Prevalence of overuse injuries in athletes from individual and team sports: A systematic review with meta-analysis and GRADE recommendations

Trials and tribulations of transparency related to inconsistencies between plan and conduct in peer-reviewed physiotherapy publications: A methodology review

RATIONALE

The physiotherapy profession strives to be a leader in providing quality care and strongly recognizes the value of research to guide clinical practice. Adherence to guidelines for research reporting and conduct is a significant step towards high-quality, transparent and reproducible research.

AIM/OBJECTIVE

Assess integrity between planned and conducted methodology in randomized controlled trials (RCTs) and systematic reviews (SRs) published in physiotherapy journals.

METHODS

Eighteen journals were manually searched for RCTs and SRs published from 1 July 2021 through 31 December 2021. Studies were included if the journal or specific study was indexed in PubMed and published/translated in English. Descriptive statistics determined congruence between preregistration data and publication.

RESULTS

Forty RCTs and 68 SRs were assessed. Forty-three SRs included meta-analysis (MA). Of the 34 registered RCTs, 7 (20.6%) had no discrepancy between the registration and publication. Two trials (5.9%) addressed all discrepancies, 4 (11.8%) addressed some and 21 (61.8%) did not address any discrepancies. Of the 36 registered MAs, 33 (91.7%) had discrepancies between the registration and publication. Two (5.6%) addressed all discrepancies and three (8.3%) had no discrepancies. Eight SRs without MA published information not matching their registration, and none provided justification for the discrepancies.

CONCLUSION

Most RCTs/SRs were registered; the majority had discrepancies between preregistration and publication, potentially influencing the outcomes and interpretations of findings. Journals should require preregistration and compare the submission with the registration information when assessing publication suitability. Readers should be aware of these inconsistencies and their implications when interpreting and translating results into practice.

The Connection Between Resistance Training, Climbing Performance, and Injury Prevention

BACKGROUND

Climbing is an intricate sport composed of various disciplines, holds, styles, distances between holds, and levels of difficulty. In highly skilled climbers the potential for further strength-specific adaptations to increase performance may be marginal in elite climbers. With an eye on the upcoming 2024 Paris Olympics, more climbers are trying to maximize performance and improve training strategies. The relationships between muscular strength and climbing performance, as well as the role of strength in injury prevention, remain to be fully elucidated. This narrative review seeks to discuss the current literature regarding the effect of resistance training in improving maximal strength, muscle hypertrophy, muscular power, and local muscular endurance on climbing performance, and as a strategy to prevent injuries.

MAIN BODY

Since sport climbing requires exerting forces against gravity to maintain grip and move the body along the route, it is generally accepted that a climber`s absolute and relative muscular strength are important for climbing performance. Performance characteristics of forearm flexor muscles (hang-time on ledge, force output, rate of force development, and oxidative capacity) discriminate between climbing performance level, climbing styles, and between climbers and non-climbers. Strength of the hand and wrist flexors, shoulders and upper limbs has gained much attention in the scientific literature, and it has been suggested that both general and specific strength training should be part of a climber`s training program. Furthermore, the ability to generate sub-maximal force in different work-rest ratios has proved useful, in examining finger flexor endurance capacity while trying to mimic real-world climbing demands. Importantly, fingers and shoulders are the most frequent injury locations in climbing. Due to the high mechanical stress and load on the finger flexors, fingerboard and campus board training should be limited in lower-graded climbers. Coaches should address, acknowledge, and screen for amenorrhea and disordered eating in climbers.

CONCLUSION

Structured low-volume high-resistance training, twice per week hanging from small ledges or a fingerboard, is a feasible approach for climbers. The current injury prevention training aims to increase the level of performance through building tolerance to performance-relevant load exposure and promoting this approach in the climbing field.

Platelet-rich plasma injections as a treatment for Achilles tendinopathy and plantar fasciitis in athletes

Platelet-rich plasma (PRP) injections represent a growing interest in the use of biologic therapies for treatment of musculoskeletal injuries. One possible application of PRP is in the management of overuse injuries commonly experienced by athletes. The aim of this review is to evaluate and summarize existing evidence regarding the efficacy of PRP in the treatment of Achilles tendinopathy and plantar fasciitis in athletes. Although many lower quality single-armed studies have demonstrated clinical improvement in athletes treated for Achilles tendinopathy with PRP, higher quality randomized controlled trials (RCTs) have shown no clear benefit in athletes. Existing data suggest PRP significantly improves clinical outcomes for plantar fasciitis in the general population, but very few studies and no RCTs are available that specifically analyze outcomes in athletic populations. More research is needed to evaluate how platelet concentration, leukocyte and erythrocyte presence, and sport type may interact to affect clinical outcomes in athletes.

Top of the podium, at what cost? injuries in female international elite climbers

Objectives

Competitive sport climbing has made its way to the Olympic stage. This prestige has brought about route setting and training alterations which presumably affect injury epidemiology. Most of the climbing injury literature contains male climbers and lacks high performing athletes. Studies with both female and male climbers, rarely included separate analyses for performance level or sex. Therefore, injury concerns for elite female competitive climbers are impossible to discern. A former study examined the prevalence of amenorrhea in elite international female climbers (n = 114) and reported that 53.5% had at least one injury in the past 12 months, but injury details were excluded. This study's aim was to report these injury details and their associations with BMI, menstrual status and eating disorders of the cohort.

Methods

Online survey was emailed to competitive female climbers recruited through the IFSC database between June and August 2021. Data was analyzed using Mann-Whitney U, χ² and logistic regression.

Results

229 registered IFSC climbers opened the questionnaire and 114 (49.7%) provided valid responses. Respondents (mean ± SD; age = 22.9 ± 5 year) represented 30 different countries and more than half (53.5%, n = 61) reported an injury in the prior 12 months with the majority in shoulders (37.7%, n = 23) and fingers (34.4%, n = 21). Injury prevalence in climbers with amenorrhea was 55.6% (n = 10). BMI was not a significant predictor of injury risk (OR = 1.082, 95% CI: 0.89, 1.3; p = 0.440) while accounting for current ED over the past 12 months. However, the odds ratio for having an injury was doubled for those with an ED (OR = 2.129, 95% CI: 0.905, 5.010; p = 0.08).

Conclusion

With over half reporting recent injuries (<12 months) mostly to shoulders and fingers, development of new strategies for injury prevention in competitive female climbers are warranted. In addition, climbers with disordered eating behaviors and/or menstrual disturbances might be more prone to injury. More research in this population is required. Suitable screening to prevent these health issues and proper monitoring of these athletes are paramount to long-term athlete success.

Holding open spaces to explore beyond: Toward a different conceptualization of specialization in high-performance sport

This conceptual analysis aims to challenge the state of high-performance sport by questioning the concept of specialization. To start, we offer a brief, but critical overview of what specialization currently entails. Then, shifting the paradigm, we suggest an expansion rather than a reduction of developmental possibilities once an athlete reaches the "top". Specifically, rather than athletes conforming to national standards imposed by governing bodies about what it means to be "elite", we suggest sport systems consider a person-environment fit approach to support ongoing development. Drawing on an ecological dynamics rationale and various socio-cultural theories, we explore how concepts such as affordances and perspectives can be harnessed to create a better "fit" between athletes' action capabilities and the opportunities within their broader environment. Our conception of specialization requires moving away from a definition of success based on the accumulation of medals, toward one that accounts for the exploration and achievement of the possible. We argue that a person-environment fit welcomes diversity, so long as it sustains the person's health, wellbeing, and performance. This, it is suggested, is about collectively holding open spaces for each other to explore beyond the constraints of high-performance sport, encouraging all to carry on their lives in directions meaningfully impactful for them. We conclude this conceptual analysis with a brief case example demonstrating what our theorizing could look like in practice.

PHYSICAL FITNESS IMPROVEMENTS IN FEMALE VOLLEYBALL PLAYERS

ABSTRACT Introduction: Volleyball is a competitive sport demanding the athlete's excellent physical fitness because the execution of its movements requires flexibility and agility. Objective: Analyze the effects of a specific training protocol on physical fitness at a competitive level on volleyball players. Methods: This paper selects 12 female volleyball players as volunteers for research subjects. The athletes’ agility quality was examined for intellectual efficiency, psychological susceptibility, and flexibility, among other indicators. The mathematical statistical analysis program SPSS13.0 was used to analyze and process female volleyball players’ sensitivity and characteristics of fitness quality. Results: The responsiveness of Chinese female volleyball players is mainly reflected in athletes’ intellectual agility and kinetic adaptations. The characteristics of technology for protection are practical, diverse, and economical. Transmission technology is characterized by high speed and quick thinking. The sensitivity and quality of the volleyball players are high. Conclusion: The sensitivity of volleyball players is produced in response to changes in the sports court environment. The use of various tactics and auxiliary equipment in volleyball will cause changes in the court situation. The quality of sensitivity is critical in the physical training of volleyball players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Altered regional 3D shear wave velocity patterns in youth competitive alpine skiers suffering from patellar tendon complaints - A prospective case-control study

AbstractPatellar tendon (PT) complaints are frequent throughout the population, with increased occurrence in athletes and, particularly, in youth competitive alpine skiers. Timely detection and treatment might improve prospects of recovery. Diagnostic modalities in clinical use to date rely on pain symptoms, manual palpation, and potentially, magnetic resonance imaging (MRI); however, MRI-based imaging yields limited sensitivity. Quantitatively measuring the morphological and mechanical properties of PTs by means of B-mode ultrasound and shear wave elastography (SWE), instead, may allow improved diagnosis or even early detection. We performed B-mode scans and three-dimensional ultrasound shear wave velocity (SWV) mapping and MRI of the PT in 106 youth skiers. A prospective one-year survey on health problems combined with clinical assessments served to categorize symptomatic and asymptomatic youth skiers. Skiers suffering from distal or proximal tendon complaints showed lower SWV in the respective tendon region than asymptomatic skiers (p = 0.035 and p = 0.019, respectively). Youth skiers with distal tendon complaints additionally exhibited decreased SWV in the proximal region compared to asymptomatic counterparts (p = 0.020). Cross-validated analysis of retrospective prediction indicated sensitivity and specificity in detecting tendon complaints in the range of 0.606-0.621 and 0.536-0.650, respectively. MRI detected distal tendon complaints with a sensitivity of 0.410 (12/29) but failed to detect any proximal cases. This study agrees with the most recent literature in that SWE holds promise as a valuable adjunct modality for the diagnosis of PT complaints or even the detection of subclinical prestages. However, to evaluate its prospective predictive value, long-term studies are warranted.

The effect of static stretching on key hits and subjective fatigue in eSports

[Purpose] To explore the effects of static stretching for 20 s on key hits and subjective fatigue in an eSports-like setting. [Participants and Methods] The participants comprised of 15 healthy males who were instructed to hit a particular key on a computer keyboard using the left ring finger to achieve the maximum number of hits possible over a period of 30 s. Subjective fatigue of the forearm was assessed using a visual analog scale (VAS) before the experiment and after each trial. Trials 1, 2, and 3 were conducted in succession, with an inter-trial interval of 60 s to ensure a loaded state. Static stretching for 20 s preceded Trial 4. [Results] Over the first three trials, the number of key hits in the first 10 s gradually decreased, while the feeling of subjective fatigue gradually increased. After stretching, the number of key hits in the first 10 s of Trial 4 was similar to that observed in Trial 1, and there was no increase in subjective fatigue. [Conclusion] Static stretching for 20 s restored the number of key hits for 10 s after stretching to that before the load application and suppressed the increase in subjective fatigue.