of injuries and body region-specific, contact, and non-contact injuries sustained during the study period in training and match play. RESULTS Fifteen randomized and cluster-randomized controlled trials with 22,177 players, 5080 injuries, and 1,587,327 exposure hours fulfilled the inclusion criteria and reported the required outcome measures. The point estimate (RR) for the overall number of injuries was 0.71 (95% confidence interval [CI] 0.59-0.85; 95% prediction interval [PI] 0.38-1.32) with very low-quality evidence. The point estimate (RR) for lower limb injuries was 0.82 (95% CI 0.71-0.94; 95% PI 0.58-1.15) with moderate-quality evidence; for hip/groin injuries, the RR was 0.56 (95% CI 0.30-1.05; 95% PI 0.00-102.92) with low-quality evidence; for knee injuries, the RR was 0.69 (95% CI 0.52-0.90; 95% PI 0.31-1.50) with low-quality evidence; for ankle injuries, the RR was 0.73 (95% CI 0.55-0.96; 95% PI 0.36-1.46) with moderate-quality evidence; and for hamstring injuries, the RR was 0.83 (95% CI 0.50-1.37) with low-quality evidence. The point estimate (RR) for contact injuries was 0.70 (95% CI 0.56-0.88; 95% PI 0.40-1.24) with moderate-quality evidence, while for non-contact injuries, the RR was 0.78 (95% CI 0.55-1.10; 95% PI 0.25-2.47) with low-quality evidence. CONCLUSIONS This systematic review and meta-analysis indicated that the treatment effect associated with the use of multi-component exercise-based injury prevention programs in football is uncertain and inconclusive. In addition, the majority of the results are based on low-quality evidence. Therefore, future high-quality trials are needed to provide more reliable evidence. CLINICAL TRIAL REGISTRATION PROSPERO CRD42020221772.
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Affiliation(s)
- Rilind Obërtinca
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany.
- Department of Physiotherapy, University of Gjakova "Fehmi Agani", Gjakova, Kosovo.
| | - Ilir Hoxha
- Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA
- Research Unit, Heimerer College, Pristina, Kosovo
- Evidence Synthesis Group, Pristina, Kosovo
| | - Rina Meha
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany
- Research Unit, Heimerer College, Pristina, Kosovo
| | - Arber Lama
- Research Unit, Heimerer College, Pristina, Kosovo
- Evidence Synthesis Group, Pristina, Kosovo
- University Clinical Center of Kosovo, Pristina, Kosovo
| | | | | | - Bujar Shabani
- Research Unit, Heimerer College, Pristina, Kosovo
- University Clinical Center of Kosovo, Pristina, Kosovo
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany
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Nye NS, Grubic T, Kim M, O'Connor F, Deuster PA. Universal Training Precautions: A Review of Evidence and Recommendations for Prevention of Exercise-Related Injury, Illness, and Death in Warfighters and Athletes. J Athl Train 2023; 58:232-243. [PMID: 35724358 PMCID: PMC10176841 DOI: 10.4085/1062-6050-0400.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Facing pressure to train for victory, warfighters and athletes encounter numerous health risks that are directly related to their regular physical training. The concept of universal training precautions (UTPs) signifies universal processes designed to prevent unnecessary bodily harm, including injury, illness, and death, during physical training programs. Although no formal guidelines exist for collectively implementing a defined set of UTPs to address a broad scope of exercise-related health risks, recommendations and guidelines have been published relating to preventing sudden death during high school sports and collegiate conditioning sessions. A long list of critical topics must be considered as UTPs, including physical fitness factors, transition-period accommodation, hydration, environmental factors and acclimatization, appropriate recovery, use of medications and dietary supplements, and importantly, leadership. In this article, we outline in detail, with corresponding Strength of Recommendation Taxonomy ratings, what should be considered universal recommendations to minimize the risk of warfighters and athletes coming to harm when participating in group physical activities.
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Affiliation(s)
| | - Tyler Grubic
- Aviation Survival Training Center, NAS Patuxent River, MD
| | - Michael Kim
- Sports Medicine Clinic, Fort Belvoir Community Hospital, VA
| | | | - Patricia A. Deuster
- USU/MEM Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Silver Spring, MD
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16
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Di Paolo S, Nijmeijer EM, Bragonzoni L, Gokeler A, Benjaminse A. Definition of High-Risk Motion Patterns for Female ACL Injury Based on Football-Specific Field Data: A Wearable Sensors Plus Data Mining Approach. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23042176. [PMID: 36850776 PMCID: PMC9961558 DOI: 10.3390/s23042176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 05/30/2023]
Abstract
The aim of the present study was to investigate if the presence of anterior cruciate ligament (ACL) injury risk factors depicted in the laboratory would reflect at-risk patterns in football-specific field data. Twenty-four female footballers (14.9 ± 0.9 year) performed unanticipated cutting maneuvers in a laboratory setting and on the football pitch during football-specific exercises (F-EX) and games (F-GAME). Knee joint moments were collected in the laboratory and grouped using hierarchical agglomerative clustering. The clusters were used to investigate the kinematics collected on field through wearable sensors. Three clusters emerged: Cluster 1 presented the lowest knee moments; Cluster 2 presented high knee extension but low knee abduction and rotation moments; Cluster 3 presented the highest knee abduction, extension, and external rotation moments. In F-EX, greater knee abduction angles were found in Cluster 2 and 3 compared to Cluster 1 (p = 0.007). Cluster 2 showed the lowest knee and hip flexion angles (p < 0.013). Cluster 3 showed the greatest hip external rotation angles (p = 0.006). In F-GAME, Cluster 3 presented the greatest knee external rotation and lowest knee flexion angles (p = 0.003). Clinically relevant differences towards ACL injury identified in the laboratory reflected at-risk patterns only in part when cutting on the field: in the field, low-risk players exhibited similar kinematic patterns as the high-risk players. Therefore, in-lab injury risk screening may lack ecological validity.
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Affiliation(s)
- Stefano Di Paolo
- Department for Life Quality Studies, University of Bologna, 40136 Bologna, Italy
| | - Eline M. Nijmeijer
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Laura Bragonzoni
- Department for Life Quality Studies, University of Bologna, 40136 Bologna, Italy
| | - Alli Gokeler
- Exercise and Neuroscience Unit, Department Exercise & Health, Faculty of Science, University of Paderborn, 33098 Paderborn, Germany
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, VU University Medical Center, 1081 HZ Amsterdam, The Netherlands
- Faculty of Health, Amsterdam University of Applied Sciences, 1091 GC Amsterdam, The Netherlands
| | - Anne Benjaminse
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
- School of Sport Studies, Hanze University Groningen, 9747 AS Groningen, The Netherlands
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17
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Hu C, Du Z, Tao M, Song Y. Effects of Different Hamstring Eccentric Exercise Programs on Preventing Lower Extremity Injuries: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2057. [PMID: 36767424 PMCID: PMC9916392 DOI: 10.3390/ijerph20032057] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
This systematic review and meta-analysis aims to investigate the effects and differences of various hamstring eccentric training protocols for the prevention of lower limb injuries, and we further propose a more refined hamstring eccentric training protocol for the prevention of lower limb injuries. A literature search for the effects of hamstring eccentric training on lower extremity sports injuries was conducted using the PubMed, Web of Science, and EMBASE databases, and the literature was searched covering the period from the date of the database's creation to 20 August 2022. A meta-analysis of the included literature was performed using R.4.21 for lower extremity injuries, injuries in various parts of the lower extremity, and subgroup analysis for exercise frequency, exercise cycle, and exercise population. A total of 23 randomized controlled trial (RCT) studies were found to be included in the meta-analysis, and 15 of these trials, totaling 14,721 patients, were determined to be included in the overall lower extremity injury prevention effect. The analysis showed that the implementation of a hamstring eccentric training program reduced lower extremity injuries by 28%, and it resulted in a 46% decrease in hamstring injury rate and a 34% decrease in knee injury rate. The subgroup analysis revealed that the frequency of exercise was most significant in the twice-a-week exercise group, that the exercise program was most effective in preventing injuries in the 21-30-week exercise period, and that the program was most effective in preventing injuries in elite athletes and amateur adult athletic populations, compared with adolescents.
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18
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Zou J, Yang W, Cui W, Li C, Ma C, Ji X, Hong J, Qu Z, Chen J, Liu A, Wu H. Therapeutic potential and mechanisms of mesenchymal stem cell-derived exosomes as bioactive materials in tendon-bone healing. J Nanobiotechnology 2023; 21:14. [PMID: 36642728 PMCID: PMC9841717 DOI: 10.1186/s12951-023-01778-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/11/2023] [Indexed: 01/17/2023] Open
Abstract
Tendon-bone insertion (TBI) injuries, such as anterior cruciate ligament injury and rotator cuff injury, are the most common soft tissue injuries. In most situations, surgical tendon/ligament reconstruction is necessary for treating such injuries. However, a significant number of cases failed because healing of the enthesis occurs through scar tissue formation rather than the regeneration of transitional tissue. In recent years, the therapeutic potential of mesenchymal stem cells (MSCs) has been well documented in animal and clinical studies, such as chronic paraplegia, non-ischemic heart failure, and osteoarthritis of the knee. MSCs are multipotent stem cells, which have self-renewability and the ability to differentiate into a wide variety of cells such as chondrocytes, osteoblasts, and adipocytes. Numerous studies have suggested that MSCs could promote angiogenesis and cell proliferation, reduce inflammation, and produce a large number of bioactive molecules involved in the repair. These effects are likely mediated by the paracrine mechanisms of MSCs, particularly through the release of exosomes. Exosomes, nano-sized extracellular vesicles (EVs) with a lipid bilayer and a membrane structure, are naturally released by various cell types. They play an essential role in intercellular communication by transferring bioactive lipids, proteins, and nucleic acids, such as mRNAs and miRNAs, between cells to influence the physiological and pathological processes of recipient cells. Exosomes have been shown to facilitate tissue repair and regeneration. Herein, we discuss the prospective applications of MSC-derived exosomes in TBI injuries. We also review the roles of MSC-EVs and the underlying mechanisms of their effects on promoting tendon-bone healing. At last, we discuss the present challenges and future research directions.
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Affiliation(s)
- Jiaxuan Zou
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Weinan Yang
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Wushi Cui
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Congsun Li
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Chiyuan Ma
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Xiaoxiao Ji
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Jianqiao Hong
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Zihao Qu
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Jing Chen
- grid.27255.370000 0004 1761 1174The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033 People’s Republic of China
| | - An Liu
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Haobo Wu
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
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Ferguson H, Piquet J, Jemni M, Delextrat A. Effects of a Football Simulated Exercise on Injury Risk Factors for Anterior Cruciate Ligament (ACL) Injury in Amateur Female Players. BIOLOGY 2023; 12:biology12010124. [PMID: 36671816 PMCID: PMC9855934 DOI: 10.3390/biology12010124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
Females are more at risk of Anterior Cruciate Ligament (ACL) injuries than males; however, there is limited literature on neuromuscular risk factors such as angle-specific hamstring/quadriceps functional strength ratios (Hecc/Qcon) and rate of torque development (RTD) in female footballers. The aim of this study was to investigate the effects of fatigue on these neuromuscular risk factors. Thirty-three amateur players (20.3 ± 2.0 years old, 1.67 ± 9.31 m, 63.4 ±8.1 kg, 23.6 ± 5.7% body fat) performed strength assessments of the quadriceps (concentrically, Qcon) and hamstrings (eccentrically, Hecc) on both legs on an isokinetic dynamometer, before and immediately after a football-specific exercise. Results showed significantly lower peak Hecc (-15.1 to -15.5%), peak Hecc/Qcon (-8.8 to -12.9%) and RTD (-14.0 to -17.0%) for hamstring eccentric contractions after fatigue in the dominant and non-dominant legs. Furthermore, significant decreases in Hecc/Qcon were observed at 10° only in the dominant leg (-15.5%), and at 10°, 20° and 30° in the non-dominant leg (-15.1 to -21.8%). These results suggest a reduced capacity of the hamstrings to stabilise the knee joint with fatigue. Unlike results previously shown on men, the non-dominant leg seemed more affected, highlighting the need to consider specific prevention measures in females.
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Affiliation(s)
- Harriet Ferguson
- Department of Sport and Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 8HU, UK
| | - Jessica Piquet
- Department of Sport and Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 8HU, UK
| | - Monèm Jemni
- The Carrick Institute of Neuroscience, Cap Canaveral, FL 32920, USA
| | - Anne Delextrat
- Department of Sport and Health Sciences and Social Work, Oxford Brookes University, Oxford OX3 8HU, UK
- Correspondence: ; Tel.: +44-(0)-1865-48-3610
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Arundale AJH, Bizzini M, Dix C, Giordano A, Kelly R, Logerstedt DS, Mandelbaum B, Scalzitti DA, Silvers-Granelli H, Snyder-Mackler L. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention. J Orthop Sports Phys Ther 2023; 53:CPG1-CPG34. [PMID: 36587265 DOI: 10.2519/jospt.2023.0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The Academy of Orthopaedic Physical Therapy and the American Academy of Sports Physical Therapy have an ongoing effort to create evidence-based clinical practice guidelines (CPGs) for orthopaedic and sports physical therapy management and prevention of musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This guideline focuses on the exercise-based prevention of knee injuries and provides an update on the 2018 guideline, J Orthop Sports Phys Ther. 2018;48(9):A1-A42. doi:10.2519/jospt.2018.0303 J Orthop Sports Phys Ther. 2023;53(1):CPG1-CPG34. doi:10.2519/jospt.2023.0301.
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21
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Akbari H, Shimokochi Y, Sheikhi B. Ankle dorsiflexion range of motion and landing postures during a soccer-specific task. PLoS One 2023; 18:e0283150. [PMID: 36928236 PMCID: PMC10019731 DOI: 10.1371/journal.pone.0283150] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Ankle dorsiflexion range of motion (DF-ROM) has been shown to be associated with poor landing posture. However, previously used tasks have been controlled, and it is unclear whether clinical measurements of the ankle DF-ROM, are associated with landing positions during sport-specific task. This study sought to determine the relationship between ankle DF-ROM and landing positions. METHODS Thirty male soccer players participated in this study. The ankle DF-ROM was measured by the weight bearing lunge test in degrees using a cell phone app (TiltMeter). Landing patterns were assessed during a soccer-specific task using landing error scoring system items using Kinovea software. Simple correlations were used to evaluate the relationships between ankle DF-ROM and landing error scores. RESULTS Significant correlations were found between ankle DF-ROM and landing errors (r = -0.450, P = 0.006). A decreased ankle DF-ROM was associated with greater landing errors in a soccer specific situation. CONCLUSION These results suggest that ankle DF-ROM may serve a useful clinical measure for identifying poor landing posture in the real-world environment. Therefore, assessment of ankle DF-ROM could be included in the screening process, which could help identify the cause of the faulty motion.
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Affiliation(s)
- Hadi Akbari
- Department of Sport Sciences, University of Zabol, Zabol, Iran
- * E-mail:
| | - Yohei Shimokochi
- Department of Health and Sport Management, School of Health and Sport Sciences, Osaka University of Health and Sport Sciences, Osaka, Japan
| | - Bahram Sheikhi
- Department of Biomechanics and Sport Injuries, Kharazmi University, Tehran, Iran
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22
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Mayer C, Rühlemann A, Busch A, Jäger M. Measures of Knee Capability in Handball Players Differ by Age: A Cross Sectional Study. Sports Med Int Open 2022; 6:E60-E68. [PMID: 36575730 PMCID: PMC9790767 DOI: 10.1055/a-1926-0817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/08/2022] [Indexed: 12/30/2022] Open
Abstract
The return to sport after knee injury is challenging. This is burdensome for sports with a high incidence of injuries, such as team handball. Various tests guide decision making, but often the athlete's preinjury performance of these measures remains unknown. Moreover, objective return-to-sport criteria of a matching population are missing. The purpose of this study was to evaluate objective measures of knee capability in handball depending on players' age. Two hundred sixty-one handball players performed a functional test battery designed to evaluate knee capability after an anterior cruciate ligament injury: two- and one-legged stability analysis, jumps, speed tests, and agility assessments. For age-specific evaluation, athletes were divided into three age groups (16-19; 20-29;≥30 years). Male players showed differences in two and one-legged jumping height (p<0.02) as well as power per body weight (p<0.01) between age groups. Young female players reached better results in two-and one-legged stability. Besides the quick feet test, results of females did not differ between age groups. Functional knee stability in healthy handball players is partly influenced by age, and females show better results in stability and male athletes in power measurements. This aspect should be considered for return to sports testing and underlines the importance of performance measures in athletic testing.
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Affiliation(s)
- Constantin Mayer
- Orthopedics and Traumatology, St Marien-Hospital Mülheim an der
Ruhr, Mülheim, Germany,Correspondence Dr. Constantin
Mayer St Marien-Hospital Mülheim an der
RuhrOrthopedics and
TraumatologyKaiserstrasse
5045468
MülheimGermany+49
208 305 2202
| | - Alina Rühlemann
- Orthopedics and Traumatology, University of Duisburg-Essen Faculty of
Medicine, Essen, Germany
| | - Andre Busch
- Orthopedics and Traumatology, katholische Kliniken Philippusstift
Essen, Essen, Germany
| | - Marcus Jäger
- Orthopedics and Traumatology, St Marien-Hospital Mülheim an der
Ruhr, Mülheim, Germany,Orthopedics and Traumatology, University of Duisburg-Essen Faculty of
Medicine, Essen, Germany
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23
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Toyooka S, Tsukada K, Yasui Y, Saho Y, Okawa Y, Ando S, Nakagawa T, Kawano H, Miyamoto W. Association of medial arch support of foot orthoses with knee valgus angle at initial contact during cutting maneuvers in female athletes: a controlled laboratory study. BMC Sports Sci Med Rehabil 2022; 14:214. [PMID: 36536460 PMCID: PMC9762016 DOI: 10.1186/s13102-022-00608-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The effect of medial arch support foot orthoses on kinematics and kinetics of the knee joint has remained unknown. METHODS Sixteen female collegiate-level athletes volunteered to participate. Participants were asked to perform a 30° sidestep cut using orthoses of 3 different medial arch heights, comprising of the following: (1) "low," a full flat foot orthosis without arch support, (2) "mid," a commercially available foot orthosis with general height arch support, and (3) "high," a foot orthosis with double the commercially available height for arch support to observe the effect on the knee when overcorrected. Kinematics and kinetics of the knee joint were collected by a markerless motion capture system with 2 force plates and compared between orthosis types using linear regression analysis, assuming a correlation between the measurements of the same cases in the error term. RESULTS The knee valgus angle at initial contact was 2.3 ± 5.2 degrees for "low" medial arch support height, 2.1 ± 5.8 degrees for "mid," and 0.4 ± 6.6 degrees for "high". Increased arch support height significantly decreased the knee valgus angle at initial contact (p = 0.002). Other kinematic and kinetic measurements did not differ between groups. CONCLUSIONS The valgus angle of the knee at initial contact was decreased by the height of the medial arch support provided by foot orthosis during cutting manoeuvres. Increasing the arch support height may decrease knee valgus angle at initial contact. Medial arch support of foot orthosis may be effective in risk reduction of ACL injury. Clinical trial registration numbers and date of registration: UMIN000046071, 15/11/2021.
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Affiliation(s)
- Seikai Toyooka
- grid.264706.10000 0000 9239 9995Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan
| | - Keisuke Tsukada
- grid.264706.10000 0000 9239 9995Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan
| | - Youich Yasui
- grid.264706.10000 0000 9239 9995Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan
| | - Yasuaki Saho
- grid.264706.10000 0000 9239 9995Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan ,grid.264706.10000 0000 9239 9995Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Yasuaki Okawa
- grid.264706.10000 0000 9239 9995Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Shuji Ando
- grid.143643.70000 0001 0660 6861Tokyo University of Science, Tokyo, Japan
| | - Takumi Nakagawa
- grid.264706.10000 0000 9239 9995Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan
| | - Hirotaka Kawano
- grid.264706.10000 0000 9239 9995Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan
| | - Wataru Miyamoto
- grid.264706.10000 0000 9239 9995Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan
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24
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Wu CK, Lin YC, Lai CP, Wang HP, Hsieh TH. Dynamic Taping Improves Landing Biomechanics in Young Volleyball Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13716. [PMID: 36294294 PMCID: PMC9603199 DOI: 10.3390/ijerph192013716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/16/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Poor landing biomechanics such as hip adduction, internal rotation, and knee valgus have been recognized as modifiable risk factors of anterior cruciate ligament (ACL) injury. Dynamic taping is a newly developed technique with better elasticity and extensibility, which could change the landing biomechanics. The purpose of this study was to identify whether dynamic taping could improve lower limb biomechanics in athletes. Forty-two high school volleyball athletes (21 males and 21 females) participated in the study. Biomechanical properties, including the landing error scoring system (LESS) and anterior-posterior knee laxity, were evaluated before and after the application of dynamic tape while athletes performed the jump-landing task. As a result, we found that dynamic tape significantly reduced the faulty landing strategy by an average of 0.64 errors in all volleyball athletes. The effect induced by dynamic tape was more prominent in female athletes and high-risk athletes (1.1 errors). Furthermore, the application of dynamic tape improved anterior-posterior knee laxity, especially in female athletes (p < 0.001). In conclusion, we found that dynamic tape provided a short-term, passive, and clinically significant means to normalize inadequate biomechanics during landing in athlete groups, which could have a protective effect and further alleviate the risk of ACL injury.
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Affiliation(s)
- Chih-Kuan Wu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
- Center of Comprehensive Sports Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan 33302, Taiwan
| | - Yin-Chou Lin
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
- Center of Comprehensive Sports Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
| | - Chi-Ping Lai
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
| | - Hsin-Ping Wang
- Center of Comprehensive Sports Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
| | - Tsung-Hsun Hsieh
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan 33302, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan 33305, Taiwan
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25
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Alt T, Severin J, Schmidt M. Quo Vadis Nordic Hamstring Exercise-Related Research?-A Scoping Review Revealing the Need for Improved Methodology and Reporting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11225. [PMID: 36141503 PMCID: PMC9517005 DOI: 10.3390/ijerph191811225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
The objective of this scoping review is to assess Nordic Hamstring Exercise quality (ANHEQ) of assessments and interventions according to the ANHEQ rating scales and to present practical recommendations for the expedient design and reporting of future studies. A total of 71 Nordic Hamstring Exercise (NHE) assessments and 83 NHE interventions were selected from the data sources PubMed, Scopus, and SPORTDiscus. Research studies which were presented in peer-reviewed academic journals and implemented the NHE during laboratory-based assessments or multi-week interventions met the eligibility criteria. NHE assessments analyzed force (51%), muscle activation (41%), knee angle kinematics (38%), and bilateral symmetry (37%). NHE interventions lasted 4-8 weeks (56%) and implied an exercise volume of two sessions per week (66%) with two sets per session (41%) and ≥8 repetitions per set (39%). The total ANHEQ scores of the included NHE assessments and interventions were 5.0 ± 2.0 and 2.0 ± 2.0 (median ± interquartile range), respectively. The largest deficits became apparent for consequences of impaired technique (87% 0-point-scores for assessments) and kneeling height (94% 0-point-scores for interventions). The 0-point-scores were generally higher for interventions compared to assessments for rigid fixation (87% vs. 34%), knee position (83% vs. 48%), kneeling height (94% vs. 63%), and separate familiarization (75% vs. 61%). The single ANHEQ criteria, which received the highest score most frequently, were rigid fixation (66% of assessments) and compliance (33% of interventions). The quality of NHE assessments and interventions was generally 'below average' or rather 'poor'. Both NHE assessments and interventions suffered from imprecise reporting or lacking information regarding NHE execution modalities and subsequent analyses. Based on the findings, this scoping review aggregates practical guidelines how to improve the design and reporting of future NHE-related research.
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Affiliation(s)
- Tobias Alt
- Department of Biomechanics, Performance Analysis and Strength & Conditioning, Olympic Training and Testing Centre Westphalia, 44139 Dortmund, Germany
| | - Jannik Severin
- Institute of Movement and Neuroscience, German Sport University, 50933 Cologne, Germany
| | - Marcus Schmidt
- Institute for Sport and Sport Science, TU Dortmund University, 44227 Dortmund, Germany
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26
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Sigurðsson HB, Briem K, Grävare Silbernagel K, Snyder-Mackler L. Don't Peak Too Early: Evidence for an ACL Injury Prevention Mechanism of the 11+ Program. Int J Sports Phys Ther 2022; 17:823-831. [PMID: 35949375 PMCID: PMC9340830 DOI: 10.26603/001c.36524] [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] [Received: 11/01/2021] [Accepted: 04/09/2022] [Indexed: 11/29/2022] Open
Abstract
Background The 11+ program prevents anterior cruciate ligament (ACL) injuries in athletes through unknown mechanisms. Purpose The aim of the current study was to evaluate the effects of The 11+ intervention program, performed by female soccer players during a single season, on the frequency of Early Peaks during athletic tasks. Methods Three teams (69 players) of collegiate female soccer athletes (Divisions I and II) were recruited. Two teams (49 players) volunteered to perform The 11+ three times per week for one season (~22 weeks plus three weeks pre-season), and one team (20 players) served as controls. The athletes performed three repetitions of a cutting maneuver, side shuffle direction change, and forwards to backwards running direction change before and after the competitive season and were recorded using marker-based 3D motion capture. Knee valgus moment time series were calculated for each repetition with inverse kinematics and classified as either "Very Early Peak", "Early Peak" or "other" using cluster analysis. The classification was based timing of the peak relative to the timing of ACL injuries. The effect of the intervention on the frequency of Very Early Peaks and Early Peaks was evaluated with a mixed Poisson regression controlling for the movement task and pre-season frequency. Results The 11+ intervention reduced the frequency of Early Peak knee valgus moment in one intervention team (coefficient = -1.16, p = 0.004), but not the other (coefficient = -0.01, p = 0.977). No effect was observed on the frequency of Very Early Peak knee valgus moment. Conclusions Reduced frequency of knee valgus moment Early Peak during athletic tasks may explain the mechanism by which The 11+ program decreases risk of ACL injury. Prospective studies with a much larger sample size are required to establish a link between Early Peak knee valgus moments and risk of ACL injury. Level of evidence 2b.
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27
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Okobi OE, Evbayekha EO, Ilechie E, Iroro J, Nwafor JN, Gandu Z, Shittu HO. A Meta-Analysis of Randomized Controlled Trials on the Effectiveness of Exercise Intervention in Preventing Sports Injuries. Cureus 2022; 14:e26123. [PMID: 35875288 PMCID: PMC9298606 DOI: 10.7759/cureus.26123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Athletes risk injury every day during practice sessions and actual games, with the majority of the affected population being young males. The Centers for Disease Control and Prevention 2011-2014 report on sport and recreation-related injuries in the United States has consistently shown the average annual estimate of the millions of dollars spent on sport and recreation injuries. These injuries translate to a significant financial implication for the athlete, the team, the health system, and the public health. We composed a review protocol. We enumerated our inclusion and exclusion criteria, injury definition, and search strategy. We searched PubMed and SPORTDiscus. Then we used Forrest plots for the meta-analysis of the relevant selected studies. We used various keywords in our search strategy. These included “injury,” “sports,” “exercise,” “prevention,” “techniques,” and every possible combination of them. Search results showed 2516 hits with our keywords, and we included 20 of those results. Twenty trials, including 19712 individuals with 2855 injuries, were analyzed. Eccentric Training relative risk (RR) of 0.54 (95% CI 0.395 to 0.739 with X2 of p < 0.05) showed that the risk of the injury was decreased by 54% in the intervention group compared to the control group. In the neuromuscular training group, a RR of 0.682 (95% CI 0.621 to 0.749 with X2 of p < 0.001) showed that the risk of the injury was decreased by 68.2% in its intervention group subgroup compared to its control group. Also, the “11” International Federation of Association Football (FIFA) program had a RR of 0.771, indicating that there was a 77.1% decrease in injury by this set of exercises (95% CI 0.728 to 0.816 with X2 of p < 0.05), and this “11” FIFA program also had the most preventative effects. Warm-up had a RR of 0.843 (95% CI 0.749 to 0.949 with X2 of p < 0.05) and showed small prevention. Strength Training RR of 0.97 (95% CI 0.57 to 1.63 with X2 of p > 0.05) had no preventive effect. Our analysis showed that different exercises have preventive roles in sports injuries. The warm-up FIFA, neuromuscular training, and eccentric training reduced the risk of injury in the intervention group compared to the control group by a high percentage. At the same time, neuromuscular warm-up and FIFA 11 dynamic warm-up also decreased the relative risk of injury in the intervention group. These effects varied among exercise type, injury type, and sport.
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28
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Di Paolo S, Bragonzoni L, Della Villa F, Grassi A, Zaffagnini S. Do healthy athletes exhibit at-risk biomechanics for anterior cruciate ligament injury during pivoting movements? Sports Biomech 2022:1-14. [PMID: 35652896 DOI: 10.1080/14763141.2022.2080105] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
Abstract
A consistent injury mechanism involving multiple joints has been highlighted in athletes experiencing anterior cruciate ligament (ACL) rupture. However, if and to what extent healthy athletes incur an unsafe biomechanical profile during high-dynamics movements is unknown. The present study aimed to investigate the occurrence of the ACL risk profile in a competitive pivoting sports population.Thirty-four athletes (22.8 ± 4.1 y) performed a frontal deceleration and a change of direction at 90°. Full-body kinematics was collected through 15 wearable inertial sensors (Awinda, Xsens). Nine ACL risk factors were defined based on four categories: limited lower limb flexion, valgus collapse, foot rotation and trunk rotation. A movement trial was considered 'at-risk' in the presence of at least 5 simultaneous risk factors. The rate of athletes with at-risk movements was assessed and multivariate regression for associated outcomes was conducted.The overall rate of injury profile occurrence was 9-12%. The injury profile was identified at least in one trial in 24 athletes (71%) and three trials in 5 athletes (15%). Significant associations were found for higher approaching speed (OR = 4.3) and female sex (OR = 4.8). A large occurrence of the typical ACL injury biomechanical profile was noticed. Large screenings are advisable to identify at-risk athletes and promote preventative strategies.
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Affiliation(s)
- Stefano Di Paolo
- Department for Life Quality Studies, University of Bologna, Bologna, Italy
| | - Laura Bragonzoni
- Department for Life Quality Studies, University of Bologna, Bologna, Italy
| | - Francesco Della Villa
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Alberto Grassi
- Orthopaedic and Traumatologic Clinic II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Zaffagnini
- Orthopaedic and Traumatologic Clinic II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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29
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Brooks T, Dendy D. Implementing an Injury Prevention and Performance Enhancement Program During a Softball Season for Young Female Athletes. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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30
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Toresdahl B, McElheny K, Metzl J, Kinderknecht J, Quijano B, Ammerman B, Fontana MA. Factors associated with injuries in first-time marathon runners from the New York City marathon. PHYSICIAN SPORTSMED 2022; 50:227-232. [PMID: 33750264 DOI: 10.1080/00913847.2021.1907257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To determine how baseline characteristics of first-time marathon runners and training patterns are associated with risk of injuries during training and the race. METHODS First-time adult marathon runners who were registered for the 2017 New York City Marathon were monitored starting 12 weeks prior to the race. Baseline data collection included demographics and running experience. Running frequency, distance, and injury occurrence were self-reported using online surveys every 2 weeks. RESULTS A total of 720 runners participated of which 675 completed the study. There were 64/675 (9.5%) who had major injuries during training or the race that preventing starting or finishing the race. An additional 332 (49.2%) had minor injuries interfering with training and/or affecting race performance. Injury incidence was not significantly different based on age or sex. Runners who completed a half marathon prior to the study were less likely to report getting injured [multivariable odds ratio (OR) 0.40, (0.22, 0.76), p= 0.005]. Runners who averaged <4 training runs per week during the study were less likely to report getting injured compared to those who averaged ≥4 per week [relative risk 1.36, (1.13-1.63), p= 0.001]. Longest training run distance during the study was inversely associated with race-day injury incidence [OR 0.87 (0.81, 0.94), p< 0.001]. CONCLUSION Injuries are common among first-time marathon runners. We found that risk of injury during training was associated with lack of half marathon experience and averaging ≥4 training runs per week. Longer training runs were associated with a lower incidence of race-day injuries. These results can inform the development of targeted injury-prevention interventions.
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Affiliation(s)
- Brett Toresdahl
- Primary Care Sports Medicine Service, Hospital for Special Surgery, New York, NY, USA
| | - Kathryn McElheny
- Primary Care Sports Medicine Service, Hospital for Special Surgery, New York, NY, USA
| | - Jordan Metzl
- Primary Care Sports Medicine Service, Hospital for Special Surgery, New York, NY, USA
| | - James Kinderknecht
- Primary Care Sports Medicine Service, Hospital for Special Surgery, New York, NY, USA
| | - Brianna Quijano
- Primary Care Sports Medicine Service, Hospital for Special Surgery, New York, NY, USA
| | | | - Mark Alan Fontana
- Center for Advancement of Value in Musculoskeletal Care Hospital for Special Surgery, New York, NY, USA.,Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
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31
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Rolley TL, Saunders N, Bonacci J, Keast M, Fox AS. Video Analysis of Anterior Cruciate Ligament Injury Situations in the Women's Australian Football League. SCI MED FOOTBALL 2022; 7:106-123. [PMID: 35544763 DOI: 10.1080/24733938.2022.2076897] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Anterior cruciate ligament (ACL) injury rates in the Women's Australian Football League (AFLW) are alarmingly high. Understanding injuries within their sporting context is important to develop effective injury prevention strategies, yet there is currently little knowledge of how ACL injuries occur to AFLW players. This study addressed the common scenarios and characteristics of ACL injuries in the AFLW. Online match and AFLW club injury reports identified 38 ACL injury cases. After excluding injuries where footage was unavailable (i.e. training, pre-season games), a video analysis of 21 match ACL injuries from the 2017-2020 AFLW seasons was performed. We examined match characteristics, and the player's movements and body postures preceding and at the estimated time of injury. Descriptive frequencies and relative proportions were determined across the assessed categories. Non-contact ACL injuries were frequently observed (n=13, 61.9%), while contact preceding the injury event (i.e. indirect contact) was also common (n=10, 47.6%). The most common game situation was direct defence (i.e. defending an opponent in possession) (n=14, 66.7%). Sidestep cutting was the most prevalent movement (n=11, 52.4%), with this commonly performed while applying defensive pressure (n=6 of 11, 54.6%). Sidestep cutting when applying defensive pressure is the most common non-contact ACL injury scenario in the AFLW. Preceding contact potentially contributing to a player's loss of balance was another prominent AFLW scenario. AFLW players may benefit from injury prevention programs emphasising appropriate sidestep cutting technique during reactive defensive scenarios, and maintenance of lower limb postures known to withstand knee loading relative to the sporting task.
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Affiliation(s)
- Tess L Rolley
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Natalie Saunders
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jason Bonacci
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Meghan Keast
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Aaron S Fox
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Injuries in Wheelchair Basketball Players: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105869. [PMID: 35627406 PMCID: PMC9141608 DOI: 10.3390/ijerph19105869] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 12/04/2022]
Abstract
Background: Sports injuries have physical and psychological effects that negatively affect sports performance. Although there are data available on sports injuries in wheelchair basketball, some aspects need to be clarified, such as the location, mechanisms and risk factors for injury, which are not well described due to variations and/or a lack of definition of injury. The aim of this study was to determine epidemiological information, primary injury characteristics and affected body regions in wheelchair basketball players; Methods: The PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases were used; Results: eight articles were included in this review. The shoulder was the body region most affected (N = 60; 22.1%). When divided by body segments, the upper limbs were the most affected (N = 128; 47.2%), followed by the head and/or face (N = 53; 19.5%), trunk (included spine and ribs) (N = 48; 17.8%) and lower limbs (N = 42; 15.5%); Conclusions: wheelchair basketball players suffer a large number of injuries with different characteristics that are mainly linked to biomechanics and sport. These results can be used to guide coaches in structuring training to minimize recurring injuries, in addition to assisting in the organization of medical teams in competitions.
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Wong AYY, Man GCW, Wu YM, Wong HW, Ong MTY, Yung PSH. Risk of surgery and epidemiological profile of athletes presenting to a single sports injury clinic in Hong Kong. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2022. [DOI: 10.1177/22104917221082314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Although participation in sports and exercise is promoted widely due to its health benefits, sports-related injuries can also be a detriment to an individual's health and a burden for the healthcare system. Herein, the aim of this study is to provide a comprehensive review on the epidemiological profile and the risk for surgery of athletes presented to a sports injuries clinic in Hong Kong. Methods A total of 566 patients attending the sports injuries clinic at a local hospital between October 2017 and September 2018 were reviewed. Only 271 patients sustaining injuries from sports activities were included. These patients attended a survey-based data collection session, which recorded their demographic, injury site, events leading to injury, exercise details (type, level-of-play, frequency, experience), and functional score according to the injury site. Results The highest proportion of injuries was observed in amateur athletes (45.4%) than in recreational (28.8%) and professional (25.8%). Those patients aged between 18–29 years old (50.2%) had the most injuries. Both soccer (25.1%) and basketball (25.1%) were the two most common sports to incurred injuries. Whereas, the lower extremities being the most common injured sites. Based on our logistic model, athletes with less experience were more prone to required surgeries with injuries in the lower extremities. Conclusion Preventive measures should be targeted at less experience athletes, focusing on strengthening the knee region, to reduce sports-related injuries and surgeries. Importantly, this study demonstrates the need to further identify factors to develop effective sports injury prevention programmes for tailoring athletes at different levels-of-play.
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Affiliation(s)
- Ashley Ying-Ying Wong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Gene Chi-Wai Man
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yuen-Man Wu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Hiu-Wun Wong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Michael Tim-Yun Ong
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Lui Che Woo Institute of Innovative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Dinsdale A, Costin B, Dharamdasani S, Page R, Purs N, Treleaven J. What conservative interventions improve bite function in those with temporomandibular disorders? A systematic review using self-reported and physical measures. J Oral Rehabil 2022; 49:456-475. [PMID: 35108410 DOI: 10.1111/joor.13307] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/02/2022] [Accepted: 01/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bite is an important function of the human stomatognathic system. Despite this, it is commonly impaired in temporomandibular disorder (TMD) populations. The aim of this review is to evaluate the effectiveness of conservative interventions on self-reported and physical measures of bite function in individuals with TMD. METHODS This review was performed in compliance with PRISMA guidelines. An electronic search was performed on databases including Pubmed, CINAHL, Embase, and Cochrane Central. Inclusion criteria were journal articles evaluating the effect of any non-pharmacological conservative interventions on bite function in participants diagnosed with TMD. Risk of bias for individual studies was assessed using the Cochrane risk-of-bias v2 tool, and the NIH NHLBI pre-post tool. Data was synthesised based on outcome measures of bite function, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS Eleven studies were eligible for this review. Interventions included splinting, photobiomodulation, needling, exercise, manual therapy, and patient education; which were evaluated using mastication-related pain, self-reported chewing difficulty, and bite force/endurance outcome measures. Findings suggested manual therapy, needling, oral splinting, exercise and PBM interventions may improve bite function in TMD, although confidence in cumulative evidence ranged from moderate to very low. There was no evidence that patient education improved bite function. CONCLUSION Conservative interventions may be helpful to address bite-related impairments associated with TMD, although further research is needed to improve the quality of evidence and direct clinical guidelines.
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Affiliation(s)
- Alana Dinsdale
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Brianna Costin
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Simran Dharamdasani
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Ruth Page
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Nykeela Purs
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Julia Treleaven
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, QLD, 4072, Australia
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The Hamstring and ACL Injury Incidence during a Season Is Not Directly Related to Preseason Knee Strength Ratios in Elite Male Soccer Players. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background and Objectives: The aim of this study was to identify preseason isokinetic strength differences in the knee flexors and extensors and their ipsilateral/bilateral ratios and, furthermore, to compare the results among players who subsequently overcame a hamstring strain injury (HSI) or anterior cruciate ligament (ACL) rupture during the season and those who did not. Materials and Methods: A total of 134 professional soccer players underwent isokinetic strength assessment at a velocity of 60°·s−1 (knee flexors and extensors) for the dominant and non-dominant lower limb to determine preseason peak torque values and bilateral and ipsilateral strength ratios. Subsequently, the incidence of injuries during the season was recorded, and players were divided into groups according to ACL rupture injuries (n = 10), hamstring strains (n = 10), and a control group of non-injured players who were selected on a random basis (n = 20). A retrospective approach was used to analyze and compare the preseason strength characteristics and whether some variance among groups was relevant among the injured leg and non-injured leg groups. Results: The results of our study show that low-angular velocity preseason testing did not result in a player’s HSI or ACL injury during the season. The difference between the monitored groups ranged from 1.5% to 3%. The comparison showed low evidence for significant differences. Conclusions: An angular velocity of 60°·s−1 within concentric muscle contraction alone was not linked to subsequent injury of the hamstring or anterior cruciate ligament and acted as an insufficient factor of injury risk in adult professional soccer players.
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Rhodes D, Jeffrey J, Maden-Wilkinson J, Reedy A, Morehead E, Kiely J, Birdsall D, Carling C, Alexander J. The relationship between eccentric hamstring strength and dynamic stability in elite academy footballers. SCI MED FOOTBALL 2022; 5:48-54. [PMID: 35073230 DOI: 10.1080/24733938.2020.1782458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Previous research describes dynamic stability and functional strength as key aetiological risk factors associated with lower limb non-contact musculoskeletal injury. Due to the multifactorial nature of injury risk, relationships between the two factors will inform injury management and training design. METHODS A total of 59 elite academy footballers from two English premier league category 1-status academies completed the study. All players completed measures of eccentric hamstring strength and dynamic stability. Relationships between directional stability (Anteroposterior (Ant), Posteromedial (PM) and Posterolateral (PL)) and eccentric strength metrics (PkT, AvT, PkF, AvF and Ɵ) bilaterally were identified for analysis. RESULTS Significant correlations were identified bilaterally for functional hamstring strength metrics and PM and PL stability (P ≤. 0.05). No significant relationships were identified between anterior stability and eccentric hamstring strength parameters (P > 0.05). CONCLUSIONS Eccentric hamstring strength has a positive influence on directional stability through two planes, PM and PL. The lack of influence of eccentric hamstring strength on Ant directional stability could be attributed to increased ACL risk. Careful consideration of the significance of the relationships between eccentric hamstring strength and directional stability must be given when quantifying injury risk in elite academy footballers.
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Affiliation(s)
- David Rhodes
- University of Central Lancashire, Preston, Lancashire, UK
| | | | | | - Antony Reedy
- Academy Sports Science and Medicine, Burnley FC, Gawthorpe Park, Padiham, UK
| | - Erin Morehead
- University of Central Lancashire, Preston, Lancashire, UK
| | - John Kiely
- University of Central Lancashire, Preston, Lancashire, UK
| | | | - Chris Carling
- University of Central Lancashire, Preston, Lancashire, UK
| | - Jill Alexander
- University of Central Lancashire, Preston, Lancashire, UK
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Rice RP, Roach K, Kirk-Sanchez N, Waltz B, Ellenbecker TS, Jayanthi N, Raya M. Age and Gender Differences in Injuries and Risk Factors in Elite Junior and Professional Tennis Players. Sports Health 2022; 14:466-477. [PMID: 35037501 PMCID: PMC9214903 DOI: 10.1177/19417381211062834] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Elite tennis athletes experience injuries throughout the entire body. Impairments in trunk stability, lower limb flexibility, and hip range of motion (ROM) are modifiable risk factors that can impact injuries and performance. Information on nonmodifiable risk factors such as age and gender is limited. The purpose of this investigation was to provide information on risk factors to direct clinical decision-making and injury prevention and rehab programming in this population. HYPOTHESIS Prevalence and location of injuries will differ by age group and gender. Trunk stability, lower limb flexibility, and hip ROM will differ by age group and gender. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS A de-identified database (n = 237; females = 126) from the United States Tennis Association High Performance Profile (HPP) 2014-2015 was used for the analysis. Subjects were elite junior and professional tennis players (mean age 14.6 [range, 9-27] years). The HPP is a tennis-specific assessment and questionnaire that includes retrospective information on injury history. Subjects were categorized by injury, gender, and age. Injury locations were classified by region. Trunk stability measures included drop vertical jump (DVJ), single-leg squat, and prone and side planks. Lower limb measures included hamstring, quadriceps and hip flexor flexibility, and hip rotation ROM. RESULTS A total of 46% of athletes reported an injury. Significant differences were found for injury prevalence and location by age group. Adolescent athletes (age 13-17 years) had more trunk injuries, while adult athletes (age ≥18 years) had more lower limb injuries. Adolescent athletes performed worse on DVJ, dominant side plank, and hamstring flexibility compared with young (age ≤12 years) and adult athletes. Significant gender differences in hip ROM included internal rotation on both the dominant and nondominant sides. CONCLUSION Impairments in trunk stability, lower limb flexibility, and hip rotation ROM may affect both health and performance outcomes in this population. Elite tennis athletes may benefit from additional off court programming to address trunk and lower limb impairments. CLINICAL RELEVANCE Adolescent elite tennis athletes may be at higher risk of trunk injuries. Age, gender, injury history, and impairments should be considered with all assessments and programming.
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Affiliation(s)
- Robyn Porter Rice
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida,Robyn Porter Rice, PT, PhD, Department of Physical Therapy, Miller School of Medicine, University of Miami, 5915 Ponce de Leon Boulevard, Coral Gables FL 33146 () (Twitter: @RiceRobynp)
| | - Kathryn Roach
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida
| | - Neva Kirk-Sanchez
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida
| | - Bret Waltz
- DocWaltz LLC, Scottsdale, Arizona,USTA Player Development, Orlando, Florida
| | - Todd S. Ellenbecker
- Vice President Medical Services, ATP Tour, Ponte Vedra Beach, Florida,Rehab Plus Sports Therapy Scottsdale, Scottsdale, Arizona
| | - Neeru Jayanthi
- Emory Sports Medicine Center, Department of Orthopedic Surgery and Family Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Michele Raya
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, Florida
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Hogg JA, Riehm CD, Diekfuss JA, Simon JE, Acocello SN, Liang Y, Wu D, Myer GD, Wilkerson GB. An Exemplar Frontal Plane Visual Kinematic Stimulus Elicits Sex-Specific Learned Behavior. J Strength Cond Res 2022; 36:857-861. [DOI: 10.1519/jsc.0000000000004203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Szymski D, Achenbach L, Zellner J, Weber J, Koch M, Zeman F, Huppertz G, Pfeifer C, Alt V, Krutsch W. Higher risk of ACL rupture in amateur football compared to professional football: 5-year results of the 'Anterior cruciate ligament-registry in German football'. Knee Surg Sports Traumatol Arthrosc 2022; 30:1776-1785. [PMID: 34524500 PMCID: PMC9033691 DOI: 10.1007/s00167-021-06737-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Anterior cruciate ligament (ACL) injuries are a common severe type of football injury at all levels of play. A football-specific ACL registry providing both prospective ACL injury data according to the skill level and risk factors for ACL injury is lacking in the literature. METHODS This study is based on the prospective 'ACL registry in German Football' implemented in the 2014-15 season. Professional (1st-3rd league), semi-professional (4th-6th league) and amateur leagues (7th league) were analysed regarding the incidence and risk factors for ACL injuries. Injuries were registered according to the direct reports of the injured players to the study office and double-checked via media analysis. After injury registration, the players received a standardised questionnaire. Data were analysed from the 2014-15 to the 2018-19 football season. RESULTS Overall, 958 ACL injuries were registered during the 5-year study period. The incidence of ACL injuries was highest in amateur football (0.074/1000 h football exposure) compared to professional (0.058/1000 h; p < 0.0001) and semi-professional football (0.043/1000 h; p < 0.0001). At all skill levels, match incidence (professional: 0.343; semi-professional: 0.249; amateur: 0.319) was significantly higher than training incidence (professional: 0.015; semi-professional: 0.004; amateur: 0.005). Major risk factors were previous ACL injury (mean: 23.3%), other knee injuries (mean: 19.3%) and move to a higher league (mean: 24.2%). CONCLUSION This sports-specific ACL registry provides detailed information on the incidence and risk factors for ACL injuries in football over five years. Risk factors are skill level, match exposure, move to a higher league and previous knee injury. These factors offer potential starting points for screening at-risk players and applying targeted prevention. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Dominik Szymski
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
| | - Leonard Achenbach
- Department of Orthopedics, König-Ludwig-Haus, Julius-Maximilians-University Würzburg, Würzburg, Germany
| | - Johannes Zellner
- Department of Trauma Surgery, Caritas Hospital St. Josef, Regensburg, Germany
| | - Johannes Weber
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Matthias Koch
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Florian Zeman
- Centre for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Gunnar Huppertz
- Centre for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Christian Pfeifer
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Werner Krutsch
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany ,SportDocsFranken, Nürnberg, Germany
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Civilette MD, Rate WR, Haislup BD, Cohen AS, Camire L, Bodendorfer BM, Gould HP. The top 100 most impactful articles on the anterior cruciate ligament: An altmetric analysis of online media. SAGE Open Med 2022; 10:20503121221111694. [PMID: 35924141 PMCID: PMC9340895 DOI: 10.1177/20503121221111694] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/13/2022] [Indexed: 12/17/2022] Open
Abstract
Objectives: To identify the top 100 most impactful anterior cruciate ligament articles in online media as measured by the Altmetric Attention Score and compare their characteristics to the most-cited anterior cruciate ligament articles in the scientific literature. Methods: The Altmetric database was queried to identify all published articles pertaining to the anterior cruciate ligament. The search yielded 9445 articles, which were stratified by highest to lowest Altmetric Attention Score. The top 100 articles were included. Collected data included article type, article topic, journal name, and online mentions in news, blogs, Twitter, Facebook, Wikipedia, and other sources. The geographic origin of each article was also determined based on the institutional affiliation of the first author. Results: Altmetric Attention Score of the top 100 anterior cruciate ligament articles ranged from 109 to 2193 (median 172.0, interquartile range 137.5–271.5). Of the 100 articles, 65 were published in three journals: American Journal of Sports Medicine, British Journal of Sports Medicine, and Journal of Orthopaedic & Sports Physical Therapy. The most prevalent article type was original research (60%), followed by systematic review/meta-analysis (18%). The most prevalent article topic was rehabilitation and return to play after anterior cruciate ligament reconstruction (22%), followed by epidemiology/risk factors (16%), injury prevention (14%), and biomechanics of anterior cruciate ligament injuries (14%). Of the top 100 articles, 54% were American, 31% were European, and 15% were published in other countries outside of the United States and Europe. Conclusion: This study used Altmetric Attention Score to identify the 100 most engaged anterior cruciate ligament articles in online media. The characteristics of these articles differed substantially from the most-cited anterior cruciate ligament articles in the literature with regard to article type, article topic, geographic origin, and publication journal. These findings suggest that alternative metrics measure distinct components of anterior cruciate ligament article engagement and add an important dimension to understanding the overall impact of published research on the anterior cruciate ligament.
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Affiliation(s)
- Matthew D Civilette
- Georgetown University Medical Center, Washington, DC, USA
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - William R Rate
- Georgetown University Medical Center, Washington, DC, USA
| | - Brett D Haislup
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Andrew S Cohen
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Lyn Camire
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Blake M Bodendorfer
- Division of Sports Medicine and Shoulder Surgery, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA
| | - Heath P Gould
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA
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Epidemiological analysis of injury occurrence and current prevention strategies on international amateur football level during the UEFA Regions Cup 2019. Arch Orthop Trauma Surg 2022; 142:271-280. [PMID: 33740068 PMCID: PMC8783909 DOI: 10.1007/s00402-021-03861-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/08/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Football is the most popular sport worldwide and results in a high frequency of injuries. So far, mainly injuries in professional football have been investigated, and the literature lacks data regarding detailed injury epidemiology and current prevention data in amateur football tournaments. MATERIALS AND METHODS A prospective cohort study investigated an international amateur football tournament, the UEFA Regions' Cup, which took place in 2019 in Germany. Injury epidemiology, current prevention strategies of the teams and the implementation of the UEFA concussion protocol were investigated in detail by means of standardized injury definitions and data samples for football (Fuller et al., Scand J Med Sci Sports 16:83-92, https://doi.org/10.1111/j.1600-0838.2006.00528.x , 2006). RESULTS 138 player of 8 teams participated in this study, while 39 players were excluded. Overall injury incidence was 12.5 per 1000 h total football exposure, 43.5 per 1000 h for match exposure. No injuries were registered during training. Injury prevalence was 14.1% per player and 1.1 injuries per match were registered. The lower extremity was predominantly affected by injuries (71.4%) and the majority of injuries (78.6%) were non-severe injury types like contusions (50%) and sprains (18.2%). Two head injuries, one contusion and one skin lesion, were handled by the guidelines of the UEFA concussion protocol. 44.4% of the players indicated at least one previous injury before tournament, 45.3% of them during the last two football seasons before start of the tournament. Injury prevention performance was included in all participating teams during the tournament by warm up or training strategies (100%). During the warm-up program just 5 exercises of the FIFA 11 + program was detected by this investigation in participating teams to be done by more half of the teams. Running exercises were the most frequently performed exercises, while trunk muscle exercises were less represented (14.3%). CONCLUSION This study presents for the first time epidemiological injury and prevention data of the UEFA Regions Cup. Injury incidence was higher compared to injury reports of regular seasons, but lower compared to other amateur football tournaments. Currently used prevention programs revealed trunk muscle exercises as often neglected.
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Della Villa F, Di Paolo S, Santagati D, Della Croce E, Lopomo NF, Grassi A, Zaffagnini S. A 2D video-analysis scoring system of 90° change of direction technique identifies football players with high knee abduction moment. Knee Surg Sports Traumatol Arthrosc 2022; 30:3616-3625. [PMID: 33912979 PMCID: PMC9568485 DOI: 10.1007/s00167-021-06571-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 04/06/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Abnormal joint biomechanics and poor neuromuscular control are modifiable risk factors for Anterior Cruciate Ligament (ACL) injury. Although 3D motion capture is the gold standard for the biomechanical evaluation of high-speed multidirectional movements, 2D video analysis is a growing-interest alternative because of its higher cost-effectiveness and interpretability. The aim of the present study was to explore the possible association between a 2D evaluation of a 90° change of direction (COD) and the KAM measured with gold standard 3D motion analysis. METHODS Thirty-four competitive football (soccer) players (age 22.8 ± 4.1, 18 male and 16 females) were enrolled. Each athlete performed a series of pre-planned 90° COD at the maximum speed possible in a laboratory equipped with artificial turf. 3D motion analysis was recorded using 10 stereophotogrammetric cameras, a force platform, and three high-speed cameras. The 2D evaluation was performed through a scoring system based on the video analysis of frontal and sagittal plane joint kinematics. Five scoring criteria were adopted: limb stability (LS), pelvis stability (PS), trunk stability (TS), shock absorption (SA), and movement strategy (MS). For each criterion, a sub-score of 0/2 (non-adequate), 1/2 (partially adequate), or 2/2 (adequate) was attributed to the movement, based on objective measurements. The intra-rater and inter-rater reliability were calculated for each criterion and the total score. The Knee Abduction Moment (KAM) was extracted from the 3D motion analysis and grouped according to the results of the 2D evaluation. RESULTS Excellent intra-rater reliability (ICC > 0.88) and good-to-excellent inter-rater reliability (ICC 0.68-0.92) were found. Significantly higher KAM was found for athletes obtaining a 0/2 score compared to those obtaining a 2/2 score in all the sub-criteria and the total score (20-47% higher, p < 0.05). The total score and the LS score showed the best discriminative power between the three groups. CONCLUSION The 2D video-analysis scoring system here described was a simple and effective tool to discriminate athletes with high and low KAM in the assessment of a 90° COD and could be a potential method to identify athletes at high risk of non-contact ACL injury. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Francesco Della Villa
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Stefano Di Paolo
- Department for Life Quality Studies QUVI, Università Di Bologna, Via Giulio Cesare Pupilli, 1, 40136, Bologna, BO, Italy.
| | - Dario Santagati
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Edoardo Della Croce
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | | | - Alberto Grassi
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Zaffagnini
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy ,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Sandon A, Krutsch W, Alt V, Forssblad M. Increased occurrence of ACL injuries for football players in teams changing coach and for players going to a higher division. Knee Surg Sports Traumatol Arthrosc 2022; 30:1380-1387. [PMID: 33987689 PMCID: PMC9007801 DOI: 10.1007/s00167-021-06604-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/30/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE To identify football-specific factors associated with ACL injuries that can be targeted for sport-specific injury prevention. METHODS A study-specific questionnaire was developed to study the characteristics of ACL injuries in football including intrinsic, extrinsic, and injury specific factors. The questionnaire was available at the Swedish national knee ligament registry's website for the football players to voluntarily fill out. Data are presented on group level for all football players in total and for females and males separate to examine gender-specific differences. The results are based on answers collected over a 3-year period from 2875 football players, 1762 (61%) males and 1113 (39%) females. RESULTS ACL were more frequently sustained during games 66% than during practices 25%. The injury mechanism was non-contact in 59% and contact in 41%. For the contact injuries during games, no action was taken by the referee in 63% of the situation and a red card was shown in 0.5%. The risk of ACL injury was highest early in the football game with 47% sustained during the first 30 min and 24% in the first 15 min. Players changing to a higher level of play 15% had a higher rate of ACL injuries than players changing to a lower level 8%. This difference was especially seen in female football players with 20% of ACL injuries being sustained by players going to a higher division compared to 7% for those going to a lower division. 15% of the male and 21% of the female ACL injuries occurred in teams with a coach change during the season. Knee control exercises to warm up was used by 31% of the female players and 16% of the males. 40% of the players reported that they did not plan on returning to football. CONCLUSION Neuromuscular training programs have proven to reduce ACL injuries, but greater adherence to these remains a challenge as only 1 in 5 of the ACL-injured football players report using them. Teams changing coach and players going to a higher division appear to have an increased risk of ACL injury warranting attention and further investigations. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Alexander Sandon
- Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institute, Stockholm, Sweden.
| | - Werner Krutsch
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Magnus Forssblad
- Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institute, Stockholm, Sweden
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Pérez-Gómez J, Adsuar JC, Alcaraz PE, Carlos-Vivas J. Physical exercises for preventing injuries among adult male football players: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:115-122. [PMID: 33188962 PMCID: PMC8847925 DOI: 10.1016/j.jshs.2020.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/30/2020] [Accepted: 09/17/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Football is the most practised sport in the world and is associated with the risk of injuries in the players. Some studies have been published that identify injury prevention programs, but there is no review of the full body of evidence on injury prevention programs for use by football coaches. The aim of this article was to carry out a systematic review of published studies on injury prevention programs for adult male footballers, identify points of common understanding and establish recommendations that should be considered in the design of injury prevention strategies. METHODS PubMed and EMBASE databases were used to identify relevant published articles using the following keywords: "soccer" AND "injury" AND "prevention". RESULTS A total of 2512 studies were identified initially, but only 11 studies met the inclusion criteria, and their outcomes are presented. Results revealed that injury prevention programs in football have focused on strength training, proprioceptive training, multicomponent programs (balance, core stability, and functional strength and mobility), and warm-up programs. CONCLUSION Based on results from the studies analyzed, football players can lower the incidence of match and training injuries by participating in dynamic warm-up programs that include preventive exercises before games or during training sessions, and by adding strength, balance, and mobility training to the training sessions.
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Affiliation(s)
- Jorge Pérez-Gómez
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sports Sciences, University of Extremadura, Caceres 10003, Spain
| | - José Carmelo Adsuar
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sports Sciences, University of Extremadura, Caceres 10003, Spain
| | - Pedro E Alcaraz
- UCAM Research Center for High Performance Sport, Catholic University of Murcia, Murcia 30107, Spain; Faculty of Sport Sciences, Catholic University of Murcia, Murcia 30107, Spain
| | - Jorge Carlos-Vivas
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sports Sciences, University of Extremadura, Caceres 10003, Spain.
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Arundale AJH, Silvers-Granelli HJ, Myklebust G. ACL injury prevention: Where have we come from and where are we going? J Orthop Res 2022; 40:43-54. [PMID: 33913532 DOI: 10.1002/jor.25058] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 02/04/2023]
Abstract
Anterior cruciate ligament (ACL) injuries are one of the most common and severe knee injuries across sports. As such, ACL injury prevention has been a focus of research and sports medicine practice for the past three-plus decades. Examining the current research and identifying both clinical strategies and research gaps, the aim of this review is to empower clinicians and researchers with knowledge of where the ACL injury prevention literature is currently and where it is going in the future. This paper examines the mechanism of ACL injury prevention, screening, implementation, compliance, adherence, coronavirus, and areas of future research. Clinical significance: The time lag between research and practical implementation in general healthcare settings can be as long as 17 years; however, athletes playing sports today are unable to wait that long. With effective programs already established, implementation and adherence to these programs is essential. Strategies such as coaching education, increasing awareness of free programs, identifying barriers, and overcoming implementation obstacles through creative collaboration are just a few ways that could help improve both ACL injury prevention implementation and adherence.
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Affiliation(s)
- Amelia J H Arundale
- Department of Rehabilitation, Icahn School of Medicine, Mount Sinai Health System, New York, New York, USA.,Red Bull Athlete Performance Center, Red Bull GmBH, Thalgua, Austria
| | - Holly J Silvers-Granelli
- Velocity Physical Therapy, Santa Monica, California, USA.,Major League Soccer, Medical Research Committee, New York, New York, USA
| | - Grethe Myklebust
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
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Olivares-Jabalera J, Fílter-Ruger A, Dos’Santos T, Afonso J, Della Villa F, Morente-Sánchez J, Soto-Hermoso VM, Requena B. Exercise-Based Training Strategies to Reduce the Incidence or Mitigate the Risk Factors of Anterior Cruciate Ligament Injury in Adult Football (Soccer) Players: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13351. [PMID: 34948963 PMCID: PMC8704173 DOI: 10.3390/ijerph182413351] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 01/12/2023]
Abstract
Anterior cruciate ligament (ACL) is one of the most concerning injuries for football players. The aim of this review is to investigate the effects of exercise-based interventions targeting at reducing ACL injury rate or mitigating risk factors of ACL injury in adult football players. Following PRISMA guidelines, a systematic search was conducted in CINAHL, Cochrane Library, PubMed, Scopus, SPORTDiscus and Web of Science. Studies assessing the effect of exercise-based interventions in ACL injury incidence or modifiable risk factors in adult football players were included. 29 studies evaluating 4502 male and 1589 female players were included (15 RCT, 8 NRCT, 6 single-arm): 14 included warm-up, 7 resistance training, 4 mixed training, 3 balance, 1 core stability and 1 technique modification interventions. 6 out of 29 studies investigated the effect of interventions on ACL injury incidence, while the remaining 23 investigated their effect on risk factors. Only 21% and 13% studies evaluating risk of injury variables reported reliability measures and/or smallest worthwhile change data. Warm-up, core stability, balance and technique modification appear effective and feasible interventions to be included in football teams. However, the use of more ecologically valid tests and individually tailored interventions targeting specific ACL injury mechanisms are required.
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Affiliation(s)
- Jesús Olivares-Jabalera
- HUMAN Lab, Sport and Health University Research Institute (iMUDS), University of Granada, 18016 Granada, Spain; (V.M.S.-H.); (B.R.)
- FSI Sport Research Lab, 18016 Granada, Spain; (A.F.-R.); (T.D.); (J.M.-S.)
| | | | - Thomas Dos’Santos
- FSI Sport Research Lab, 18016 Granada, Spain; (A.F.-R.); (T.D.); (J.M.-S.)
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, All Saints Building, Manchester Campus John Dalton Building, Manchester Campus, Manchester Metropolitan University, Manchester M15 6BH, UK
- Manchester Institute of Sport 2.01, Manchester Metropolitan University, Manchester M1 7EL, UK
| | - Jose Afonso
- Centre for Research, Education, Innovation and Intervention in Sport, Faculty of Sports of the University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal;
| | - Francesco Della Villa
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, 40132 Bologna, Italy;
| | | | - Víctor Manuel Soto-Hermoso
- HUMAN Lab, Sport and Health University Research Institute (iMUDS), University of Granada, 18016 Granada, Spain; (V.M.S.-H.); (B.R.)
| | - Bernardo Requena
- HUMAN Lab, Sport and Health University Research Institute (iMUDS), University of Granada, 18016 Granada, Spain; (V.M.S.-H.); (B.R.)
- FSI Sport Research Lab, 18016 Granada, Spain; (A.F.-R.); (T.D.); (J.M.-S.)
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47
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Patetta M, Mayo B, Martini OZ, Sullivan B, Onsen L, Hutchinson M. Preseason elimination impact on anterior cruciate ligament injury in the National Football League. World J Orthop 2021; 12:833-841. [PMID: 34888143 PMCID: PMC8613689 DOI: 10.5312/wjo.v12.i11.833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/03/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Anterior cruciate ligament (ACL) injuries represent detrimental injuries in the National Football League (NFL). A significant portion of these injuries often occur in preseason exhibitions. The Coronavirus disease 2019 pandemic presented a unique disruption to preseason NFL football with the cancelation of all preseason games.
AIM To compare the incidence of ACL tears through the first eight weeks of the NFL season in 2020 to the mean incidence over the previous 5 seasons (2015-2019) and determine if there was any change in incidence with the elimination of the preseason.
METHODS NFL players who suffered ACL tears during the preseason and first eight weeks of the NFL season from 2015-2020 were identified. The number of ACL injuries for the 2015-2019 seasons was compared to the 2020 season for four different timeframes. For each analysis, the cumulative number of ACL injuries to that time point was used to calculate the percent difference for descriptive analysis. Additionally, the number of teams with at least one player suffering an ACL tear were identified and compared using Chi-Squared testing. Finally, a cumulative relative risk was calculated for each week played.
RESULTS There were 14 ACL tears through the first four games of the 2020 season, a 118.8% (14 vs 6.4) increase in comparison to the 5-year average over the first 4 regular season weeks of 2015-2019. However, when accounting for injuries occurring during the preseason from 2015-2019, there were 18.6% (14 vs 17.2) fewer total ACL injuries through regular season week 4 with no significant difference in percentage of teams impacted when these preseason injuries were accounted for P = 0.394. Results were similar (19 vs 17.2) over 8 total games played (whether regular season or preseason), and over 8 regular season games (P = 0.196, P = 0.600).
CONCLUSION The elimination of the NFL preseason resulted in a higher rate of injuries during the first 4 games of the regular season. However, these increases are offset by the injuries typically sustained during the preseason. This suggests there may be front-loading of injuries over the course of an NFL season, such that players may be more prone to injury when the intensity of play suddenly increases, whether in the preseason or regular season.
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Affiliation(s)
- Michael Patetta
- Department of Orthopaedics, University of Illinois Chicago College of Medicine, Chicago, IL 60612, United States
| | - Benjamin Mayo
- Department of Orthopaedics, University of Illinois Chicago College of Medicine, Chicago, IL 60612, United States
| | - Omar Zaki Martini
- Department of Orthopaedics, University of Illinois Chicago College of Medicine, Chicago, IL 60612, United States
| | - Breanna Sullivan
- Department of Orthopaedics, University of Illinois Chicago College of Medicine, Chicago, IL 60612, United States
| | - Leonard Onsen
- Department of Orthopaedics, University of Illinois Chicago College of Medicine, Chicago, IL 60612, United States
| | - Mark Hutchinson
- Department of Orthopaedics, University of Illinois Chicago College of Medicine, Chicago, IL 60612, United States
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Grygorowicz M, Wiernicka M, Wiernicka M. Systematic Review of Cost-Effectiveness of Injury Prevention Interventions in Soccer-Evidence Why Health Agencies Should Address It. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11901. [PMID: 34831654 PMCID: PMC8624619 DOI: 10.3390/ijerph182211901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022]
Abstract
Soccer injuries are a recognized problem worldwide. Several injury prevention programs have been confirmed to reduce the number of injuries in female and male players. Unfortunately, there is a lack of data about their cost, burden, and benefit for the health care system. In this paper we aim to systematically review the literature and critically evaluate the economic quality of injury prevention interventions implemented across different populations of soccer players. Web of Science, Medline, SPORTDiscus, Ovid, and other databases were searched from January 2011 through July 2021. Research articles were only selected for analysis if they focused on the cost-effectiveness of injury prevention, were experimental papers written in English, and were published following the peer-review process. Three cluster RCT and one retrospective study met the criteria. Cost data on incremental cost-effectiveness ratios (ICERs) were extracted. The included studies had a good/average quality of economic evaluation. Based on ICERs, injury prevention interventions were cost-effective in three out of the three comparisons. One study did not report the ICER value. However, since economic analyses were reported with varying methodological approaches and results, more data are required to recognize the cost-effectiveness of soccer-specific injury prevention interventions and their benefit for the health care system.
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Affiliation(s)
- Monika Grygorowicz
- Department of Physiotherapy, Poznan University of Medical Sciences, 61-701 Poznan, Poland
- Rehasport Clinic FIFA Medical Centre of Excellence, Sports Science Research Group, 60-201 Poznan, Poland
| | | | - Marzena Wiernicka
- Department of Kinesiotherapy Developmental Physiotherapy, Faculty of Health Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland;
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Kiers K, Ellenberger L, Javet M, Bruhin B, Frey WO, Spörri J. A Cross-Sectional Observation on Maximal Eccentric Hamstring Strength in 7- to 15-Year-Old Competitive Alpine Skiers. BIOLOGY 2021; 10:biology10111128. [PMID: 34827120 PMCID: PMC8615154 DOI: 10.3390/biology10111128] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 11/21/2022]
Abstract
Simple Summary Competitive alpine skiing is a sport with frequent occurrence of severe knee injuries, and it is well known that the hamstring muscles play an important role in preventing these injuries. The aim of this study was to assess the maximal strength capacity for braking, the downward movement during Nordic Hamstring Exercises, the so called maximal eccentric hamstring strength, in 7- to 15-year-old skiers. Absolute strength values were greater in skiers under 15 years old (U15) skiers than in those under 10 years old (U10), as well as in U15 males compared to their female counterparts. There were no sex differences in U10 skiers. Absolute strength values were generally dependent on age and biological developmental stage, but this dependence was considerably attenuated when body weight was considered. This should be kept in mind when testing athletes around the growth spurt. Abstract Severe knee injuries are common in alpine skiing and the hamstring muscles are known to counteract the anterior tibial displacement that typically accompanies major injury mechanisms. This study aimed to assess the Maximal Eccentric Hamstring Strength (MEHS) of youth competitive alpine skiers during Nordic Hamstring Exercise (NHE) in terms of dependence of sex, age and biological maturation. A total of 246 7- to 15-year-old skiers were tested with respect to their MEHS using an NHE-based measurement device (Vald Performance, Newstead, Australia). Significantly greater absolute MEHS was observed in skiers of the under 15 years (U15) category compared to skiers under 10 years old (U10) (227.9 ± 61.1 N vs. 142.6 ± 28.9 N; p < 0.001), also when grouped by sex. Absolute MEHS was revealed to be lower in U15 females compared to males (213.5 ± 49.0 N vs. 241.9 ± 68.4 N; p = 0.001); in U10 skiers there was no sex difference. For all age groups and sexes, absolute MEHS values were significantly correlated with age and biological maturation (p < 0.001). However, when normalized to body weight such associations disappeared, which is why this is strongly recommended when testing around their growth spurt. Overall, this study established sport-specific normative reference data that may be of interest to researchers and sport practitioners alike.
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Affiliation(s)
- Kirsten Kiers
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland; (K.K.); (L.E.); (W.O.F.)
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
| | - Lynn Ellenberger
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland; (K.K.); (L.E.); (W.O.F.)
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
| | - Marie Javet
- Section for Elite Sport, Swiss Federal Institute of Sport Magglingen, 2532 Magglingen, Switzerland;
| | | | - Walter O. Frey
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland; (K.K.); (L.E.); (W.O.F.)
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland; (K.K.); (L.E.); (W.O.F.)
- University Centre for Prevention and Sports Medicine, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland
- Correspondence: ; Tel.: +41-44-510-70-09
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50
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Wang C, Vander Voort W, Haus BM, Carter CW. COVID-19 and Youth Sports: What Are the Risks of Getting Back on the Field Too Quickly? Pediatr Ann 2021; 50:e465-e469. [PMID: 34757879 DOI: 10.3928/19382359-20211019-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The widespread shutdown in response to the coronavirus disease 2019 (COVID-19) pandemic, although varied across state and county levels, has undoubtedly impacted everyone to some degree. Within the pediatric population, the closure of schools and organized youth athletic programs has resulted in a unique situation that has made athletes physically deconditioned and at risk for injury. As sports and competition gradually restart, there are considerable risks to the skeletally immature athlete. The anatomic and physiologic changes that occur to bone and cartilage during growth make the young athlete particularly susceptible to both acute and overuse injuries. In the context of the pandemic, deconditioning, obesity, lack of variety, and the resultant mental health burden pose unique challenges in ensuring that young athletes safely return to the field. This review aims to identify risk factors for sport-related injuries and to outline strategies for minimizing these injuries as pediatric patients return-to-play after COVID-19. [Pediatr Ann. 2021;50(11):e465-e469.].
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