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Lin CL, DeMessie B, Ye K, Hu S, Lipton ML. Neck strength alone does not mitigate adverse associations of soccer heading with cognitive performance in adult amateur players. PLoS One 2024; 19:e0302463. [PMID: 38753699 PMCID: PMC11098408 DOI: 10.1371/journal.pone.0302463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 04/03/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES Soccer heading is adversely associated with neurocognitive performance, but whether greater neck strength or anthropometrics mitigates these outcomes is controversial. Here, we examine the effect of neck strength or anthropometrics on associations of soccer heading with neurocognitive outcomes in a large cohort of adult amateur players. METHODS 380 adult amateur league soccer players underwent standardized measurement of neck strength (forward flexion, extension, left lateral flexion, right lateral flexion) and head/neck anthropometric measures (head circumference, neck length, neck circumference and neck volume). Participants were assessed for heading (HeadCount) and cognitive performance (Cogstate) on up to 7 visits over a period of two years. Principal components analysis (PCA) was performed on 8 neck strength and anthropometric measures. We used generalized estimating equations to test the moderation effect of each of the three PCs on 8 previously identified adverse associations of 2-week and 12-month heading estimates with cognitive performance (psychomotor speed, immediate verbal recall, verbal episodic memory, attention, working memory) and of unintentional head impacts on moderate to severe central nervous system symptoms. RESULTS 3 principal components (PC's) account for 80% of the variance in the PCA. In men, PC1 represents head/neck anthropometric measures, PC2 represents neck strength measures, and PC3 represents the flexor/extensor (F/E) ratio. In women, PC1 represents neck strength, PC2 represents anthropometrics, and PC3 represents the F/E ratio. Of the 48 moderation effects tested, only one showed statistical significance after Bonferroni correction, which was not robust to extensive sensitivity analyses. CONCLUSION Neither neck strength nor anthropometrics mitigate adverse associations of soccer heading with cognitive performance in adult amateur players.
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Affiliation(s)
- Chin Lun Lin
- Montefiore Medical Center, Bronx, New York, United States of America
| | - Bluyé DeMessie
- Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Kenny Ye
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
- Department of Systems and Computational Biology, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Shanshan Hu
- The Epoch Times, New York, New York, United States of America
| | - Michael L. Lipton
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Biomedical Engineering, Columbia University, New York, New York, United States of America
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The Incidence, Cost, and Burden of Concussion in Women's Rugby League and Rugby Union: A Systematic Review and Pooled Analysis. Sports Med 2022; 52:1751-1764. [PMID: 35113388 PMCID: PMC9325800 DOI: 10.1007/s40279-022-01645-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 11/05/2022]
Abstract
Background The extent of concussion injury in the rugby codes for women is unclear. Objective Our aim was to review all published studies reporting concussion injuries from match and training participation in rugby codes and report the pooled data estimates for rugby league and union concussion injury epidemiology. Methods We conducted a systematic literature analysis of concussion in rugby league and rugby union for published studies from January 1990 to July 2021. Data from 16 studies meeting the inclusion criteria were extracted for women’s concussion injuries and were subsequently pooled. Costs from Accident Compensation Corporation (ACC) data were attributed to the results to provide cost estimates. Results The pooled analysis match injury incidence of women’s concussion was higher for rugby league (10.3 per 1000 match hours) than rugby 15 s (2.8 per 1000 match hours) or rugby 7 s (8.9 per 1000 match hours). There was a fourfold difference in the pooled incidence of concussion in women’s rugby league (risk ratio [RR] 4.53, 95% confidence interval [CI] 1.8–11.3]; p = 0.0001) when compared with rugby 15 s. There was also a ninefold higher risk of a concussion during match participation compared with training participation for women’s rugby 15 s (RR 9.3, 95% CI 1.29–66.78; p = 0.0070). The total estimated costs for the concussions reported were NZ$1,235,101. For rugby 7 s, the pooled concussive injury burden was 33.2 days. Conclusions Our pooled analysis clarified the extent of concussion injury and the possible associated costs at several levels of the game for women’s rugby codes. The pooled mean days lost because of concussions was 33 days. As this was considerably longer than the 7- to 10-day expected timeframe outlined in the Concussion in Sport Consensus statement, these guidelines need to be updated to include sex-specific differences. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-022-01645-8.
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Yurac R, Zamorano JJ, Quinteros G, Izquierdo G, Novoa F, Brañes R, Valencia M, Silva A, Marré B. Treatment strategies for managing cervical spine injuries in rugby players. Surg Neurol Int 2021; 12:6. [PMID: 33500821 PMCID: PMC7827305 DOI: 10.25259/sni_794_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/14/2020] [Indexed: 11/04/2022] Open
Abstract
Background Cervical spine fractures are potentially catastrophic injuries in rugby players. Here, we reviewed seven patients who sustained rugby-related cervical spine fractures. Notably, three of seven fractures were missed on initial X-rays, but were ultimately documented on CT studies obtained an average of 10 days later. Methods Seven patients sustained cervical spine fracture attributed to rugby (2009-2016) and were followed an average of 52 posttrauma months. Most injuries occurred at the C6-C7 level, and six of seven patients required surgery. Further, only two of seven patients exhibited resultant neurological deficits (e.g., one myelopathy and one radiculopathy). Results Although the rugby injury was sufficiently documented on initial X-rays in four patients, three initial X-rays missed fractures, which were documented on the CT studies obtained an average of 10 days later. Conclusion Rugby-related cervical fractures must be considered where players continue to complain of pain following trauma. Notably, routine X-rays may miss fractures in 3 of 7 cases (43%), thus warranting supplemental CT examinations to definitively rule out fractures.
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Affiliation(s)
- Ratko Yurac
- Department of Othopedics, Clinica Alemana, Santiago, Chile
| | | | | | | | - Felipe Novoa
- Department of Othopedics, Clinica Alemana, Santiago, Chile
| | - Rocío Brañes
- Department of Othopedics, Clinica Alemana, Santiago, Chile
| | | | - Alvaro Silva
- Department of Othopedics, Clinica Alemana, Santiago, Chile
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Effects of Physical Activity on the Physical and Psychosocial Health of Youth With Intellectual Disabilities: A Systematic Review and Meta-Analysis. J Phys Act Health 2019; 16:1187-1195. [PMID: 31586434 DOI: 10.1123/jpah.2018-0675] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/22/2019] [Accepted: 08/06/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND The physical and psychosocial benefits of physical activity for typically developing youth are well established; however, its impact on youth with intellectual disabilities is not as well understood. The aims of this review and meta-analysis were to synthesize the literature and quantify the effects of physical activity on the physical and psychosocial health of youth with intellectual disabilities. METHOD Studies meeting the inclusion criteria were grouped by their focus on physical health and/or psychosocial health outcomes. Meta-analyses were performed using 3-level, random effects and mixed effects models. RESULTS One hundred nine studies met the inclusion criteria. Physical activity had a large effect on physical health (g = 0.773, P < .001) and a moderately large effect (g = 0.682, P < .001) on psychosocial health. Participant age, intellectual disability level, other developmental disabilities, outcome type, and intervention type moderated the effects of physical activity on physical health, whereas study design, risk of bias, other developmental disabilities, outcome type, and intervention type were moderators on psychosocial health. CONCLUSIONS Physical activity has positive effects on the physical and psychosocial health of youth with intellectual disabilities. Although resistance training shows the most physical benefits, teaching movement and sports skills appear to benefit their physical and psychosocial health.
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Wittkopf PG, Zomkowski K, Cardoso FL, Sperandio FF. The effect of chronic musculoskeletal pain on several quality of life dimensions: A critical review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.8.327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Kamilla Zomkowski
- MSc student, Department of Physical Therapy, Santa Catarina State University, Florianópolis, SC, Brazil
| | - Fernando Luiz Cardoso
- Director, Gender, Sexuality and Corporeity Laboratory, Department of Physical Education, Santa Catarina State University, Florianópolis, SC, Brazil
| | - Fabiana Flores Sperandio
- Director, Women's Health Laboratory, Department of Physical Therapy, Santa Catarina State University, Florianópolis, SC, Brazil
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Minatto G, Barbosa Filho VC, Berria J, Petroski EL. School-Based Interventions to Improve Cardiorespiratory Fitness in Adolescents: Systematic Review with Meta-analysis. Sports Med 2017; 46:1273-92. [PMID: 26846429 DOI: 10.1007/s40279-016-0480-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND School-based intervention can contribute to the promotion of cardiorespiratory fitness (CRF) in adolescents. However, it is neces sary to systematize how intervention strategies and the methodological characteristics of studies influence the effects of CRF interventions. OBJECTIVE A meta-analysis review of school-based intervention studies aimed at increasing CRF in adolescents (10-19 years of age) was conducted. METHODS A search for studies was conducted using the Medline, Web of Science, LILACS, PsycINFO, Embase, Scopus, SPORTDiscus and Cochrane databases and the reference lists of the selected studies. The peer selection process included consideration of school-based randomized or non-randomized controlled trials with a duration ≥12 weeks published in English, Portuguese or Spanish, and with some CRF measures. The methodological quality of the studies was also assessed. The standardized mean differences (SMDs) and 95 % confidence intervals (95 % CIs) were calculated as an effect measure. RESULTS Forty publications of 30 interventions were included in the review, and 25 of these were meta-analysed. The effects of CRF interventions were moderate and significant (SMD = 0.68, 95 % CI 0.45-0.90), with high heterogeneity (I (2) = 97 %). The effect size varied significantly according to the age group, sample size, intervention environment, strategies in experimental groups, CRF priority in the study, CRF test and indicator, session length, weekly frequency, intervention duration and presentation of results by sex. CONCLUSION Interventions in the school environment seem to have a positive effect on CRF among adolescents, but there is high heterogeneity between studies. Some intervention characteristics can explain better effects on CRF (e.g. exercise sessions in addition to physical education classes; primary focus on this outcome; combination of aerobic and resistance exercises; classes lasting ≥60 min; frequency of three times weekly; and intensity control).
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Affiliation(s)
- Giseli Minatto
- Research Centre for Kinanthropometry and Human Performance, Sports Centre, Campus Universitário, Federal University of Santa Catarina, Trindade, Caixa Postal 476, Florianópolis, SC, CEP 88040-900, Brazil.
| | - Valter Cordeiro Barbosa Filho
- Research Centre for Physical Activity and Health, Sports Centre, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Juliane Berria
- Research Centre for Kinanthropometry and Human Performance, Sports Centre, Campus Universitário, Federal University of Santa Catarina, Trindade, Caixa Postal 476, Florianópolis, SC, CEP 88040-900, Brazil
| | - Edio Luiz Petroski
- Research Centre for Kinanthropometry and Human Performance, Sports Centre, Campus Universitário, Federal University of Santa Catarina, Trindade, Caixa Postal 476, Florianópolis, SC, CEP 88040-900, Brazil
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Effects of a 12-week neck muscles training on muscle function and perceived level of muscle soreness in amateur rugby players. SPORT SCIENCES FOR HEALTH 2016. [DOI: 10.1007/s11332-016-0314-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zronek M, Sanker H, Newcomb J, Donaldson M. The influence of home exercise programs for patients with non-specific or specific neck pain: a systematic review of the literature. J Man Manip Ther 2016; 24:62-73. [PMID: 27559275 DOI: 10.1179/2042618613y.0000000047] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
STUDY DESIGN Systematic review of randomized controlled trials (RCT). OBJECTIVES To examine the effects of a therapeutic home exercise program (HEP) for patients with neck pain (associated with whiplash, non-specific, or specific neck pain, with or without radiculopathy, or cervicogenic headache) on pain, function, and disability. Our secondary aim was to describe the design, dosage, and adherence of the prescribed HEPs. BACKGROUND Neck pain is a leading cause of disability that affects 22-70% of the population. Different techniques have been found effective for the treatment of neck pain. However, there is conflicting evidence to support the role of a therapeutic HEP to reduce pain, disability, and improve function and quality of life (QOL). METHODS A systematic review in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement for reporting systematic reviews. The full-text review utilized the Maastricht-Amsterdam assessment tool to assess quality among RCTs. RESULTS A total of 1927 subjects included within seven full-text articles met our specific search strategy. It was found that HEPs with a focus on strength and endurance-training exercises, as well as self- mobilization, have a positive effect when used in combination with other conservative treatments or alone. CONCLUSIONS Home exercise programs that utilize either self-mobilizations within an augmented HEP to address specific spinal levels, or strengthening, and/or endurance exercise are effective at reducing neck pain, function, and disability and improving QOL. The benefit of HEPs in combination with other conservative interventions yields some benefit with a range of effect sizes.
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Affiliation(s)
- Margaret Zronek
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Holly Sanker
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Jennifer Newcomb
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
| | - Megan Donaldson
- Department of Physical Therapy, Walsh University, North Canton, OH, USA
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Reboursiere E, Bohu Y, Retière D, Sesboüé B, Pineau V, Colonna JP, Hager JP, Peyrin JC, Piscione J. Impact of the national prevention policy and scrum law changes on the incidence of rugby-related catastrophic cervical spine injuries in French Rugby Union. Br J Sports Med 2016; 52:674-677. [PMID: 27457796 DOI: 10.1136/bjsports-2016-096122] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND AIMS Catastrophic cervical spine injuries are rare in rugby union but require close monitoring. The aim of this study was to analyse the incidence of severe cervical spine injuries and determine the impact of a national prevention programme and new scrum rules implemented by the French Rugby Union. METHODS A prospective study was performed between 2006 and 2013 including all players affiliated to the French Rugby Union. All cervical spine injuries resulting in death, tetraplegia or a permanent neurological deficit were included. Prevention programmes were implemented from 2007 to 2013 and a change in scrum rules in 2010. To measure the impact of rule changes, results between 2006-2010 and 2010-2013 were compared using a Poisson regression. RESULTS Altogether, 31 injuries were observed and the mean annual incidence was 1.6 per 100 000 players. There were significantly more injuries in senior players compared to junior players (3.5 vs 0.6 per 100 000 players; CI 95% (2.1 to 4.9) vs (0.1 to 1.0)). Incidence decreased from 1.8 in 2006 to 1.0 per 100 000 players in 2013 (p<0.0001). After 2010, there were significantly fewer injuries during scrums (p=0.02). In contrast, there were significantly more injuries in backs during 2010-2013 compared to 2006-2010 (p=0.003). CONCLUSIONS The incidence of catastrophic cervical spine injuries has declined in French Rugby Union. The implementation of specific prevention programmes and scrum law changes has notably resulted in a decrease in scrum injuries in forwards. This prospective study should be continued to monitor the future progression of injuries and adapt prevention programmes accordingly.
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Affiliation(s)
- E Reboursiere
- Institut Régional de Médecine du Sport CHU Caen, Caen, France.,Fédération Française de Rugby, Marcoussis, France
| | - Y Bohu
- Fédération Française de Rugby, Marcoussis, France.,Clinique du Sport Paris V, Paris, France
| | - D Retière
- Fédération Française de Rugby, Marcoussis, France
| | - B Sesboüé
- Institut Régional de Médecine du Sport CHU Caen, Caen, France
| | - V Pineau
- Institut Régional de Médecine du Sport CHU Caen, Caen, France.,Clinique Médipôle Garonne, Toulouse, France
| | - J P Colonna
- Centre de Gestion Administratif Colonna, Paris, France
| | - J P Hager
- Fédération Française de Rugby, Marcoussis, France.,Centre Orthopédique Santy, Lyon, France
| | - J C Peyrin
- Fédération Française de Rugby, Marcoussis, France
| | - J Piscione
- Fédération Française de Rugby, Marcoussis, France
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Hrysomallis C. Neck Muscular Strength, Training, Performance and Sport Injury Risk: A Review. Sports Med 2016; 46:1111-24. [DOI: 10.1007/s40279-016-0490-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Gardner AJ, Iverson GL, Williams WH, Baker S, Stanwell P. A systematic review and meta-analysis of concussion in rugby union. Sports Med 2015; 44:1717-31. [PMID: 25138311 DOI: 10.1007/s40279-014-0233-3] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Rugby Union, a popular full-contact sport played throughout the world, has one of the highest rates of concussion of all full-contact sports. OBJECTIVE The aim of the current review was to systematically evaluate the available evidence on concussion in Rugby Union and to conduct a meta-analysis of findings regarding the incidence of concussion. METHODS Articles were retrieved via a number of online databases. The current review examined all articles published in English up to May 2014 pertaining to concussion in Rugby Union players. The key search terms included 'Rugby Union', 'rugby', 'union', and 'football', in combination with the injury terms 'athletic injuries', 'concussion', 'sports concussion', 'sports-related concussion', 'brain concussion', 'brain injury', 'brain injuries', 'mild traumatic brain injury', 'mTBI', 'traumatic brain injury', 'TBI', 'craniocerebral trauma', 'head injury', and 'brain damage'. RESULTS The final search outcome following the eligibility screening process resulted in the inclusion of 96 articles for this review. The meta-analysis included a total of 37 studies. The results of the meta-analysis revealed an overall incidence of match-play concussion in men's rugby-15s of 4.73 per 1,000 player match hours. The incidence of concussion during training was 0.07 per 1,000 practice hours. The incidence of concussion in women's rugby-15s was 0.55 per 1,000 player match hours. In men's rugby-7s match-play, concussion incidence was 3.01 per 1,000 player match hours. The incidence of concussion varied considerably between levels of play, with elite level play recording a rate of 0.40 concussions per 1,000 player match hours, schoolboy level 0.62 concussions per 1,000 player match hours, and the community or sub-elite level recording a rate of 2.08 concussions per 1,000 player match hours. The incidence of concussion in men's rugby-15s as a function of playing position (forwards vs. backs) was 4.02 and 4.85 concussions per 1,000 player match hours, respectively. CONCLUSIONS Concussion is a common injury sustained and reported in match play and to a lesser extent during practice by Rugby Union players. Based on the available published data, there appears to be a variation in risk of concussion across level of play, with the sub-elite level having the greatest incidence of injury. Future research focused on studying the acute consequences and best management strategies in current players, and the potential longer term outcomes of concussion in retired players, is needed. A focus on the areas of prevention, injury identification, and medical management, and risk for long-term outcomes will be of benefit to current athletes.
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Affiliation(s)
- Andrew J Gardner
- Centre for Translational Neuroscience and Mental Health, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia,
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Lystad RP, Gregory K, Wilson J. The Epidemiology of Injuries in Mixed Martial Arts: A Systematic Review and Meta-analysis. Orthop J Sports Med 2014; 2:2325967113518492. [PMID: 26535267 PMCID: PMC4555522 DOI: 10.1177/2325967113518492] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Mixed martial arts (MMA) has experienced a surge in popularity since emerging in the 1990s, but the sport has also faced concomitant criticism from public, political, and medical holds. Notwithstanding the polarized discourse concerning the sport, no systematic review of the injury problems in MMA has been published to date. PURPOSE To systematically review the epidemiologic data on injuries in MMA and to quantitatively estimate injury incidence and risk factor effect sizes. STUDY DESIGN Systematic review and meta-analysis; Level of evidence, 4. METHODS Electronic searching of PubMed, Scopus, CINAHL, EMBASE, AMED, and SPORTDiscus databases to identify studies reporting on the epidemiology of injuries in MMA. Random-effects models were used to obtain pooled summary estimates of the injury incidence rate per 1000 athlete-exposures (IIRAE) and rate ratios with 95% confidence intervals (CIs). Heterogeneity was evaluated with the I (2) statistic. RESULTS A total of 6 studies were eligible for inclusion in this review. The IIRAE summary estimate was found to be 228.7 (95% CI, 110.4-473.5). No studies reported injury severity. The most commonly injured anatomic region was the head (range, 66.8%-78.0%) followed by the wrist/hand (range, 6.0%-12.0%), while the most frequent injury types were laceration (range, 36.7%-59.4%), fracture (range, 7.4%-43.3%), and concussion (range, 3.8%-20.4%). The most notable risk factors pertained to the outcome of bouts. Losers incurred 3 times as many injuries as winners, and fighters in bouts ending with knockout or technical knockout incurred more than 2 times as many injuries as fighters in bouts ending with submission. CONCLUSION Notwithstanding the paucity of data, the injury incidence in MMA appears to be greater than in most, if not all, other popular and commonly practiced combat sports. In general, the injury pattern in MMA is very similar to that in professional boxing but unlike that found in other combat sports such as judo and taekwondo. More epidemiologic research is urgently needed to improve the accuracy of the injury incidence estimate, to determine the injury severity, and to identify more risk factors for injury in MMA.
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Affiliation(s)
- Reidar P Lystad
- Faculty of Science, Macquarie University, Sydney, New South Wales, Australia
| | - Kobi Gregory
- Faculty of Science, Macquarie University, Sydney, New South Wales, Australia
| | - Juno Wilson
- Faculty of Science, Macquarie University, Sydney, New South Wales, Australia
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15
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Lystad RP, Bell G, Bonnevie-Svendsen M, Carter CV. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review. Chiropr Man Therap 2011; 19:21. [PMID: 21923933 PMCID: PMC3182131 DOI: 10.1186/2045-709x-19-21] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 09/18/2011] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Manual therapy is an intervention commonly advocated in the management of dizziness of a suspected cervical origin. Vestibular rehabilitation exercises have been shown to be effective in the treatment of unilateral peripheral vestibular disorders, and have also been suggested in the literature as an adjunct in the treatment of cervicogenic dizziness. The purpose of this systematic review is to evaluate the evidence for manual therapy, in conjunction with or without vestibular rehabilitation, in the management of cervicogenic dizziness. METHODS A comprehensive search was conducted in the databases Scopus, Mantis, CINHAL and the Cochrane Library for terms related to manual therapy, vestibular rehabilitation and cervicogenic dizziness. Included studies were assessed using the Maastricht-Amsterdam criteria. RESULTS A total of fifteen articles reporting findings from thirteen unique investigations, including five randomised controlled trials and eight prospective, non-controlled cohort studies were included in this review. The methodological quality of the included studies was generally poor to moderate. All but one study reported improvement in dizziness following either unimodal or multimodal manual therapy interventions. Some studies reported improvements in postural stability, joint positioning, range of motion, muscle tenderness, neck pain and vertebrobasilar artery blood flow velocity. DISCUSSION Although it has been argued that manual therapy combined with vestibular rehabilitation may be superior in the treatment of cervicogenic dizziness, there are currently no observational and experimental studies demonstrating such effects. A rationale for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is presented. CONCLUSION There is moderate evidence to support the use of manual therapy, in particular spinal mobilisation and manipulation, for cervicogenic dizziness. The evidence for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is lacking. Further research to elucidate potential synergistic effects of manual therapy and vestibular rehabilitation is strongly recommended.
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Affiliation(s)
- Reidar P Lystad
- Department of Chiropractic, Macquarie University, Sydney, Australia
| | - Gregory Bell
- Department of Chiropractic, Macquarie University, Sydney, Australia
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