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Pi-Rusiñol R, Verhagen E, Blanch M, Rodas Font G. Process mining to investigate the relationship between clinical antecedents and injury risk, severity and return to play in professional sports. BMJ Open Sport Exerc Med 2024; 10:e001890. [PMID: 38835540 PMCID: PMC11149139 DOI: 10.1136/bmjsem-2024-001890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/06/2024] Open
Abstract
Objective This paper presents an exploratory case study focusing on the applicability and value of process mining in a professional sports healthcare setting. We explore whether process mining can be retrospectively applied to readily available data at a professional sports club (Football Club Barcelona) and whether it can be used to obtain insights related to care flows. Design Our study used discovery process mining to detect patterns and trends in athletes' Post-Pre-Participation Medical Evaluation injury route, encompassing five phases for analysis and interpretation. Results We examined preprocessed data in event log format to determine the injury status of athletes in respective baseline groups (healthy or pathological). Our analysis found a link between thigh muscle injuries and later ankle joint problems. The process model found three loops with recurring injuries, the most common of which were thigh muscle injuries. There were no differences in injury rates or the median number of days to return to play between the healthy and pathological groups. Conclusions This study explored the applicability and value of process mining in a professional sports healthcare setting. We established that process mining can be retrospectively applied to readily available data at a professional sports club and that this approach can be used to obtain insights related to sports healthcare flows.
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Affiliation(s)
- Ramon Pi-Rusiñol
- FC Barcelona Medical Department, FIFA Medical Excellence Center, and Barça Innovation Hub, Barcelona, Spain
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Amsterdam, Netherlands
| | - Miriam Blanch
- ITEREM BPM Consulting Barcelona Spain, Barcelona, Spain
| | - Gil Rodas Font
- FC Barcelona Medical Department, FIFA Medical Excellence Center, and Barça Innovation Hub, Barcelona, Spain
- Barnaclinic Sports Medicine Unit, Barcelona, Spain
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Reis FJJ, Alaiti RK, Vallio CS, Hespanhol L. Artificial intelligence and Machine Learning approaches in sports: Concepts, applications, challenges, and future perspectives. Braz J Phys Ther 2024; 28:101083. [PMID: 38838418 PMCID: PMC11215955 DOI: 10.1016/j.bjpt.2024.101083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 04/09/2024] [Accepted: 05/08/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND The development and application of Artificial Intelligence (AI) and Machine Learning (ML) in healthcare have gained attention as a promising and powerful resource to change the landscape of healthcare. The potential of these technologies for injury prediction, performance analysis, personalized training, and treatment comes with challenges related to the complexity of sports dynamics and the multidimensional aspects of athletic performance. OBJECTIVES We aimed to present the current state of AI and ML applications in sports science, specifically in the areas of injury prediction, performance enhancement, and rehabilitation. We also examine the challenges of incorporating AI and ML into sports and suggest directions for future research. METHOD We conducted a comprehensive literature review, focusing on publications related to AI and ML applications in sports. This review encompassed studies on injury prediction, performance analysis, and personalized training, emphasizing the AI and ML models applied in sports. RESULTS The findings highlight significant advancements in injury prediction accuracy, performance analysis precision, and the customization of training programs through AI and ML. However, future studies need to address challenges such as ethical considerations, data quality, interpretability of ML models, and the integration of complex data. CONCLUSION AI and ML may be useful for the prevention, detection, diagnosis, and treatment of health conditions. In this Masterclass paper, we introduce AI and ML concepts, outline recent breakthroughs in AI technologies and their applications, identify the challenges for further progress of AI systems, and discuss ethical issues, clinical and research opportunities, and future perspectives.
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Affiliation(s)
- Felipe J J Reis
- Department of Physical Therapy, Federal Institute of Rio de Janeiro, Rio de Janeiro, Brazil; Pain in Motion Research Group, Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
| | - Rafael Krasic Alaiti
- Nucleus of Neuroscience and Behavior and Nucleus of Applied Neuroscience, Universidade de Sao Paulo (USP), Sao Paulo, Brazil; Research, Technology, and Data Science Office, Grupo Superador, Sao Paulo, Brazil
| | - Caio Sain Vallio
- Health Innovation, Data Science, and MLOps Semantics, São Paulo, Brazil
| | - Luiz Hespanhol
- Department of Physical Therapy, Faculty of Medicine, University of Sao Paulo (USP), Sao Paulo, Brazil; Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers (UMC) location VU University Medical Center Amsterdam (VUmc), Amsterdam, the Netherlands
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Bruder AM, Patterson BE, Crossley KM, Mosler AB, Haberfield MJ, Hägglund M, Culvenor AG, Cowan SM, Donaldson A. If we build it together, will they use it? A mixed-methods study evaluating the implementation of Prep-to-Play PRO: an injury prevention programme for women's elite Australian Football. Br J Sports Med 2024; 58:213-221. [PMID: 38216324 DOI: 10.1136/bjsports-2023-107518] [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: 12/12/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVES We evaluated the implementation of Prep-to-Play PRO, an injury prevention programme for women's elite Australian Football League (AFLW). METHODS The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) of Prep-to-Play PRO were assessed based on the proportion of AFLW players and/or staff who: were aware of the programme (R), believed it may reduce anterior cruciate ligament injury (E), attempted to implement any/all programme components (A), implemented all intended components as practically as possible (I) and intended future programme implementation (M). Quantitative and qualitative data were triangulated to assess 58 RE-AIM items (evidence of yes/no/unsure/no evidence) and the 5 RE-AIM dimensions (fully achieved=evidence of yes on >50% dimension items, partially achieved=50% of items evidence of yes and 50% unsure or 50% mix of unsure and unanswered, or not met=evidence of yes on <50% dimension items). RESULTS Multiple sources including AFLW training observations (n=7 total), post-implementation surveys (141 players, 25 staff), semistructured interviews (19 players, 13 staff) and internal programme records (9 staff) contributed to the RE-AIM assessment. After the 2019 season, 8 of 10 (80%) AFLW clubs fully met all five RE-AIM dimensions. All 10 clubs participating in the AFLW fully achieved the reach (R) dimension. One club partially achieved the implementation (I) dimension, and one club partially achieved the effectiveness (E) and adoption (A) dimensions. CONCLUSION The Prep-to-Play PRO injury prevention programme for the AFLW achieved high implementation, possibly due to the programme's deliberately flexible approach coupled with our pragmatic definition of implementation. Engaging key stakeholders at multiple ecological levels (organisation, coaches, athletes) throughout programme development and implementation likely enhanced programme implementation.
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Affiliation(s)
- Andrea M Bruder
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, Melbourne, Victoria, Australia
| | - Brooke E Patterson
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, Melbourne, Victoria, Australia
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, Melbourne, Victoria, Australia
| | - Andrea B Mosler
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, Melbourne, Victoria, Australia
| | - Melissa J Haberfield
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, Melbourne, Victoria, Australia
| | - Martin Hägglund
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, Melbourne, Victoria, Australia
| | - Sallie M Cowan
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Australian IOC Research Centre, Melbourne, Victoria, Australia
| | - Alex Donaldson
- Centre for Sport and Social Impact, La Trobe University, Melbourne, Victoria, Australia
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Tooth C, Schwartz C, Croisier JL, Gofflot A, Bornheim S, Forthomme B. Prevention of shoulder injuries in volleyball players: The usefulness and efficiency of a warm-up routine. Phys Ther Sport 2023; 64:97-103. [PMID: 37812954 DOI: 10.1016/j.ptsp.2023.09.006] [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: 06/13/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVES The objective of this study was to assess the efficiency of a warm-up routine focused on shoulder injury prevention in volleyball players. DESIGN Prospective study. SETTING University. PARTICIPANTS Eight recreational volleyball teams (44 males, 49 females) were included in the study and assigned to two different groups (prevention or control) in a blinded way. In the prevention group, the players had to perform specific exercises at the beginning of each training session twice a week. MAIN OUTCOME MEASURES Injuries were recorded monthly in both groups with an online questionnaire. RESULTS A significant decrease in the total number of injuries as well as in the severity of the injuries was observed in the prevention group in comparison to the control group (p = 0.0001-0.013). For the shoulder, a decrease in injury incidence was also observed in the prevention group. This decrease reached significance in male players (p = 0.045). CONCLUSIONS The program appears to be efficient to reduce the risk of shoulder injuries in recreational volleyball players. Adjustments in the duration and in the contents of the program will have to be made to further improve compliance and better meet the requirements of both players and trainers.
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Affiliation(s)
- Camille Tooth
- Laboratory of Human Motion Analysis, University of Liège, Liège, Belgium; Department of Physical Medicine and Rehabilitation, University of Liège, Liège, Belgium.
| | - Cédric Schwartz
- Laboratory of Human Motion Analysis, University of Liège, Liège, Belgium
| | - Jean-Louis Croisier
- Laboratory of Human Motion Analysis, University of Liège, Liège, Belgium; Department of Physical Medicine and Rehabilitation, University of Liège, Liège, Belgium
| | - Amandine Gofflot
- Laboratory of Human Motion Analysis, University of Liège, Liège, Belgium; Department of Physical Medicine and Rehabilitation, University of Liège, Liège, Belgium
| | - Stephen Bornheim
- Department of Physical Medicine and Rehabilitation, University of Liège, Liège, Belgium
| | - Bénédicte Forthomme
- Laboratory of Human Motion Analysis, University of Liège, Liège, Belgium; Department of Physical Medicine and Rehabilitation, University of Liège, Liège, Belgium
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Cornelissen MH, Kemler E, Baan A, van Nassau F. Mixed-methods process evaluation of the injury prevention Warming-up Hockey programme and its implementation. BMJ Open Sport Exerc Med 2023; 9:e001456. [PMID: 37342787 PMCID: PMC10277536 DOI: 10.1136/bmjsem-2022-001456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/23/2023] Open
Abstract
Warming-up Hockey (WUP) is an effective injury prevention programme to reduce acute field hockey injuries among youth. This paper describes the process evaluation of the nationwide scaling-up. We conducted a mixed-methods process evaluation from September 2019 to December 2020 according to the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, focusing on the intervention and its implementation. We collected data through questionnaires, interviews and web/app analytics. Participants were trainers/coaches, technical/board members of hockey clubs (TBMs) and employees of the Royal Dutch Hockey Federation (KNHB). In total, 226 trainers/coaches (61 via WUP and 165 via training courses) and 14 TBMs filled in questionnaires. Ten individuals (four trainers/coaches, four TBMs and two KNHB employees) participated in semistructured interviews. The study showed the following results according to the RE-AIM framework. Reach: According to web/app analytics, 1492 new accounts were registered. Effectiveness: Overall, users were satisfied with WUP and the implementation strategies, and believed WUP could reduce field hockey injuries. Adoption: 63% of the trainers/coaches (enrolled via WUP) indicated they used WUP. Implementation: Most trainers/coaches did not use WUP during every training session or match. Most TBMs promoted WUP in their club. Implementation barriers included lack of integration with other training programmes, 'know-it-all' trainers, lack of supervision on WUP use and delayed start of implementation. Facilitators included perceived added value, information need on injury prevention in small clubs and tailored communication. Maintenance: Users planned to use WUP occasionally. The KNHB intended to integrate WUP in their newly developed Knowledge Platform. To conclude, WUP was evaluated as a useful programme, but adherence to WUP was challenging. Timely preparation and creating an implementation plan based on stakeholder input, including communication at key moments during the sports season and tailored communication, were found to be important during implementation. Findings can be useful for others planning to implement evidence-based injury prevention programmes on a larger scale.
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Affiliation(s)
| | - Ellen Kemler
- Dutch Consumer Safety Institute, Amsterdam, Netherlands
| | - Anneloes Baan
- Dutch Consumer Safety Institute, Amsterdam, Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, Netherlands
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Tischer T, Martens G, Cabri J, Thoreux P, Tscholl P, Edouard P, Leclerc S, Le Garrec S, Delvaux F, Croisier JL, Kaux JF, Hannouche D, Lutter C, Seil R. The awareness of injury prevention programmes is insufficient among French- and German-speaking sports medicine communities in Europe. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07416-w. [PMID: 37074402 DOI: 10.1007/s00167-023-07416-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/06/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Evaluate the current state of sports injury prevention perception, knowledge and practice among sports medicine professionals located in Western Europe and involved in injury prevention. METHODS Members of two different sports medicine organizations (GOTS and ReFORM) were invited to complete a web-based questionnaire (in German and in French, respectively) addressing perception, knowledge and implementation of sports injury prevention through 22 questions. RESULTS 766 participants from a dozen of countries completed the survey. Among them, 43% were surgeons, 23% sport physicians and 18% physiotherapists working mainly in France (38%), Germany (23%) and Belgium (10%). The sample rated the importance of injury prevention as "high" or "very high" in a majority of cases (91%), but only 54% reported to be aware of specific injury prevention programmes. The French-speaking world was characterized by lower levels of reported knowledge, unfamiliarity with existing prevention programmes and less weekly time spent on prevention as compared to their German-speaking counterparts. Injury prevention barriers reported by the respondents included mainly insufficient expertise, absence of staff support from sports organizations and lack of time. CONCLUSION There is a lack of awareness regarding injury prevention concepts among sports medicine professionals of the European French- and German-speaking world. This gap varied according to the professional occupation and working country. Relevant future paths for improvement include specific efforts to build awareness around sports injury prevention. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Thomas Tischer
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - Géraldine Martens
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium.
- Physical Medicine and Sport Traumatology Department, SportS2, University and University Hospital of Liege, Avenue de L'Hôpital, 1, 4000, Liège, Belgium.
| | - Jan Cabri
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Sports Medicine and Science, Luxembourg Institute of Research in Orthopedics, Luxembourg, Luxembourg
| | - Patricia Thoreux
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- French National Institute of Sport (INSEP), Paris, France
- Centre d'Investigations en Médecine du Sport (CIMS) - Hôpital Hôtel Dieu-APHP, Paris, France
| | - Philippe Tscholl
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Department of Orthopaedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Pascal Edouard
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
- Inter-University Laboratory of Human Movement Biology, EA 7424, Univ Lyon, UJM-Saint-Etienne, F-42023, Saint-Etienne, France
| | - Suzanne Leclerc
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Institut National du Sport du Québec (INS), Montréal, QC, Canada
| | - Sébastien Le Garrec
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- French National Institute of Sport (INSEP), Paris, France
| | - François Delvaux
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Physical Medicine and Sport Traumatology Department, SportS2, University and University Hospital of Liege, Avenue de L'Hôpital, 1, 4000, Liège, Belgium
| | - Jean-Louis Croisier
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Physical Medicine and Sport Traumatology Department, SportS2, University and University Hospital of Liege, Avenue de L'Hôpital, 1, 4000, Liège, Belgium
| | - Jean-François Kaux
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Physical Medicine and Sport Traumatology Department, SportS2, University and University Hospital of Liege, Avenue de L'Hôpital, 1, 4000, Liège, Belgium
| | - Didier Hannouche
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Department of Orthopaedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Christoph Lutter
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - Romain Seil
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Sports Medicine and Science, Luxembourg Institute of Research in Orthopedics, Luxembourg, Luxembourg
- Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg-Clinique d'Eich, Luxembourg, Luxembourg
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Ageberg E, Brodin EM, Linnéll J, Moesch K, Donaldson A, Adébo E, Benjaminse A, Ekengren J, Granér S, Johnson U, Lucander K, Myklebust G, Møller M, Tranaeus U, Bunke S. Cocreating injury prevention training for youth team handball: bridging theory and practice. BMJ Open Sport Exerc Med 2022; 8:e001263. [PMID: 35505981 PMCID: PMC8984048 DOI: 10.1136/bmjsem-2021-001263] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 11/12/2022] Open
Abstract
Although it is advocated that end-users are engaged in developing evidence-based injury prevention training to enhance the implementation, this rarely happens. The ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ uses an ecological participatory design incorporating the perspectives of multiple stakeholders throughout the project. Within the I-PROTECT project, the current study aimed to describe the development of holistic injury prevention training specifically for youth handball players through using knowledge from both end-users (coaches and players) and researchers/handball experts. Employing action evaluation within participatory action research, the cyclical development process included three phases: research team preparation, handball expert-based preparation and end-user evaluation to develop injury prevention training incorporating both physical and psychological perspectives. To grow the knowledge of the interdisciplinary research team, rethinking was conducted within and between phases based on participants’ contributions. Researchers and end-users cocreated examples of handball-specific exercises, including injury prevention physical principles (movement technique for upper and lower extremities, respectively, and muscle strength) combined with psychological aspects (increase end-user motivation, task focus and body awareness) to integrate into warm-up and skills training within handball practice. A cyclical development process that engaged researchers/handball experts and end-users to cocreate evidence-based, theory-informed and context-specific injury prevention training specifically for youth handball players generated a first pilot version of exercises including physical principles combined with psychological aspects to be integrated within handball practice.
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Affiliation(s)
- Eva Ageberg
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Eva M Brodin
- Department of Educational Sciences, Lund University, Lund, Sweden.,Centre for Higher and Adult Education (CHAE), Stellenbosch University, Stellenbosch, South Africa
| | - Jennie Linnéll
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Karin Moesch
- Department of Psychology, Lund University, Lund, Sweden
| | - Alex Donaldson
- Centre for Sport and Social Impact (CSSI), La Trobe University, Melbourne, Victoria, Australia
| | - Emme Adébo
- Regional Handball Federation in South Sweden, Lund, Sweden
| | - Anne Benjaminse
- Center for Human Movement Sciences, University of Groningen, Groningen, The Netherlands.,School of Sport Studies, Hanze University Groningen School of Social Studies, Groningen, The Netherlands
| | - Johan Ekengren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Simon Granér
- Department of Psychology, Lund University, Lund, Sweden
| | - Urban Johnson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | - Grethe Myklebust
- Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
| | - Merete Møller
- Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ulrika Tranaeus
- Department of physiology, nutrition and biomechanics, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sofia Bunke
- Department of Psychology, Lund University, Lund, Sweden
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Wijker BJ, de Groot S, van Dongen JM, van Nassau F, Adriaansen JJE, Achterberg-Warmer WJ, Anema JR, Riedstra AT, van Tulder MW, Janssen TWJ. Electrical stimulation to prevent recurring pressure ulcers in individuals with a spinal cord injury compared to usual care: the Spinal Cord Injury PREssure VOLTage (SCI PREVOLT) study protocol. Trials 2022; 23:156. [PMID: 35172888 PMCID: PMC8848924 DOI: 10.1186/s13063-022-06088-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 02/05/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Pressure ulcers (PUs) on the buttocks are among the most common secondary complications in individuals with chronic spinal cord injury (SCI). PUs can result from sitting for extended periods, disuse atrophy, increased sitting pressure and reduced circulation. Compared with usual care, activation of paralysed muscles using electrical stimulation (ES) has been shown to markedly increase paralysed muscle mass, improve circulation of skin and muscle and improve sitting pressure distribution. ES might therefore be a useful method to reduce PU incidence. METHODS A multicentre randomized controlled trial (SCI PREVOLT) will be conducted with an economic and process evaluation alongside. One hundred participants with a SCI in the chronic phase and a minimal incidence of 1 PU in the last 5 years will be recruited from rehabilitation centres across the Netherlands. Participants will be stratified by centre and age and randomized to the intervention or control group. The intervention group will use ES at least 1 h/day during at least 4 times a week for 1 year next to usual care. The control group will only receive usual care. The primary outcome is the incidence of PUs, measured by a blinded person assessing the presence or absence of a PU on the buttocks on a photo made by the participant or his/her caregiver. The incidence of a PU will be evaluated every 2 weeks. Secondary outcomes include interface pressure distribution, blood flow in the profunda femoris artery, muscle thickness of the hamstrings and gluteal muscles and questionnaires about different dimensions of life, e.g. participation and quality of life. Secondary outcomes will be measured at baseline and 3, 6, 9 and 12 months after randomization. DISCUSSION This study will assess if electrical stimulation is a (cost-)effective method to prevent PUs and reduce the risk factors of getting PUs. If ES is effective and cost-effective compared with usual care, ES could be implemented in daily treatment of individuals with a SCI. TRIAL REGISTRATION Netherlands Trials Register NTR NL9469 . Registered on 26 May 2021.
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Affiliation(s)
- Boas J. Wijker
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sonja de Groot
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
| | - Johanna M. van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | | | - Johan R. Anema
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Andries T. Riedstra
- Paraplegia Organization | Dwarslaesie Organisatie Nederland (DON), Nijkerk, The Netherlands
| | - Maurits W. van Tulder
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thomas W. J. Janssen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
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Verhagen E, Warsen M, Silveira Bolling C. 'I JUST WANT TO RUN': how recreational runners perceive and deal with injuries. BMJ Open Sport Exerc Med 2021; 7:e001117. [PMID: 34631146 PMCID: PMC8477337 DOI: 10.1136/bmjsem-2021-001117] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Running injuries impact the health gains achieved through running and are linked to drop-out from this otherwise healthy activity. The need for effective prevention is apparent, however, implementation of preventive measures implies a change in runners’ behaviour. This exploratory qualitative study aimed to explore Dutch recreational runners’ perception on injuries, injury occurrence and prevention. An interpretative paradigm underpins this study. We conducted 12 individual semistructured interviews with male (n=6) and female runners (n=6). Through a constant comparative data analysis, we developed a conceptual model to illustrate the final product of the analysis and represent the main themes’ connection. We present a framework that describes the pathway from load to injury and the self-regulatory process controlling this pathway. Runners mentioned that pain is not necessarily an injury, and they usually continue running. Once complaints become unmanageable and limit the runner’s ability to participate, an injury was perceived. Based on our outcomes, we recommend that preventive strategies focus on the self-regulation by which runners manage their complaints and injuries—providing information, advice and programmes that support the runner to make well-informed, effective decisions.
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Affiliation(s)
- Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marit Warsen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Caroline Silveira Bolling
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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10
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Perceived Barriers to and Facilitators of an Injury Prevention Program Among Professional Male Ice Hockey Players and Staff Members. J Sport Rehabil 2021; 30:1080-1087. [PMID: 34034228 DOI: 10.1123/jsr.2020-0410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/16/2021] [Accepted: 03/31/2021] [Indexed: 12/16/2022]
Abstract
CONTEXT Injury prevention programs for the lower extremities are effective in team-sport athletes. OBJECTIVE To identify barriers and facilitators among professional ice hockey players and staff members for adhering to an injury prevention program. DESIGN Cross-sectional survey. SETTING AND PARTICIPANTS A questionnaire about barriers and facilitators related to knowledge/perceptions, beliefs, adoption, and habits about injury prevention was filled out by Swiss professional male ice hockey players and staff members. MAIN OUTCOME MEASURES Frequencies of ratings were calculated and binary logistic regression analysis was applied to predict a relationship between a high/low perceived benefit of an injury prevention program and player characteristics. RESULTS Knowledge, perceived benefit, and relevance of injury prevention as well as awareness of high risk of injuries in ice hockey were identified as important facilitators. Players' habit of exercise performance was identified as a barrier. Program understanding of staff members was identified as a facilitator and barrier. No significant relationships were observed between a high/low perceived benefit of an injury prevention program and age (P = .85), nationality (P = .53), level of education (P = .63), National League experience (P = .50), or occurrence of lower-extremity injuries in the previous season (P = .10). CONCLUSIONS Players and staff members clearly rated perceived benefits of an injury prevention program, which can be considered an important facilitator of the uptake and adoption of such a program in ice hockey teams. Players should be educated about well-performed injury prevention exercises. Staff members should be educated about the aim of a regular injury prevention program. An injury prevention program might be implemented in players of all ages, levels of education, and experience in the National League, irrespective of previous injuries. Identified barriers and facilitators should be addressed when implementing an injury prevention program in a setting of professional ice hockey teams in the future.
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Lutter C, Seil R, Best R, Gokeler A, Patt T, Krutsch W, Grim C, Tischer T. Results of a tri-national online survey on the current status of sports injury prevention among members of the German-Speaking Orthopaedic Sports Medicine Society (GOTS). SPORTVERLETZUNG-SPORTSCHADEN 2021; 35:80-87. [PMID: 33957676 DOI: 10.1055/a-1397-0710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To assess the current opinions and state of knowledge in primary sports injury prevention among members of the German-Speaking Society for Orthopaedic and Traumatologic Sports Medicine (GOTS). METHODS On 21 August 2019, a web-based questionnaire was sent to the members of the tri-national society GOTS (Austria, Germany and Switzerland). The survey was online until 21 November 2019 and included twenty-two questions, which were divided into five sections: 1) general importance of prevention (n = 4), 2) specifications of the study population (n = 3), 3) implementation of prevention (n = 8), 4) improvement opportunities in prevention (n = 4) and 5) future research areas (n = 3). RESULTS A total of 272 participants completed the survey, representing a total survey participation of 17.7 % of all members. The study population consisted of orthopaedic surgeons (55 % with surgical and 21 % with non-operative orientation), medical students (10 %), physical therapists (8 %) and sports scientists (4 %). Ninety-four percent of all participants stated that they considered the importance of sports injury prevention to be "very high" (68 %) or "high" (26 %). However, almost 70 % of all participants stated that they spend less than one hour per week on injury prevention work. The term "prevention" was clearly defined and practicable for only 40 %, understandable but difficult to implement for 51 %, and unclear and difficult to implement for 9 % of the participants. Seventy-two percent of respondents were aware of existing prevention programs such as "Stop-X" or "FIFA 11 +", whereas 28 % of participants were uninformed regarding these programs. CONCLUSIONS A strong divergence was identified between participants' perception of the importance of sports injury prevention and the existing implementation of preventive measures. Future funding of prevention programs, expansion of research strategies for injury prevention and better financial reimbursement are of utmost importance.
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Affiliation(s)
- Christoph Lutter
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - R Seil
- Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg-Clinique d'Eich, Luxembourg, Luxembourg.,Luxembourg Institute of Health, Luxembourg
| | - R Best
- Sportklinik Stuttgart, Stuttgart, Germany
| | - A Gokeler
- Department Exercise & Health, Exercise Science and Neuroscience, University of Paderborn, Paderborn, Germany
| | - T Patt
- Bergman Clinics, Delft, Netherlands
| | - W Krutsch
- SportDocsFranken, Nürnberg; Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - C Grim
- Department of Orthopedic, Trauma and Hand Surgery, Klinikum Osnabrück, Germany
| | - T Tischer
- Department of Orthopedics, University Medical Center, Rostock, Germany
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Enz A, Schöffl V, Simon M, Back DA, Tischer T, Lutter C. [Generation "Social Media": use of modern media to gain information regarding sports injuries]. SPORTVERLETZUNG-SPORTSCHADEN 2021; 35:95-102. [PMID: 33851384 DOI: 10.1055/a-1386-6758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Digital media have found their way into almost all areas of daily life. The aim of this study was to analyse the extent to which injured athletes use online media to gather information on sports injuries or on how to prevent them. MATERIAL AND METHODS Between 07-2017 and 12-2019, both recreational and competitive climbing athletes were surveyed on their use of various media with regard to sports medicine and prevention. RESULTS 488 athletes were included in the study (70.9 % male, 29.1 % female, 33.2 ± 10.3 (13-71) years of age). 69.9 % of the athletes use web-based medical content, with the video platform YouTube being most frequently used for specific searches (24.4 %). Younger athletes (< 30y) use video platforms significantly more often than older athletes (p = 0.011). Sports-specific literature is most frequently used by the age group 30-50 years (37.4 %). The age group > 50 uses this medium significantly less frequently (18.8 %; p = 0.013). Competitive athletes use web-based medical content significantly more often than recreational athletes (p = 0.005). The general interest in injury prevention is high, with competitive athletes using relevant content more often. Almost 9 % of all patients interviewed visited a sports-orthopaedic facility because of their online research work. SUMMARY Internet-based medical information is used by 69.9 % of athletes, with the video platform YouTube being most frequently used. Video platforms and sports-specific literature are used significantly more often by younger athletes than by older athletes. Web-based medical content is accessed significantly more often by professional athletes than by recreational athletes. The general interest in injury prophylaxis is high, with competitive athletes using or browsing medical content more often.
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Affiliation(s)
- Andreas Enz
- Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Volker Schöffl
- Unfallchirurgische Klinik und Orthopädische Chirurgie, Friedrich Alexander Universität Erlangen-Nürnberg, Erlangen, Deutschland.,Klinik für Orthopädie und Unfallchirurgie, Klinikum Bamberg, Bamberg, Deutschland
| | - Michael Simon
- Klinik für Orthopädie und Unfallchirurgie, Klinikum Bamberg, Bamberg, Deutschland
| | - David Alexander Back
- Bundeswehrkrankenhaus Berlin, Klinik für Unfallchirurgie und Orthopädie, Berlin, Deutschland
| | - Thomas Tischer
- Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - Christoph Lutter
- Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland
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