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McKenzie A, Larequi SA, Hams A, Headrick J, Whiteley R, Duhig S. Shoulder pain and injury risk factors in competitive swimmers: A systematic review. Scand J Med Sci Sports 2023; 33:2396-2412. [PMID: 37515375 DOI: 10.1111/sms.14454] [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] [Received: 01/18/2023] [Revised: 06/10/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
AIM To synthesize and assess the literature for shoulder pain and injury risk factors in competitive swimmers. DESIGN Systematic review with best-evidence synthesis. DATA SOURCES CINHAL, SportDiscus, Scorpus, PubMed, and Embase databases from 1966 to April 30 2022. SEARCH AND INCLUSION Cohort, cross-sectional, and case-control studies investigating shoulder pain or injury risk factors in competitive swimmers were included. Quality of eligible studies were assessed using a modified Newcastle-Ottawa scale. Risk factors were divided into four categories: modifiable-intrinsic, modifiable-extrinsic, non-modifiable, and other/secondary. RESULTS Of 1356 studies identified, 24 full texts were evaluated for methodological quality, 22 met the criteria and were included in best evidence synthesis. There was no strong evidence supporting or refuting the association between 80 assessed variables and shoulder injury or pain. The swimmers' competitive level (nondirectional), and shoulder muscle recruitment profiles (e.g., increased activity of serratus anterior) exhibited moderate evidence supporting an association. Conversely, internal and external range of motion, middle finger back scratch test, training frequency, specialty stroke, height/weight, sex, and age all had moderate evidence opposing an association. Limited evidence was found for 58 variables, and conflicting for 8. The highest quality study (n = 201) suggested high acute-to-chronic workload ratio and reduced posterior shoulder strength endurance are associated with injury. CONCLUSIONS Due to the paucity of high-quality studies, future prospective studies are needed to reevaluate known risk factor associations over exploring additional potential risk factors. Swimming practitioners should be aware of the nondirectional association of a swimmer's competitive level and pain, as squad changes could impact injury incidence. Moreover, swimmers experiencing shoulder pain may show increased activity in shoulder stabilizers during specific movements. Importantly, shoulder strength-endurance may be the most clinically relevant modifiable intrinsic risk factor.
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Affiliation(s)
- Alec McKenzie
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Queensland Academy of Sport, Brisbane, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institution Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Sophie-Alexandra Larequi
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Andrea Hams
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institution Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Jonathon Headrick
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Rod Whiteley
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Steven Duhig
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institution Queensland, Griffith University, Gold Coast, Queensland, Australia
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McGrath JW, Neville J, Stewart T, Lamb M, Alway P, King M, Cronin J. Can an inertial measurement unit, combined with machine learning, accurately measure ground reaction forces in cricket fast bowling? Sports Biomech 2023:1-13. [PMID: 37941397 DOI: 10.1080/14763141.2023.2275251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 01/17/2023] [Indexed: 11/10/2023]
Abstract
This study examined whether an inertial measurement unit (IMU) could measure ground reaction force (GRF) during a cricket fast bowling delivery. Eighteen male fast bowlers had IMUs attached to their upper back and bowling wrist. Each participant bowled 36 deliveries, split into three different intensity zones: low = 70% of maximum perceived bowling effort, medium = 85%, and high = 100%. A force plate was embedded into the bowling crease to measure the ground truth GRF. Three machine learning models were used to estimate GRF from the IMU data. The best results from all models showed a mean absolute percentage error of 22.1% body weights (BW) for vertical and horizontal peak force, 24.1% for vertical impulse, 32.6% and 33.6% for vertical and horizontal loading rates, respectively. The linear support vector machine model had the most consistent results. Although results were similar to other papers that have estimated GRF, the error would likely prevent its use in individual monitoring. However, due to the large differences in raw GRFs between participants, researchers may be able to help identify links among GRF, injury, and performance by categorising values into levels (i.e., low and high).
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Affiliation(s)
- Joseph W McGrath
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
- Manukau Institute of Technology School of Sport, Auckland, New Zealand
- Paramedicine and Emergency Management, School of Health Care Practice, AUT University, Auckland, New Zealand
| | - Jonathon Neville
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Tom Stewart
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
- Human Potential Centre, AUT University, Auckland, New Zealand
| | - Matt Lamb
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Peter Alway
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- England & Wales Cricket Board
| | - Mark King
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - John Cronin
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
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Arumugam S, Perumal S, Raman SA, Ayyadurai P, Nimishaanth SS, Thiagarajan KA. Lumbar Spine Injury in Indian Fast Bowlers: 3D Biomechanical Analysis and Prevention Strategies. Indian J Orthop 2023; 57:1600-1604. [PMID: 37766957 PMCID: PMC10519895 DOI: 10.1007/s43465-023-00928-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/05/2023] [Indexed: 09/29/2023]
Abstract
Background Lumbar spine injuries are among the most common overuse injuries in a fast bowler. Among various causative factors, bowling action technique is a crucial one. Three-dimensional motion analysis has been accepted as a gold standard tool to identify incorrect techniques. Previous studies have identified key biomechanical variables associated with lumbar injury risk in fast bowlers. Despite the large popularity of the sport, there is limited information available on the subject in Indian fast bowlers. This study aims to analyse the lumbar spine injury risk in Indian fast bowlers with respect to key biomechanical variables, using 3D motion analysis. Methods Forty-seven male first class fast bowlers underwent 3D motion analysis in an indoor biomechanics laboratory. Motion capture was done with 3D cameras and 2D video cameras, using a standard marker set. Data processing and analysis was done using proprietary software. Biomechanical variables associated with lumbar spine injury risk including lateral trunk flexion (LTF) and knee angle at front foot contact (KA at FFC) were measured, and peak vertical ground reaction forces (pVGRF) were simultaneously recorded using force plates. Descriptive analysis of the data was done. Results 26% of bowlers had a high LTF, 29% had low KA at FFC and 43% had high pVGRF. Thus, a large proportion of bowlers in this study were at risk of lumbar spine injury with respect to the assessed variables. Conclusion This highlights the role of 3D motion analysis in early identification of injurious techniques, which can be modified by coaching and training interventions to prevent injuries. This study thus has implications on coaching and training of fast bowlers in India.
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Affiliation(s)
- S. Arumugam
- Department of Arthroscopy & Sports Medicine, Sri Ramachandra Centre for Sports Science, Chennai, India
- Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), 1, Ramachandra Nagar, Porur, Chennai, Tamil Nadu 600116 India
| | - Suresh Perumal
- Department of Arthroscopy & Sports Medicine, Sri Ramachandra Centre for Sports Science, Chennai, India
- Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), 1, Ramachandra Nagar, Porur, Chennai, Tamil Nadu 600116 India
| | - Sai Aditya Raman
- Department of Arthroscopy & Sports Medicine, Sri Ramachandra Centre for Sports Science, Chennai, India
- Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), 1, Ramachandra Nagar, Porur, Chennai, Tamil Nadu 600116 India
| | - Prakash Ayyadurai
- Department of Arthroscopy & Sports Medicine, Sri Ramachandra Centre for Sports Science, Chennai, India
- Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), 1, Ramachandra Nagar, Porur, Chennai, Tamil Nadu 600116 India
| | - S. S. Nimishaanth
- Department of Arthroscopy & Sports Medicine, Sri Ramachandra Centre for Sports Science, Chennai, India
- Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), 1, Ramachandra Nagar, Porur, Chennai, Tamil Nadu 600116 India
| | - K. A. Thiagarajan
- Department of Arthroscopy & Sports Medicine, Sri Ramachandra Centre for Sports Science, Chennai, India
- Sri Ramachandra Institute of Higher Education and Research (Deemed to Be University), 1, Ramachandra Nagar, Porur, Chennai, Tamil Nadu 600116 India
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Farhart P, Beakley D, Diwan A, Duffield R, Rodriguez EP, Chamoli U, Watsford M. Intrinsic variables associated with low back pain and lumbar spine injury in fast bowlers in cricket: a systematic review. BMC Sports Sci Med Rehabil 2023; 15:114. [PMID: 37730648 PMCID: PMC10512628 DOI: 10.1186/s13102-023-00732-1] [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: 02/24/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Lumbar spine injuries in fast bowlers account for the greatest missed playing time in cricket. A range of extrinsic and intrinsic variables are hypothesised to be associated with low back pain and lumbar spine injury in fast bowlers, and an improved understanding of intrinsic variables is necessary as these may alter load tolerance and injury risk associated with fast bowling. This review critically evaluated studies reporting intrinsic variables associated with low back pain and lumbar spine injury in fast bowlers and identified areas for future investigation. METHODS OVID Medline, EMBASE, SPORTDiscus, CINAHL, Web of Science and SCOPUS databases were last searched on 3 June 2022 to identify studies investigating intrinsic variables associated with low back pain and lumbar spine injury in cricket fast bowlers. Terms relevant to cricket fast bowling, and intrinsic variables associated with lumbar spine injury and low back pain in fast bowlers were searched. 1,503 abstracts were screened, and 118 full-text articles were appraised to determine whether they met inclusion criteria. Two authors independently screened search results and assessed risk of bias using a modified version of the Quality in Prognostic Studies tool. RESULTS Twenty-five studies met the inclusion criteria. Overall, no included studies demonstrated a low risk of bias, two studies were identified as moderate risk, and twenty-three studies were identified as high risk. Conflicting results were reported amongst studies investigating associations of fast bowling kinematics and kinetics, trunk and lumbar anatomical features, anthropometric traits, age, and neuromuscular characteristics with low back pain and lumbar spine injury. CONCLUSION Inconsistencies in results may be related to differences in study design, injury definitions, participant characteristics, measurement parameters, and statistical analyses. Low back pain and lumbar spine injury occurrence in fast bowlers remain high, and this may be due to an absence of low bias studies that have informed recommendations for their prevention. Future research should employ clearly defined injury outcomes, analyse continuous datasets, utilise models that better represent lumbar kinematics and kinetics during fast bowling, and better quantify previous injury, lumbar anatomical features and lumbar maturation. TRIAL REGISTRATION Open Science Framework https://doi.org/10.17605/OSF.IO/ERKZ2 .
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Affiliation(s)
- Patrick Farhart
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia.
- Spine Labs, Discipline of Surgery, St. George and Sutherland Campus of the Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, 2217, Australia.
- Cricket New South Wales, 161 Silverwater Road, Sydney Olympic Park, Sydney, NSW, 2127, Australia.
- Delhi Capitals, JSW GMR Cricket Private Limited, Bahadurshah Zafar Marg, New Delhi, 110002, India.
| | - David Beakley
- Deakin University, Burwood Highway, Burwood, VIC, 3125, Australia
| | - Ashish Diwan
- Spine Labs, Discipline of Surgery, St. George and Sutherland Campus of the Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, 2217, Australia
- Spine Service, Department of Orthopaedic Surgery, St. George Hospital Campus, Kogarah, NSW, 2217, Australia
| | - Rob Duffield
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia
| | - Elizabeth Pickering Rodriguez
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia
| | - Uphar Chamoli
- Spine Labs, Discipline of Surgery, St. George and Sutherland Campus of the Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, 2217, Australia
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Broadway, NSW, 2007, Australia
| | - Mark Watsford
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia
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Dobbs IJ, Oliver JL, Wong MA, Moore IS, Myer GD, Lloyd RS. Effects of a 4-Week Neuromuscular Training Program on Movement Competency During the Back-Squat Assessment in Pre- and Post-Peak Height Velocity Male Athletes. J Strength Cond Res 2021; 35:2698-2705. [PMID: 31343558 PMCID: PMC9641668 DOI: 10.1519/jsc.0000000000003210] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Dobbs, IJ, Oliver, JL, Wong, MA, Moore, IS, Myer, GD, and Lloyd, RS. Effects of a 4-week neuromuscular training program on movement competency during the back-squat assessment in pre- and post-peak height velocity male athletes. J Strength Cond Res 35(10): 2698-2705, 2021-The back-squat assessment (BSA) is a novel movement screen to detect functional deficits; however, its sensitivity to detect meaningful changes in movement competency after exposure to short-term neuromuscular training remains unclear. Twenty-six pre- and 22 post-peak height velocity (PHV) males were divided into experimental (EXP) and control groups (CON) and performed the BSA before and after a twice weekly, 4-week neuromuscular training intervention. Intra-rater reliability was determined by rating both EXP group's baseline BSA on 3 separate sessions. Intraclass correlation coefficient (ICC) revealed very strong agreement for BSA total score in pre-PHV (ICC ≥ 0.81) and post-PHV (ICC ≥ 0.97) groups across all sessions, but systematic bias was evident in the pre-PHV group for sessions 1-2. Analysis of kappa values for BSA individual criteria showed greater variability for pre-PHV (K ≥ 0.31) than post-PHV (K ≥ 0.62) across sessions. At baseline, there were no differences in total score between the EXP and CON cohorts (p > 0.05). There were significant within-group improvements in total score for the EXP pre-PHV (5.0 to 3.0, effect size [ES] = 0.68) and post-PHV (2.0 to 1.0, ES = 0.82) cohorts, with no changes in total score for either CON groups (p > 0.05). Hip position was the criterion with the greatest improvement for both the EXP pre-PHV (12.0 to 7.0) and post-PHV (7.0 to 0.0) groups. The BSA seems to be a reliable screening tool for measuring movement competency in youth male athletes and was sensitive to adaptations in movement competency after neuromuscular training.
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Affiliation(s)
- Ian J Dobbs
- Youth Physical Development Center, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Jon L Oliver
- Youth Physical Development Center, Cardiff Metropolitan University, Cardiff, United Kingdom
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand
| | - Megan A Wong
- Youth Physical Development Center, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Isabel S Moore
- Youth Physical Development Center, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Gregory D Myer
- The Sport Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, College of Medicine, Cincinnati, Ohio
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Rhodri S Lloyd
- Youth Physical Development Center, Cardiff Metropolitan University, Cardiff, United Kingdom
- Sport Performance Research Institute, New Zealand (SPRINZ), AUT University, Auckland, New Zealand
- Center for Sport Science and Human Performance, Waikato Institute of Technology, Hamilton, New Zealand
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Constable M, Wundersitz D, Bini R, Kingsley M. Quantification of the demands of cricket bowling and the relationship to injury risk: a systematic review. BMC Sports Sci Med Rehabil 2021; 13:109. [PMID: 34507613 PMCID: PMC8431903 DOI: 10.1186/s13102-021-00335-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 08/29/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Bowling in cricket is a complex sporting movement which, despite being well characterised, still produces a significant number of injuries each year. Fast bowlers are more likely to be injured than any other playing role. Frequency, duration, intensity and volume of bowling, which have been generalised as measurements of workload, are thought to be risk factors for injuries. Injury rates of fast bowlers have not reduced in recent years despite the implementation of various workload monitoring practices. OBJECTIVE To identify the variables used to quantify frequency, intensity, time and volume of bowling; and evaluate relationships between these variables and injury risk. METHODS Six online databases were systematically searched for studies on fast bowling that included terms related to workload. Population characteristics, variables relating to demand and their relationship to standardised definitions of physical activity were extracted from all included studies. RESULTS Bowling workload is typically quantified through measures of frequency, duration, or indirect intensity, with few studies reporting on bowling volume. CONCLUSIONS When reported on, volume was often described using imprecise or insufficient measures of intensity. There is a need to develop more appropriate measures of intensity during bowling and improve the quality of evidence to inform on bowling programme management practices.
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Affiliation(s)
- Matthew Constable
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Daniel Wundersitz
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Rodrigo Bini
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Michael Kingsley
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia.
- Department of Exercise Science, Faculty of Science, The University of Auckland, Auckland, New Zealand.
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Senington B, Lee RY, Williams JM. Validity and reliability of innovative field measurements of tibial accelerations and spinal kinematics during cricket fast bowling. Med Biol Eng Comput 2021; 59:1475-1484. [PMID: 34173966 PMCID: PMC8313468 DOI: 10.1007/s11517-021-02381-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/08/2021] [Indexed: 11/25/2022]
Abstract
The use of inertial sensors in fast bowling analysis may offer a cheaper and portable alternative to current methodologies. However, no previous studies have assessed the validity and reliability of such methods. Therefore, this study aimed to assess the validity and reliability of collecting tibial accelerations and spinal kinematics using inertial sensors during in vivo fast bowling. Thirty-five elite male fast bowlers volunteered for this study. An accelerometer attached to the skin over the tibia was used to determine impacts and inertial sensors over the S1, L1 and T1 spinous processes used to derive the relative kinematics. These measurements were compared to optoelectronic and force plate data for validity analysis. Most acceleration and kinematics variables measured report significant correlations > 0.8 with the corresponding gold standard measurement, with intraclass correlation coefficients greater than 0.7. Low standard error of measurement and consequently small minimum detectable change (MDC) values were also observed. This study demonstrates that inertial sensors are as valid and reliable as current methods of fast bowling analysis and may provide some advantages over traditional methods. The novel metrics and methods described in this study may aid coaches and practitioners in the design and monitoring of fast bowling technique. ![]()
Graphical abstract illustrating the synopsis of the findings from this paper.
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Affiliation(s)
- Billy Senington
- School of Biosciences and Medicine, University of Surrey, Guildford, GU2 7WG UK
| | - Raymond Y. Lee
- Faculty of Technology, Portsmouth University, Portsmouth, UK
| | - Jonathan Mark Williams
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth Gateway Building, St Paul’s Lane, Bournemouth, BH8 8GP Dorset UK
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Orejel Bustos A, Belluscio V, Camomilla V, Lucangeli L, Rizzo F, Sciarra T, Martelli F, Giacomozzi C. Overuse-Related Injuries of the Musculoskeletal System: Systematic Review and Quantitative Synthesis of Injuries, Locations, Risk Factors and Assessment Techniques. SENSORS (BASEL, SWITZERLAND) 2021; 21:2438. [PMID: 33916269 PMCID: PMC8037357 DOI: 10.3390/s21072438] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/19/2022]
Abstract
Overuse-related musculoskeletal injuries mostly affect athletes, especially if involved in preseason conditioning, and military populations; they may also occur, however, when pathological or biological conditions render the musculoskeletal system inadequate to cope with a mechanical load, even if moderate. Within the MOVIDA (Motor function and Vitamin D: toolkit for risk Assessment and prediction) Project, funded by the Italian Ministry of Defence, a systematic review of the literature was conducted to support the development of a transportable toolkit (instrumentation, protocols and reference/risk thresholds) to help characterize the risk of overuse-related musculoskeletal injury. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach was used to analyze Review papers indexed in PubMed and published in the period 2010 to 2020. The search focused on stress (overuse) fracture or injuries, and muscle fatigue in the lower limbs in association with functional (biomechanical) or biological biomarkers. A total of 225 Review papers were retrieved: 115 were found eligible for full text analysis and led to another 141 research papers derived from a second-level search. A total of 183 papers were finally chosen for analysis: 74 were classified as introductory to the topics, 109 were analyzed in depth. Qualitative and, wherever possible, quantitative syntheses were carried out with respect to the literature review process and quality, injury epidemiology (type and location of injuries, and investigated populations), risk factors, assessment techniques and assessment protocols.
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Affiliation(s)
- Amaranta Orejel Bustos
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Valeria Belluscio
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Valentina Camomilla
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Leandro Lucangeli
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Francesco Rizzo
- Joint Veterans Defence Center, Army Medical Center, 00184 Rome, Italy; (F.R.); (T.S.)
| | - Tommaso Sciarra
- Joint Veterans Defence Center, Army Medical Center, 00184 Rome, Italy; (F.R.); (T.S.)
| | - Francesco Martelli
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00161 Rome, Italy;
| | - Claudia Giacomozzi
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00161 Rome, Italy;
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9
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Senington B, Lee RY, Williams JM. Biomechanical risk factors of lower back pain in cricket fast bowlers using inertial measurement units: a prospective and retrospective investigation. BMJ Open Sport Exerc Med 2020; 6:e000818. [PMID: 32843992 PMCID: PMC7430332 DOI: 10.1136/bmjsem-2020-000818] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2020] [Indexed: 12/23/2022] Open
Abstract
Objectives To investigate spinal kinematics, tibial and sacral impacts during fast bowling, among bowlers with a history of low back pain (LBP) (retrospective) and bowlers who developed LBP in the follow-up season (prospective). Methods 35 elite male fast bowlers; senior (n=14; age=24.1±4.3 years; height=1.89±0.05 m; weight=89.2±4.6 kg) and junior (n=21; age=16.9±0.7; height=1.81±0.05; weight=73.0±9.2 kg) were recruited from professional county cricket clubs. LBP history was gathered by questionnaire and development of LBP was monitored for the follow-up season. Spinal kinematics, tibial and sacral impacts were captured using inertial measurement units placed over S1, L1, T1 and anteromedial tibia. Bonferroni corrected pairwise comparisons and effect sizes were calculated to investigate differences in retrospective and prospective LBP groups. Results Approximately 38% of juniors (n=8) and 57% of seniors (n=8) reported a history of LBP. No differences were evident in spinal kinematics or impacts between those with LBP history and those without for seniors and juniors. Large effect sizes suggest greater rotation during wind-up (d=1.3) and faster time-to-peak tibial impacts (d=1.5) in those with no history of LBP. One junior (5%) and four (29%) seniors developed LBP. No differences were evident in spinal kinematics or impacts between those who developed LBP and those who did not for seniors. In seniors, those who developed LBP had lower tibial impacts (d=1.3) and greater lumbar extension (d=1.9) during delivery. Conclusion Retrospective analysis displayed non-significant differences in kinematics and impacts. It is unclear if these are adaptive or impairments. Prospective analysis demonstrated large effect sizes for lumbar extension during bowling suggesting a target for future coaching interventions.
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Affiliation(s)
- Billy Senington
- School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Raymond Y Lee
- Faculty of Technology, University of Portsmouth, Portsmouth, UK
| | - Jonathan M Williams
- Department of Rehabilitation and Sport Sciences, Bournemouth University, Bournemouth, UK
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10
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Forrest MRL, Hebert JJ, Scott BR, Dempsey AR. Modifying bowling kinematics in cricket pace bowlers with exercise-based injury prevention: A cluster-randomised controlled trial. J Sci Med Sport 2020; 23:1172-1177. [PMID: 32653248 DOI: 10.1016/j.jsams.2020.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Undesirable bowling kinematics can increase the risk of low back injury. This study investigated if an exercise-based injury prevention program (IPP) could modify bowling kinematics in community-level adolescent pace bowlers. DESIGN Cluster-randomised controlled trial. METHODS Pace bowlers from eight cricket organisations were cluster-randomised into an intervention or control group. At baseline and follow-up sessions biomechanical bowling data were collected. Between sessions, the intervention group completed an eight-week IPP while the control continued their normal cricket activity. Treatment effects (95% CI) were estimated with linear mixed models. RESULTS There were significant treatment effects favouring the intervention group for shoulder counter-rotation (-3.8°; -7.2° to -0.3°) and lateral trunk flexion relative to the pelvis (-2.2°; -4.0° to -0.5°). Shoulder counter-rotation also increased in the control group by 2.2° (Cohen's d=0.22). There were no effects of the intervention on: lateral trunk flexion at front foot contact (FFC) (1.2°; -2.5° to 4.8°), lateral trunk flexion at ball release (BR) (-0.5°; -3.0° to 2.0°), pelvis rotation at FFC (0.9°; -4.0° to 2.2°), pelvis rotation at BR (-1.1°; -5.7° to 3.6°), front hip angle at FFC (1.6°; -3.6° to 6.7°), front hip angle at BR (-1.6°; -5.0° to 1.9°), front knee angle at FFC (-1.1°; -4.5° to 2.3°), front knee angle at BR (1.7°; -5.6° to 9.1°), or ball velocity (1.1kmh-1; -7.5kmh-1 to 9.7kmh-1). CONCLUSIONS The IPP maintained shoulder counter-rotation and lateral trunk flexion relative to the pelvis in the intervention group and this could attenuate injury risk. No treatment effects were observed for lower-limb kinematics.
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Affiliation(s)
- Mitchell R L Forrest
- College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia; Murdoch Applied Sports Science Laboratory, Murdoch University, Perth, WA, Australia
| | - Jeffrey J Hebert
- College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia; Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Brendan R Scott
- College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia; Murdoch Applied Sports Science Laboratory, Murdoch University, Perth, WA, Australia
| | - Alasdair R Dempsey
- College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, Australia; Murdoch Applied Sports Science Laboratory, Murdoch University, Perth, WA, Australia
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Is there an association between external workload and lower-back injuries in cricket fast bowlers? A systematic review. Phys Ther Sport 2020; 41:71-79. [DOI: 10.1016/j.ptsp.2019.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/31/2019] [Accepted: 11/14/2019] [Indexed: 12/18/2022]
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Forrest MRL, Hebert JJ, Scott BR, Dempsey AR. Exercise-based injury prevention for community-level adolescent cricket pace bowlers: A cluster-randomised controlled trial. J Sci Med Sport 2019; 23:475-480. [PMID: 31874733 DOI: 10.1016/j.jsams.2019.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/30/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To investigate if an exercise-based injury prevention program (IPP) can modify risk factors for injury in community-level adolescent cricket pace bowlers. DESIGN Cluster-randomised controlled trial. METHODS Eight cricket organisations (training two times per week and no previous involvement in a structured IPP) participated in this cluster-randomised trial. Participants were aged 14-17 years, injury free, and not currently performing a rehabilitation/exercise program. Cricket organisations (clusters) were block-randomised by computerised number generation into an intervention group (performed an eight-week IPP at training) or control group (continued their usual cricket activity). Participants were not blinded to group allocation. Strength, endurance, and neuromuscular control were assessed at baseline and follow-up. Treatment effects were estimated using linear mixed models. RESULTS Sixty-five male adolescent pace bowlers (intervention n=32 and control n=33) were randomised. There were significant treatment effects favouring the intervention group for shoulder strength (90°/s) 0.05 (95% CI 0.02-0.09) Nm/kg, hamstring strength (60°/s) 0.32 (95% CI 0.13-0.50) Nm/kg, hip adductor strength dominant 0.40 (95% CI 0.26-0.55) Nm/kg and non-dominant 0.33 (95% CI 0.20-0.47) Nm/kg, SEBT reach distance dominant 3.80 (95% CI 1.63-6.04) percent of leg length (%LL) and non-dominant 3.60 (95% CI 1.43-5.78) %LL, and back endurance 20.4 (95% CI 4.80-36.0) seconds. No differences were observed for shoulder strength (180°/s) (p=0.09), hamstring strength (180°/s) (p=0.07), lumbopelvic stability (p=0.90), and single leg squat knee valgus angle (dominant p=0.06, non-dominant p=0.15). CONCLUSIONS Exercise-based IPPs can modify risk factors for injury in community-level adolescent pace bowlers. Future research is needed to confirm if IPPs can also reduce injury risk in this population.
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Affiliation(s)
- Mitchell R L Forrest
- College of Science, Health, Engineering and Education, Murdoch University, Australia; Murdoch Applied Sports Science Laboratory, Murdoch University, Australia.
| | - Jeffrey J Hebert
- College of Science, Health, Engineering and Education, Murdoch University, Australia; Faculty of Kinesiology, University of New Brunswick, Canada
| | - Brendan R Scott
- College of Science, Health, Engineering and Education, Murdoch University, Australia; Murdoch Applied Sports Science Laboratory, Murdoch University, Australia
| | - Alasdair R Dempsey
- College of Science, Health, Engineering and Education, Murdoch University, Australia; Murdoch Applied Sports Science Laboratory, Murdoch University, Australia
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Abstract
Adolescent cricket pace bowlers are prone to non-contact shoulder, low back and lower-limb injuries. Exercise-based injury prevention programmes (IPPs) are effective for reducing non-contact injuries in athletes; however, a specific programme for adolescent pace bowlers has not been published. This paper therefore seeks to provide a rationale for the development of an exercise-based IPP specific for adolescent pace bowlers. It also outlines design principles and provides an example exercise programme that can be implemented at the community level. In addition, the paper addresses other injury prevention techniques concerned with the prescription of appropriate bowling loads and the modification of poor bowling biomechanics. Performing an exercise-based IPP before cricket training could reduce injury rates in adolescent pace bowlers. Eccentric strengthening exercises can be employed to target injuries to the posterior shoulder muscles, hip adductors and hamstring muscles. The risk of low back, knee and ankle injury could also be reduced with the inclusion of dynamic neuromuscular control exercises and trunk extensor endurance exercises. Other prevention strategies that need to be considered include the modification of poor bowling biomechanics, such as shoulder counter-rotation and lateral trunk flexion. Coaches and players should also aim to quantify bowling load accurately and coaches should use this information to prescribe appropriate individualised bowling loads. Specifically, players would benefit from avoiding both long periods of low load and acute periods when load is excessively high. Future evidence is needed to determine the effectiveness of the example programme outlined in this paper. It would also be beneficial to investigate whether the modification of bowling biomechanics is achievable at the non-elite level and if bowling load can be accurately measured and manipulated within a community-level population.
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