1
|
Ayala F, Robles-Palazón FJ, Blázquez-Rincón D, López-Valenciano A, López-López JA, De Ste Croix M. A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 2: an analysis by movement patterns. Ann Med 2024; 56:2337724. [PMID: 38614120 PMCID: PMC11018023 DOI: 10.1080/07853890.2024.2337724] [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: 10/13/2023] [Accepted: 02/29/2024] [Indexed: 04/15/2024] Open
Abstract
The objectives of this network meta-analysis were: (a) to estimate and compare the pooled effects of some injury prevention programs (IPPs) whose exercise-based components were categorized using a movement pattern-specific taxonomy on reducing overall and some specific body regions (lower extremity, thigh, knee, and ankle) injury incidences in youth team sport athletes and (b) to explore the individual effects of these components on the injury incidence rates (IIRs) previously mentioned. Searches were performed in PubMed, Web of Science, SPORTDiscus, and Cochrane Library. Eligible criteria were: exercise-based interventions comprised of exercises involving athletic motor skill competencies and evaluated against a control group, overall IIRs were reported, and youth (≤19 years old) team sport players. For the current analysis, a taxonomy based on movement patterns was employed for exercise component identification (upper body pushing and pulling; lower body concentric and eccentric; core; mechanics; acceleration; and lower body stability). Pooled effects were calculated by frequentist random effects pairwise and network meta-analyses. Nineteen studies were included. Most of the IPPs exhibit risk reduction when compared to their control groups on overall, lower extremity, and ankle injuries. Interventions comprised of lower body concentric and eccentric, core, mechanics, and lower body stability exercises were the most effective measures for reducing these injuries. None of the IPPs demonstrated to be effective for reducing thigh injuries, and contradictory results were found for knee injuries. Individual analysis at component level revealed that the lower body (bilateral and unilateral, concentric, and eccentric) component was the only one associated with a significant reduction on overall injuries. Indirect evidence suggests that interventions incorporating lower body concentric and eccentric, core, mechanics, and lower body stability exercises might be the most effective for reducing overall, lower extremity, and ankle injuries in youth team sports.
Collapse
Affiliation(s)
- Francisco Ayala
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
- School of Education, Sport and Applied Sciences, University of Gloucestershire, Gloucester, UK
| | - Francisco Javier Robles-Palazón
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, UK
| | - Desirée Blázquez-Rincón
- Department of Psychology and Education, Faculty of Health Sciences and Education, Madrid Open University (UDIMA), Madrid, Spain
| | - Alejandro López-Valenciano
- Department of Education Science, School of Humanities and Communication Sciences, CEU-Cardenal Herrera University, Castellón de la Plana, Spain
| | - José Antonio López-López
- Department of Basic Psychology and Methodology, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain
| | - Mark De Ste Croix
- School of Education, Sport and Applied Sciences, University of Gloucestershire, Gloucester, UK
| |
Collapse
|
2
|
Darragi M, Zouhal H, Bousselmi M, Karamti HM, Clark CCT, Laher I, Hackney AC, Granacher U, Zouita ABM. Effects of In-Season Strength Training on Physical Fitness and Injury Prevention in North African Elite Young Female Soccer Players. SPORTS MEDICINE - OPEN 2024; 10:94. [PMID: 39223396 PMCID: PMC11368885 DOI: 10.1186/s40798-024-00762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 08/11/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Strength training (ST) primarily enhances physical fitness (e.g., muscle strength, power, speed) and bone density in female soccer players. Less information is available on the injury preventive effects of ST in female athletes. Accordingly, this study aimed to investigate the effects of a 12-week in-season ST on measures of physical fitness and injury occurrence in young elite female soccer players. METHODS Thirty elite female soccer players (15.4 ± 1.9 years; maturity offset + 2.3 ± 1.1 years) participated in this study, and were randomly assigned to a strength training group (STG, n = 14) or an active control (CG, n = 16) group. ST lasted twelve weeks and included full body muscle strengthening exercises using primarily weight machines at progressive intensities ranging between 40 and 85% of the one-repetition-maximum (1-RM). The CG practiced a traditional soccer training program. Overall, training volumes of the two groups were similar with a training load (rating of perceived exertion × time) of 1158.4 ± 67.7 arbitrary unity (AU) for the STG and 1188.8 ± 44.1 AU for the CG. Pre and post training, the following physical fitness tests were applied: dynamic muscle strength (relative [to body mass] and absolute 1-RM bench/leg press, lat-pull down), jump performance (countermovement jump [CMJ], squat jump [SJ], five-jump-test [5JT]), linear-sprint speed (5-m, 10-m, 30-m), change-of-direction speed (T-test with and without ball), sport-specific performance (Yo-Yo Intermittent Level1 [YYIRTL1], and repeated shuttle sprint ability [RSSA]). The injury rate per 1000-h exposure was monitored throughout the soccer season. RESULTS No significant baseline differences were observed between groups. Statistically significant group-by-time interactions were found for absolute (p < 0.001, d = 2.59) and relative 1-RM bench press (p < 0.001, d = 2.39), absolute 1-RM lat-pull down (p < 0.001, d = 1.68), and relative 1-RM leg press (p < 0.001, d = 1.72). Significant group-by-time interactions were observed for CMJ (p = 0.005, d = 1.27), RSSAmean (p = 0.007, d = 0.81), and RSSAtotal (p < 0.001, d = 1.90). Post-hoc tests indicated that the STG group demonstrated greater improvements in all tested variables compared to CG (1.2 < d < 2.5). However, no significant interaction effects were noted for measures of linear sprint speed and YYIRTL1 performance. Additionally, non-contact injuries during the season were significantly lower (p = 0.003, d = 1.31) in the STG (0.48/1000 h of exposure) than the CG (2.62/1000 h of exposure). CONCLUSIONS Twelve weeks of an in-season ST resulted in larger physical fitness improvements and fewer injuries compared with an active control in elite young female soccer players. Accordingly, ST should be systematically applied in female soccer to enhance performance and prevent injuries.
Collapse
Affiliation(s)
- Manel Darragi
- Higher Institute of Sport and Physical Education of SFAX University of Sfax, Sfax, Tunisia
- Research Unit (UR17JS01) "Sport Performance, Health & Society", Higher Institute of Sport and Physical Education, Ksar Said, Tunisia
| | - Hassane Zouhal
- Movement, Sport, Health and Sciences Laboratory (M2S). UFR APS, University of Rennes 2-ENS Cachan, Av. Charles Tillon, 35044, Rennes Cedex, France.
- Institut International Des Sciences du Sport (2I2S), 35850, Irodouer, France.
| | - Mariem Bousselmi
- Higher Institute of Sport and Physical Education of SFAX University of Sfax, Sfax, Tunisia
- Research Unit (UR17JS01) "Sport Performance, Health & Society", Higher Institute of Sport and Physical Education, Ksar Said, Tunisia
| | - Houssem M Karamti
- Higher Institute of Sport and Physical Education of SFAX University of Sfax, Sfax, Tunisia
- Research Unit (UR17JS01) "Sport Performance, Health & Society", Higher Institute of Sport and Physical Education, Ksar Said, Tunisia
| | - Cain C T Clark
- College of Life Sciences, Birmingham City University, Birmingham, B15 3TN, UK
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, Canada
| | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany.
| | - Amira B M Zouita
- Research Unit (UR17JS01) "Sport Performance, Health & Society", Higher Institute of Sport and Physical Education, Ksar Said, Tunisia
- Higher Institute of Sport and Physical Education of Ksar Said, University of Manouba, Tunis, Tunisia
| |
Collapse
|
3
|
Larruskain J, Lekue JA, Angulo P, Santisteban JM, Diaz-Beitia G, Martin-Garetxana I, Gil SM, Bidaurrazaga-Letona I, Monasterio X. An injury burden heat map of all men's and women's teams of a professional football club over a decade. Res Sports Med 2024; 32:740-750. [PMID: 37358165 DOI: 10.1080/15438627.2023.2228959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
The aim was to present a descriptive 10-season summary of injury data from all teams of a professional football club using a heat map approach. Injuries and exposure time were registered according to the FIFA consensus in all men's and women's teams from Athletic Club over 10 seasons. A team-by-injury table was created, showing the incidence, median severity, and burden in each cell. Cells were coloured based on the injury burden value using a green - yellow-red gradient (lowest to highest). The highest overall injury burden was found in the women's 2nd and 1st teams and the men's U(under)17 team (>200 days lost/1000 h). Muscle injury burden demonstrated an increasing pattern with age. Knee joint/ligament injuries, particularly anterior cruciate ligament ruptures, had the highest impact on women's teams, followed by the men's 2nd team. In comparison, ankle joint/ligament injuries had a relatively low injury burden in most teams. Growth-related injuries were the most impactful injuries in the men's U15 and younger teams, and the women's U14 team. In conclusion, epidemiological data on injuries can inform and guide injury management processes. New and improved visualization methods might be important assets when presenting injury data to key decision-makers.
Collapse
Affiliation(s)
| | | | - Paco Angulo
- Medical Services, Athletic Club, Lezama, Spain
| | | | | | | | - Susana M Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Iraia Bidaurrazaga-Letona
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | | |
Collapse
|
4
|
Ribeiro N, Martinho DV, Pereira JR, Rebelo A, Monasterio X, Gonzalo-Skok O, Valente-Dos-Santos J, Tavares F. Injury Risk in Elite Young Male Soccer Players: A Review on the Impact of Growth, Maturation, and Workload. J Strength Cond Res 2024:00124278-990000000-00530. [PMID: 39178105 DOI: 10.1519/jsc.0000000000004889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2024]
Abstract
ABSTRACT Ribeiro, N, Martinho, DV, Pereira, JR, Rebelo, A, Monasterio, X, Gonzalo-Skok, O, Valente-dos-Santos, J, and Tavares, F. Injury risk in elite young male soccer players: a review on the impact of growth, maturation, and workload. J Strength Cond Res XX(X): 000-000, 2024-The long-term development of young male soccer players involves a prolonged period of significant adjustments, highlighting the importance of studying the complex interaction between dynamic variables, including workload, and inherent elements like growth and maturity. This analysis examines the intricate connections involving the development, maturity, workload, and susceptibility to injuries among adolescent male soccer players. Significantly, these connections become prominent at the peak height velocity (PHV) period, a crucial moment in maturation. Growth rates vary among individuals, and higher rates have been associated with an increased risk of injury in young soccer players, particularly during periods of rapid growth. Identifying possible risk factors and understanding the complex connections between them is crucial to developing specific methods for reducing the risk of injury. Sharing this valuable information with essential stakeholders is crucial for guaranteeing young athletes' comprehensive growth and maturation process. Furthermore, this review emphasizes the immediate need for long-term studies and thorough injury analyses to comprehend better the dynamic interactions that influence injury patterns in young male soccer players. This review will allow practitioners to better understand the main modifiable and nonmodifiable risk factors for injury and provide essential information focusing on practical strategies, facilitating more informed decision making by all stakeholders. The review aims to clarify these complexities and offer crucial insights that can assist in designing and implementing efficient strategies to reduce the risk of injury, specifically for the challenges faced during PHV and within the broader framework of long-term athletic development in young soccer.
Collapse
Affiliation(s)
- Nuno Ribeiro
- Faculty of Physical Education and Sport, Lusófona University, Lisbon, Portugal
- Medical and Performance Department, Sporting Clube de Portugal, Lisbon, Portugal
| | - Diogo V Martinho
- CIDEFES, Center for Research in Sport, Physical Education, and Exercise and Health, Lusófona University, Lisbon, Portugal
| | - João R Pereira
- COD, Center of Sports Optimization, Sporting Clube de Portugal, Lisbon, Portugal
- Medical Services, Athletic Club, Lezama, Spain
| | - André Rebelo
- COD, Center of Sports Optimization, Sporting Clube de Portugal, Lisbon, Portugal
- Medical Services, Athletic Club, Lezama, Spain
| | - Xabier Monasterio
- Department of Communication and Education, Universidad Loyola Andalucía, Seville, Spain; and
| | - Oliver Gonzalo-Skok
- Research Unity in Sport and Physical Activity (CIDAF, UID/DTP/04213/2020), Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - João Valente-Dos-Santos
- COD, Center of Sports Optimization, Sporting Clube de Portugal, Lisbon, Portugal
- Medical Services, Athletic Club, Lezama, Spain
| | - Francisco Tavares
- Medical and Performance Department, Sporting Clube de Portugal, Lisbon, Portugal
| |
Collapse
|
5
|
King DA, Hume PA, Clark TN. Match Injury Incidence for a New Zealand Amateur Domestic Female Soccer Team over Two Consecutive Seasons. Sports (Basel) 2024; 12:216. [PMID: 39195592 PMCID: PMC11359641 DOI: 10.3390/sports12080216] [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: 07/10/2024] [Revised: 07/29/2024] [Accepted: 08/07/2024] [Indexed: 08/29/2024] Open
Abstract
OBJECTIVE To determine the match injury incidence for a New Zealand amateur domestic female soccer team over two consecutive seasons. METHODS A descriptive, epidemiological observational study was conducted to determine match injury incidence for 49 players over two domestic seasons. Match exposure and injury burden were calculated. RESULTS A total of 84 match-related injuries resulted in a match injury incidence of 145.5 (95% confidence interval (CI): 117.4 to 180.1) per 1000 match h. Attackers had a higher incidence of injuries for total (200.0 per 1000 match h) and missed matches (152.4 per 1000 match h). The lower limbs had the highest injury incidence (105.6 per 1000 match h), with ankle injury being the most reported (43.3 per 1000 match h) lower limb injury. Over three quarters (75.3%) of the injuries recorded were missed match injuries. Sprains/strains were the most recorded total (86.6 per 1000 match h) injury type. Fractures were recorded as having the highest mean injury burden (68.7 ± 70.4 days). DISCUSSION Historically, there was a paucity of injury burden data for female football; however, the data presented within this study can be utilised to support the identification of injury patterns and areas to be included within injury reduction programmes.
Collapse
Affiliation(s)
- Doug A. King
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1023, New Zealand; (P.A.H.); (T.N.C.)
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland 1142, New Zealand
- School of Science and Technology, University of New England, Armidale 2351, Australia
- Wolfson Research Institute for Health and Wellbeing, Department of Sport and Exercise Sciences, Durham University, Durham DH1 3LE, UK
| | - Patria A. Hume
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1023, New Zealand; (P.A.H.); (T.N.C.)
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland 1142, New Zealand
- Technology and Policy Lab, Law School, The University of Western Australia, Perth 6009, Australia
| | - Trevor N. Clark
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1023, New Zealand; (P.A.H.); (T.N.C.)
| |
Collapse
|
6
|
Bandak E, Zebis M, Alkjaer T, Nielsen SM, Bennike S, Thorborg K. Injury Prevention Training in Girls' and Women's Elite Football in Denmark: A Survey of Practices and Perceptions. Scand J Med Sci Sports 2024; 34:e14696. [PMID: 39022878 DOI: 10.1111/sms.14696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/20/2024]
Abstract
Through a national cross-sectional survey, the present study investigated the use and content of injury prevention training (IPT), and associated attitudes and beliefs, involving stakeholders in Danish girls' and women's elite football (U14, U16, U18, and Danish Women's League teams). A total of 168 stakeholders (coaches, physical performance coaches, physiotherapists, medical doctors, and club management) from 18 Danish elite clubs were invited to participate. Of these, 158 were eligible to participate, and 110 participants (69.6% response rate) provided 191 valid survey responses, as some provided more than one response due to multiple affiliations within the same club. The use of IPT ranged from 91.1% to 100% across team levels, with approximately 50% reporting up to 1-2 h/week. Interestingly, only 52.9%-72.7% of the responses indicated use of an evidence-based IPT program, with lowest adoption at the U14 and Danish Women's League teams. The FIFA 11+ was the most used evidence-based IPT program. The majority of the participants (>72%) had positive perceptions regarding IPT impact on injury reduction. These findings indicate that, while IPT is broadly used across Danish girls' and women's elite football teams, the implementation of evidence-based IPT programs varies, with lower adoption of these programs among the youngest and senior elite teams. Hence, there is a need to enhance integration of IPT programs proven effective in girls' and women's elite football. Notably, stakeholders expressed positive perceptions regarding the impact of IPT on injury reduction, which provides valuable support for future efforts to strengthen IPT in football practice.
Collapse
Affiliation(s)
- Elisabeth Bandak
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Mette Zebis
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Faculty of Health, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Tine Alkjaer
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Sabrina Mai Nielsen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | | | - Kristian Thorborg
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center - Copenhagen (SORC-C), Amager-Hvidovre Hospital, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| |
Collapse
|
7
|
Flore Z, Hambly K, De Coninck K, Welsch G. A Rehabilitation Algorithm After Lateral Ankle Sprains in Professional Football (Soccer): An Approach Based on Clinical Practice Guidelines. Int J Sports Phys Ther 2024; 19:910-922. [PMID: 38966831 PMCID: PMC11221331 DOI: 10.26603/001c.120205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/20/2024] [Indexed: 07/06/2024] Open
Abstract
Lateral ankle sprain (LAS) is one of the most common types of injury in professional football (soccer) players with high risk of recurrence. The rehabilitation after LAS in professional football players is often still time-based and relies on anecdotal experience of clinicans. There is still a lack of utilization of criteria-based rehabilitation concepts after LAS in professional football. The aims of this clinical commentary are (1) to critically discuss the need for criteria-based rehabilitation concepts after LAS in professional football players, (2) to highlight the current lack of these approaches and (3) to present a novel clinical guideline-based rehabilitation algorithm. Short time-loss (15 days) and high recurrence rate (17%) raise the question of trivialization of LAS in professional football. Despite consequences for many stakeholders involved (players, teams, clubs, insurers), there is still a lack of of criteria-based, step-by-step approaches. The use of a criteria-based rehabilitation approach might reduce the high recurrence rate after LAS in professional football players and will lead, in turn, to increased long-term player availability. Practical experiences of he authors demonstrate the feasibility of such an approach. The effectiveness of this novel rehabilitation algorithm remains to be evaluated in future studies. Level of Evidence: 5.
Collapse
Affiliation(s)
- Zacharias Flore
- School of Sport and Exercise SciencesUniversity of Kent
- Medical Department1. FC Magdeburg
| | - Karen Hambly
- School of Sport and Exercise SciencesUniversity of Kent
| | | | - Götz Welsch
- UKE-AthleticumUniversity Medical Center Hamburg-Eppendorf
- Department of Trauma and Orthopaedic SurgeryUniversity Medical Center Hamburg-Eppendorf
| |
Collapse
|
8
|
Quintana-Cepedal M, López-Aguado I, Fernández-Somoano A, Rodríguez MÁ, del Valle M, Olmedillas H. Injury incidence and characteristics in adolescent female football players: A systematic review with meta-analysis of prospective studies. Biol Sport 2024; 41:137-151. [PMID: 38952921 PMCID: PMC11167467 DOI: 10.5114/biolsport.2024.132996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/25/2023] [Accepted: 11/11/2023] [Indexed: 07/03/2024] Open
Abstract
To observe overall, training, and match injury incidence in female youth football. We also aimed to quantify the incidence of injuries by affected tissue and body location. The following databases were examined: PubMed, Web of Science, Scopus, SPORTDiscus, Cochrane and PEDro. Papers that reported overall injury incidence, training or match injury incidence were included. Additionally, studies had to be performed in adolescent female football players (13-19 years of age). The Newcastle-Ottawa Scale and the checklist of items that must be included in epidemiological football reports were used to assess methodological quality of the included articles. For the meta-analyses, a random effect model was used. A total of 13 studies were included. There were 2,333 injuries; incidence was higher during games (12.7/1000 h) compared to training sessions (2.3/1000 h). The injury match-to-training ratio was 5.8. The lower limbs were the region in which the greatest number of injuries occurred, with the ankle (1.2/1000 h) and knee (0.8/1000 h) having the most injuries. In relation to injured tissue, ligament injuries represented an incidence of 1.3/1000 h, followed by muscle injuries (0.9/1000 h). This study represents the first step towards the creation and implementation of preventative measures in female youth football. The results suggest that attention should be focused on ankle and knee injuries, since they are the most frequent and can lead to sport retirement in some cases depending on the severity.
Collapse
Affiliation(s)
- Marcos Quintana-Cepedal
- Department of Functional Biology, University of Oviedo, Oviedo, Spain
- Asturian Research Group in Performance, Readaptation, Training and Health (ASTURES), University of Oviedo, Oviedo, Spain
| | | | - Ana Fernández-Somoano
- Unidad de Epidemiología Molecular del Cáncer, Instituto Universitario de Oncología del Principado de Asturias-Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERSP), Madrid, Spain
| | | | - Miguel del Valle
- Asturian Research Group in Performance, Readaptation, Training and Health (ASTURES), University of Oviedo, Oviedo, Spain
- Department of Cellular Morphology and Biology, University of Oviedo, Oviedo, Spain
| | - Hugo Olmedillas
- Department of Functional Biology, University of Oviedo, Oviedo, Spain
- Asturian Research Group in Performance, Readaptation, Training and Health (ASTURES), University of Oviedo, Oviedo, Spain
| |
Collapse
|
9
|
Obërtinca R, Meyer T, Aus der Fünten K. Epidemiology of football-related injuries in young male football players. An additional analysis of data from a cluster-randomised controlled trial. SCI MED FOOTBALL 2024:1-11. [PMID: 38922821 DOI: 10.1080/24733938.2024.2369545] [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: 11/26/2023] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
Football carries a high risk of injury for youth players. The aim of this study was to investigate the epidemiology of football-related injuries in young male players. The data stems from a previously conducted cluster-randomised controlled trial that investigated the efficacy of 'FUNBALL', a new injury prevention programme. This study contains the data of the 503 players of the control arm. The players belonged to 22 football teams of the Under-(U)15, U17 and U19 age groups. The time-loss injuries were recorded during the season 2021-2022 according to the Football Consensus Statement. An analysis on the injury incidence (IR, calculated per 1000 hours of exposure), location, severity, category, and type was performed. Incidence rate ratios (IRRs) were used to compare the variables between the specific age groups. 187 injuries (96 in training and 91 in matches) occurred during 52 938 hours of exposure. The overall IR was 3.53 injuries/1000 h (95% confidence intervals (CI) 3.06 to 4.07). The training IR was 2.16 injuries/1000 h (95% CI 1.17 to 2.64). The match IR was 10.50 injuries/1000 h (95% CI 8.55 to 12.89). In the U19s, the overall IRR was higher compared to the U17s (IRR 1.57, CI 1.12 to 2.19; p = 0.008) and compared to the U15s (IRR 1.82, 95% CI 1.25 to 2.62; p = 0.001). The thigh was the most commonly affected body region (IR 0.92/1000 h, 95% CI 0.69 to 1.22). Muscle injuries were the most common injury type (IR 1.05/1000 h, 95% CI 0.81 to 1.37). Injury burden was 74 lost days/1000 h. The findings of this study indicate a lower injury incidence in youth players than in adult ones. We observed a higher injury incidence towards the older age groups.
Collapse
Affiliation(s)
- Rilind Obërtinca
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
- Department of Physiotherapy, University of Gjakova "Fehmi Agani", Gjakova, Kosovo
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| |
Collapse
|
10
|
Magistrali M, Stefanini L, Abate M, Biancalana G, Stegagno A, Cugia P, Candoli P, Anania G, Lucchese PL, Gaddi D, Volpi P, Mariani F, Boldrini L, Filippi N, Cerrone A, Sirtori C, Battaglino P, Bravin G, Del Fabro E, Berti M, Vecchini E, Minetto MA. Epidemiology of Non-Contact Muscle Injuries in the Italian Male Elite Under-19 Football (Soccer) Championship. SPORTS MEDICINE - OPEN 2024; 10:75. [PMID: 38902551 PMCID: PMC11190129 DOI: 10.1186/s40798-024-00738-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/28/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND While extensive research exists on muscle injuries among adult football players, a notable gap persists in studies concerning younger footballers. The aim of the current study is to provide epidemiological data on the characteristics of time-loss muscle injuries in young football players participating in the Italian Under-19 male elite Championship ("Primavera 1"). RESULTS Conducted as a multicentre, prospective, observational cohort study, this research gathered injury data from the 2022-23 season across 14 of the 18 Clubs in the first Italian Under-19 championship. The cohort comprised 391 players with a mean age (± standard deviation) of 18.0 ± 0.4 years. A total of 479 injuries were reported, resulting in 14,231 days of activity lost. Of these, muscle injuries were 209 (44%), accounting for 4,519 (32%) days lost. Overall muscle injuries incidence was 1.82/1000 hours, with a mean injury burden of 39.4 days lost/1000 hours. Almost all muscle injuries (206 out of 209: 98.5%) occurred in hamstrings, quadriceps, adductors, calf and iliopsoas. Hamstrings injuries were the most burdensome (18.8 days lost/1000 hours) accounting for nearly half of all days lost due to muscle injuries. Incidence and burden of adductors injuries (0.25 injuries and 4.1 days lost/1000 hours, respectively) were found to be comparable to calf injuries (0.24 injuries and 4.7 days lost/1000 hours, respectively). Iliopsoas injuries accounted for a noteworthy portion of the total, with an injury incidence of 0.16/1000 hours and a burden of 3.3 days lost/1000 hours. Injuries with myo-tendinous or myo-aponeurotic involvement demonstrated delayed return-to-football compared to those without such involvement (35.6 vs. 18.5 days, p < 0.0001). CONCLUSIONS The study highlighted a peculiar distribution of non-contact muscle injuries among elite young football players. While hamstring injuries were confirmed as the most burdensome, incidence and burden of adductors and calf injuries were found to be similar. A significant incidence and burden of iliopsoas injuries were observed. These findings suggest potential implementations for targeted injury prevention strategies in the Italian male elite Under-19 football Championship.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Diego Gaddi
- FC Internazionale Milano SpA, Milano, Italy
- Department of Orthopedics and Traumatology, Policlinico San Pietro, Ponte San Pietro, Bergamo, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Monza-Brianza, Italy
| | - Piero Volpi
- Istituto Clinico Humanitas IRCCS Rozzano, Milano, Italy
- FC Internazionale Milano SpA, Milano, Italy
| | | | | | | | | | | | | | - Guido Bravin
- SOC Ortopedia e Traumatologia ASUFC, Udine, Italy
- Udinese Calcio, Udine, Italy
| | | | - Mattia Berti
- Department of Knee Surgery, Policlinico Abano Terme, Abano Terme, Italy
- Hellas Verona Calcio, Verona, Italy
| | - Eugenio Vecchini
- Hellas Verona Calcio, Verona, Italy
- Clinica Ortopedica, University of Verona, Verona, Italy
| | - Marco A Minetto
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Torino, Italy
| |
Collapse
|
11
|
Della Villa F, Buckthorpe M, Pellegrini A, Ranzini A, Esposito F, Crescenzo C, Nanni G, Zago M. A comparative video analysis of hamstring injuries mechanism and situational pattern in men's and women's football (soccer). Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38881374 DOI: 10.1002/ksa.12313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/03/2024] [Accepted: 05/29/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE To describe the injury mechanism and situational patterns of severe (absence >28 days) hamstring muscle injuries in professional male and female football (soccer) players. METHODS The data for males were sourced from Serie A clubs participating in both national and international competitions from 2018 to 2021. For the female cohort, hamstring injuries were identified during matches of the top national/international competitions from 2017 to 2023. Video footage was obtained, and three raters categorised injury mechanisms and situational patterns. Injuries were also examined according to the month, minute and location. RESULTS A total of 129 severe hamstring injuries were identified, with 64 occurring in females and 65 in males. Video analysis was possible for 29 (45%) female cases and 61 (94%) male cases. Female injuries had longer lay-off times (97.8 ± 77.1 days) than males (39.6 ± 20.9 days). Females had a higher proportion of indirect contact injuries (34%) than males (13%) and a lower proportion of non-contact injuries (66% vs. 87%). Four situational patterns were identified: running was the most common for both sexes, representing 59% of female injuries and 41% of male injuries. Over-stretching injuries were split across open and CKC scenarios but collectively explained nearly half (48%) of male injuries but only one in five (21%) female injuries. Kicking injuries had a higher proportion in females (17%) than males (10%). Injuries were more common in the second half for females and the first half for males. CONCLUSION Females had a higher proportion of indirect contact, running and kicking injuries and a lower proportion of non-contact and stretch-type injuries than males. Understanding injury patterns can inform tailored prevention programs, considering sex-specific differences. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
| | - Matthew Buckthorpe
- Education and Research Department, Isokinetic Medical Group, Bologna, Italy
- Faculty of Sport, Technology and Health Sciences, St Mary's University, Twickenham, London, UK
| | - Alessandro Pellegrini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Alice Ranzini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | | | - Gianni Nanni
- Medical Area, Bologna Football Club 1909, Bologna, Italy
| | - Matteo Zago
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| |
Collapse
|
12
|
Fan D, Liu Y, Hu P, Lin D, Rao J, Sun L, Wang W, Wu L, Liu L, Ma Y, Liu Z, Guo X. Prevalence of placenta previa among deliveries: An update systematic review and meta-analysis after the introduction of the two-child policy in Mainland China. J Glob Health 2024; 14:04108. [PMID: 38867677 PMCID: PMC11170231 DOI: 10.7189/jogh.14.04108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
Background As birth policy can affect maternal and infant health, we sought to identify whether and how the introduction of the two-child policy might have affected the prevalence of placenta previa in pregnant women in mainland China. Methods In this update meta-analysis and systematic review, we searched PubMed, Web of Science, the Cochrane Library, Weipu, Wanfang, and the China National Knowledge Infrastructure (CNKI) databases for studies evaluating the prevalence of placenta previa in China published between the inception of each database and March 2024, with no restrictions. Two investigators independently extracted the data from each included study. We then combined the prevalence of placenta previa using random-effects models. Results We included 128 studies in our analysis, 48 more than in our previous review. The prevalence of placenta previa among Chinese pregnant women was 1.44% (95% confidence interval (CI) = 1.32, 1.56). After the implementation of the two-child policy, the prevalence increased significantly, from 1.25% (95% CI = 1.16, 1.34) to 4.12% (95% CI = 3.33, 4.91). Conclusions The prevalence of placenta previa increased significantly from the one-child policy period to the two-child policy period among mainland Chinese pregnant women, with varying trends across regions. This change requires the attention of health officials and timely adjustment of resource allocation policies. Registration PROSPERO: CRD42021262309.
Collapse
Affiliation(s)
- Dazhi Fan
- Foshan Fetal Medicine Research Institute, Foshan Women and Children Hospital, Foshan, Guangdong, China
- Department of Obstetrics, Foshan Women and Children Hospital, Foshan, Guangdong, China
| | - Yushi Liu
- Department of Obstetrics, Foshan Women and Children Hospital, Foshan, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Pengzhen Hu
- Department of Obstetrics, Foshan Women and Children Hospital, Foshan, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Dongxin Lin
- Foshan Fetal Medicine Research Institute, Foshan Women and Children Hospital, Foshan, Guangdong, China
| | - Jiaming Rao
- Foshan Fetal Medicine Research Institute, Foshan Women and Children Hospital, Foshan, Guangdong, China
| | - Li Sun
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen Wang
- Department of Obstetrics, Foshan Women and Children Hospital, Foshan, Guangdong, China
| | - Linlin Wu
- Department of Obstetrics, Foshan Women and Children Hospital, Foshan, Guangdong, China
| | - Li Liu
- Department of Library, Foshan Women and Children Hospital, Foshan, Guangdong, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Zhengping Liu
- Foshan Fetal Medicine Research Institute, Foshan Women and Children Hospital, Foshan, Guangdong, China
- Department of Obstetrics, Foshan Women and Children Hospital, Foshan, Guangdong, China
| | - Xiaoling Guo
- Foshan Fetal Medicine Research Institute, Foshan Women and Children Hospital, Foshan, Guangdong, China
- Department of Obstetrics, Foshan Women and Children Hospital, Foshan, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
13
|
King D, Hume P, Clark T, Wethe J. Use of the concussion check protocol for concussion assessment in a female soccer team over two consecutive seasons in New Zealand. J Neurol Sci 2024; 460:123011. [PMID: 38615404 DOI: 10.1016/j.jns.2024.123011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/24/2024] [Accepted: 04/09/2024] [Indexed: 05/12/2024]
Abstract
AIM Address deficiencies in access to sports sideline medical care by using a Concussion Check Protocol (CCP) for non-medically-trained people. METHOD A prospective observational cohort study was undertaken on a single amateur female club-based soccer team over two consecutive years in New Zealand utilising a non-medically trained support person termed a Safety officer. CCP is an extension of the King-Devick test with features such as warning signs and symptoms of concussion built into the application. All players suspected of having a potential concussive injury were tested on the match sideline. RESULTS The study overall incidence of match-related concussions was 20.8 (95% CI: 11.8 to 36.6) per 1000 match-hrs, with mean missed-match duration of 31 (95% CI: 27.9 to 34.1) days. Twelve players over the study had a significantly slower post-injury KD (49.9 [44.3 to 64.1]s; χ2(1) = 11.0; p = 0.0009; z = -2.9; p = 0.0033; d = 0.30) and/or reported symptoms, compared with their own baseline (47.2 [44.3 to 64.1]s). CCP had an overall sensitivity of 100% (95% CI: 73.5% to 100.0%), specificity of 100% (95% CI: 69.2% to 100.0%) and positive predictive value (PPV) of 100% (84.6% to 100.0%). CONCLUSION Sideline use of CCP was undertaken successfully by non-medically trained people and provided a reliable platform for concussion identification.
Collapse
Affiliation(s)
- Doug King
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand; Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand; School of Science and Technology, University of New England, Armidale, NSW, Australia; Wolfson Research Institute for Health and Wellbeing, Department of Sport and Exercise Sciences, Durham University, Durham, UK; Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand.
| | - Patria Hume
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand; Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand; Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand; Technology and Policy Lab - Law School, The University of Western Australia, Perth, Australia
| | - Trevor Clark
- International College of Management Sydney, Manly, New South Wales, Australia
| | | |
Collapse
|
14
|
Obërtinca R, Meha R, Hoxha I, Shabani B, Meyer T, Aus der Fünten K. Efficacy of a new injury prevention programme (FUNBALL) in young male football (soccer) players: a cluster-randomised controlled trial. Br J Sports Med 2024; 58:548-555. [PMID: 38499320 PMCID: PMC11103335 DOI: 10.1136/bjsports-2023-107388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To evaluate the efficacy of a new multicomponent, exercise-based injury prevention programme in football players 13-19 years old. METHODS Two-arm cluster-randomised controlled trial with clubs as the unit of randomisation. 55 football teams from Kosovo of the under 15, under 17 and under 19 age groups were randomly assigned to the intervention (INT; 28 teams) or the control group (CON; 27 teams) and were followed for one football season (August 2021-May 2022). The INT group performed the 'FUNBALL' programme after their usual warm-up at least twice per week, while the CON group followed their usual training routine. The primary outcome measure was the overall number of football-related injuries. Secondary outcomes were region-specific injuries of the lower limbs (hip/groin, thigh, knee, lower leg, ankle and foot) and injury severity. RESULTS 319 injuries occurred, 132 in the INT and 187 in the CON group. The INT group used the 'FUNBALL' programme in 72.2% of all training sessions, on average 2.2 times per week. There was a significantly lower incidence in the INT group regarding the overall number of injuries (incidence rate ratio (IRR) 0.69, 95% CI 0.55 to 0.87), the number of thigh injuries (IRR 0.62, 95% CI 0.39 to 0.98), of moderate (time loss between 7 and 28 days) (IRR 0.65, 95% CI 0.44 to 0.97) and of severe injuries (time loss >28 days) (IRR 0.51, 95% CI 0.28 to 0.91). CONCLUSION The 'FUNBALL' programme reduced the incidence of football-related injuries among male adolescent football players, and its regular use for injury prevention in this population is recommended. TRIAL REGISTRATION NUMBER NCT05137015.
Collapse
Affiliation(s)
- Rilind Obërtinca
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
- Department of Physiotherapy, University 'Fehmi Agani' in Gjakova, Gjakova, Kosovo
| | - Rina Meha
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
| | - Ilir Hoxha
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Evidence Synthesis Group, Prishtina, Kosovo
| | - Bujar Shabani
- Faculty of Medicine, University of Prishtina, Prishtina, Kosovo
- Université Claude Bernard, Lyon, France
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
| |
Collapse
|
15
|
Beech J, Jones B, Hughes T, Emmonds S. Injury Profile in Youth Female Athletes: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:1207-1230. [PMID: 38263483 PMCID: PMC11127887 DOI: 10.1007/s40279-023-01988-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND An increasing number of epidemiological studies assessing the incidence, prevalence and severity of injury in youth female sport are available. However, no study has sought to synthesise the current evidence base across all youth female sport. As such, a systematic review and meta-analysis of injury in this cohort is necessary to understand the diversity of injury and its associated burden between sports in addition to identifying the density of research available. OBJECTIVE To conduct a systematic review and meta-analysis of epidemiological data of injuries in youth female athletes with particular attention to injury incidence, mean days lost and injury burden. METHODS Searches were performed in PubMed, EBSCO (SPORTDiscus with Full Text MEDLINE, APA PsycINFO, CINAHL, Academic Search Complete) and Cochrane databases. Studies were considered if they reported time-loss injury incidence or prevalence in youth female (≤ 19 years old) athletes. Study quality and risk of bias were assessed using STROBE-SIIS extension, Newcastle-Ottawa Scale, and funnel plots, respectively. Injury incidence and burden rate data were modelled using a mixed-effect Poisson regression model. Days lost data were modelled using a generalised linear mixed model. RESULTS Thirty-two studies were included. The overall incidence rate, mean days lost per injury, and burden rate were 4.4 injuries per 1000 h (95% CI 3.3-5.9), 10 days (95% CI 6-15), and 46 days per 1000 h (95% CI 23-92), respectively. Forty percent of athletes sustained at least one time-loss injury. Competitive level was a significant moderator of match and training injury incidence, with elite youth athletes presenting greater pooled injury incidence estimates than non-elite athletes (p = 0.0315 and p = 0.0047, respectively). The influence of moderators on days lost and injury burden could not be determined due to an insufficient number of studies for analysis. CONCLUSION Despite a broad inclusion criterion, there is limited injury surveillance research available across youth female sport. Outside of soccer, little research density is evidenced with single studies available in popular team sports such as Australian football and rugby union. Insufficient study numbers reporting mean days lost and injury burden data were available for analysis, and pooled days lost data could only be estimated for soccer. This highlights a need for future research to report days lost data alongside injury number and exposure so burden can be calculated and the full risk of injury to youth female athletes can be identified.
Collapse
Affiliation(s)
- Jake Beech
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
- The Football Association, Burton-Upon-Trent, UK.
| | - Ben Jones
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, The Rugby Football League, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, the University of Cape Town and the Sports Science Institute of South Africa, Cape Town, South Africa
- School of Science and Technology, University of New England, Armidale, NSW, Australia
| | - Thomas Hughes
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Stacey Emmonds
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- The Football Association, Burton-Upon-Trent, UK
| |
Collapse
|
16
|
García-Angulo FJ, Palao JM, Giménez-Egido JM, Ortega-Toro E. Effect of Rule Modifications on Kinematic Parameters Using Maturity Stage as a Moderating Variable in U-10 Football Players. SENSORS (BASEL, SWITZERLAND) 2024; 24:2462. [PMID: 38676078 PMCID: PMC11053628 DOI: 10.3390/s24082462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
The aim of the present study was to analyse the effects of regulatory modifications in competitive situations on cinematic variables, considering maturity stage as a moderating factor, in youth football players. A quasi-experimental study was conducted in which 45 players with a mean age of 9.47 ± 0.54 participated. The independent variable analysed was the modification of rules (playing time, scoring, and specific rules). The dependent variables analysed were cinematic variables. These variables were recorded with WimuTM. The maturity stage was considered a moderating factor in this effect. The main results indicate that the modified competition reduced the total distance covered, maximum acceleration speed, and distance covered in acceleration and deceleration in different speed zones. In addition, the maturity stage was found to moderate the effect of the intervention on the total distance covered, distance covered by accelerating in zone 3, and distance covered by decelerating in zone 3. Thus, the proposed modification appeared to reduce the physical demand for competition. Furthermore, it reduced the differences between players with early maturational development and those with late maturational development.
Collapse
Affiliation(s)
- Francisco Javier García-Angulo
- Department of Physical Activity and Sport, Faculty of Sport Science, University of Murcia, 30720 Murcia, Spain; (F.J.G.-A.); (J.M.G.-E.)
- Sport Performance Analysis Association, 30720 Murcia, Spain;
| | - José Manuel Palao
- Sport Performance Analysis Association, 30720 Murcia, Spain;
- Department of Health, Exercise and Sport Management, University of Wisconsin-Parkside, Kenosha, WI 53144, USA
| | - José María Giménez-Egido
- Department of Physical Activity and Sport, Faculty of Sport Science, University of Murcia, 30720 Murcia, Spain; (F.J.G.-A.); (J.M.G.-E.)
- Sport Performance Analysis Association, 30720 Murcia, Spain;
| | - Enrique Ortega-Toro
- Department of Physical Activity and Sport, Faculty of Sport Science, University of Murcia, 30720 Murcia, Spain; (F.J.G.-A.); (J.M.G.-E.)
- Sport Performance Analysis Association, 30720 Murcia, Spain;
| |
Collapse
|
17
|
Martin-Garetxana I, Hughes J, De Ste Croix M, Larruskain J, Lekue JA, Ayala F. Acute pre- and post-competitive soccer match-play changes in neuromuscular factors, physical performance, and muscle response in youth male players. SCI MED FOOTBALL 2024:1-11. [PMID: 38497787 DOI: 10.1080/24733938.2024.2329273] [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] [Accepted: 03/04/2024] [Indexed: 03/19/2024]
Abstract
There is a paucity of literature analyzing the impact of fatigue from actual competitive soccer match-play on measures of neuromuscular function and muscle damage markers in youth players. Aims The main purpose was to analyze the acute pre- and post-competitive soccer match-play changes in measures of landing mechanics, stretch-shortening cycle capability, physical performance, muscle damage, and match intensity. A secondary purpose was to explore whether the players' maturity status and chronological age were associated with post-soccer match-play responses. Methods Thirty-two male youth outfield soccer players from two chronological competition age groups (U14 and U16) were assessed pre-and post-competitive soccer match-play for 2D dynamic knee valgus at landing (DKV), leg stiffness, reactive strength index, 20 m sprint time, CMJ-Abalakov jump height, creatine kinase and urea activity and visual analogue scale for muscle soreness (VAS). Players' maturity status was also estimated using a previously validated regression equation. Results There were statistically significant (p < 0.05) post-competitive soccer match-play impairments in all measures of stretch-shortening cycle capability and muscle damage markers assessed irrespective of the age group. Likewise, significant post-match play alterations in landing mechanics (DKV of the dominant leg) and physical performance (sprint time and jump height) scores were documented for the U14 players. Significant interactions between maturity and landing mechanics and VAS responses to competitive soccer match-play were also found whereby more mature players demonstrated larger post-match changes. Conclusion The findings of this study suggest the existence of a negative influence of competitive match-play on neuromuscular function and muscle damage in youth soccer.
Collapse
Affiliation(s)
- Imanol Martin-Garetxana
- Medical Services, Athletic Club, Lezama, Spain
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Jonathan Hughes
- Youth Physical Development Center, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK
| | - Mark De Ste Croix
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | | | - Jose A Lekue
- Medical Services, Athletic Club, Lezama, Spain
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Francisco Ayala
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, San Javier, Spain
| |
Collapse
|
18
|
Modena R, Schena F. External training load and performance recovery after small-sided games in soccer: Insights for return-to-play management. AIMS Public Health 2024; 11:315-329. [PMID: 38617408 PMCID: PMC11007412 DOI: 10.3934/publichealth.2024016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 04/16/2024] Open
Abstract
The return-to-play process' characteristics can vary by injury and sport type but are typically composed of phases of different durations, training targets, and intensities that gradually increase the physiological and mechanical load. In team sports, contact drills are a necessary part of the last phases of this process, and they should be planned using the optimal mechanical load. The present study investigated the external load and kinetic recovery in U19 soccer players performing 6vs6 and 3vs3 small-sided games. A global positioning system (GPS) measured external load metrics. The rate of perceived exertion (RPE) was registered at the end. Total quality of recovery (TQR) was collected at the beginning of the training session and after 24 h. Moreover, before and after the small-sided games (SSGs) and at 24 h, delayed-onset muscle soreness (DOMS) of the legs, sprinting time, and vertical jump height (CMJ) were collected. 6vs6 presented higher values in total distance low-, moderate-, high, and very-high-speed distance, and maximum speed (p < 0.05). However, 3vs3 showed higher number of sprints, acceleration, and deceleration at different intensities. Furthermore, no difference was shown in RPE. The effect of fatigue on sprint seems greater for 6vs6, showing an impairment persistent at 24 h (p < 0.05). Moreover, CMJ height was impaired after 6vs6 and at 24 h (p < 0.05) but did not change after 3vs3 (p > 0.05). DOMS values after SSGs and at 24 h were higher than baseline for both conditions (p < 0.05), while TQR decreased at 24 h in both conditions (p < 0.05). Based on our results, it seems that 6vs6, leading to a greater high-speed running distance, might cause a training load that needs more time to recover. This point may be crucial in a return-to-play process, especially when hamstring muscles are involved.
Collapse
Affiliation(s)
- Roberto Modena
- CeRiSM, Sport Mountain and Health Research Center, University of Verona, Rovereto, Italy
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Federico Schena
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| |
Collapse
|
19
|
Massidda M, Flore L, Cugia P, Piras F, Scorcu M, Kikuchi N, Cięszczyk P, Maciejewska-Skrendo A, Tocco F, Calò CM. Association Between Total Genotype Score and Muscle Injuries in Top-Level Football Players: a Pilot Study. SPORTS MEDICINE - OPEN 2024; 10:22. [PMID: 38448778 PMCID: PMC10917720 DOI: 10.1186/s40798-024-00682-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/30/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Recently, genetic predisposition to injury has become a popular area of research and the association between a few single nucleotide polymorphisms (SNPs) and the susceptibility to develop musculoskeletal injuries has been shown. This pilot study aimed to investigate the combined effect of common gene polymorphisms previously associated with muscle injuries in Italian soccer players. RESULTS A total of 64 Italian male top football players (age 23.1 ± 5.5 years; stature 180.2 ± 7.4 cm; weight 73.0 ± 7.9 kg) were genotyped for four gene polymorphisms [ACE I/D (rs4341), ACTN3 c.1729C > T (rs1815739), COL5A1 C > T (rs2722) and MCT1 c.1470A > T (rs1049434)]. Muscle injuries were gathered for 10 years (2009-2019). Buccal swabs were used to obtain genomic DNA, and the PCR method was used to genotype the samples. The combined influence of the four polymorphisms studied was calculated using a total genotype score (TGS: from 0 to 100 arbitrary units; a.u.). A genotype score (GS) of 2 was assigned to the "protective" genotype for injuries, a GS of 1 was assigned to the heterozygous genotype while a GS of 0 was assigned to the "worst" genotype. The distribution of genotype frequencies in the ACE I/D (rs4341), ACTN3 c.1729C > T (rs1815739) and MCT1 c.1470A > T (rs1049434) polymorphisms was different between non-injured and injured football players (p = 0.001; p = 0.016 and p = 0.005, respectively). The incidence of muscle injuries was significantly different among the ACE I/D (rs4341), ACTN3 c.1729C > T (rs1815739) and COL5A1 C > T (rs2722) genotype groups, showing a lower incidence of injuries in the "protective" genotype than "worse" genotype (ACE, p < 0.001; ACTN3, p = 0.005) or intermediate genotype (COL5A1, p = 0.029). The mean TGS in non-injured football players (63.7 ± 13.0 a.u.) was different from that of injured football players (42.5 ± 12.5 a.u., p < 0.001). There was a TGS cut-off point (56.2 a.u.) to discriminate non-injured from injured football players. Players with a TGS beyond this cut-off had an odds ratio of 3.5 (95%CI 1.8-6.8; p < 0.001) to suffer an injury when compared with players with lower TGS. CONCLUSIONS These preliminary data suggest that carrying a high number of "protective" gene variants could influence an individual's susceptibility to developing muscle injuries in football. Adapting the training load parameters to the athletes' genetic profile represents today the new frontier of the methodology of training.
Collapse
Affiliation(s)
- Myosotis Massidda
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
- Italian Federation of Sports Medicine, Rome, Italy.
| | - Laura Flore
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Paolo Cugia
- Italian Federation of Sports Medicine, Rome, Italy
- Cagliari Calcio SpA, Cagliari, Italy
| | - Francesco Piras
- Italian Federation of Sports Medicine, Rome, Italy
- Cagliari Calcio SpA, Cagliari, Italy
| | - Marco Scorcu
- Italian Federation of Sports Medicine, Rome, Italy
- Cagliari Calcio SpA, Cagliari, Italy
| | - Naoki Kikuchi
- Nippon Sport Science University (NSSU), Tokyo, Japan
| | - Pawel Cięszczyk
- Department of Physical Education, University of Physical Education and Sport, Gdańsk, Poland
| | - Agnieszka Maciejewska-Skrendo
- Department of Physical Education, University of Physical Education and Sport, Gdańsk, Poland
- Institute of Physical Culture Sciences, University of Szczecin, 71-065, Szczecin, Poland
| | - Filippo Tocco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Italian Federation of Sports Medicine, Rome, Italy
| | - Carla Maria Calò
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| |
Collapse
|
20
|
Škomrlj J, Modrić T, Sekulić D, Bandalović A, Turić A, Bećir B, Veršić Š. Longitudinal analysis of the incidence rate of injury in elite youth football: Trends over six years including the COVID-19 pandemic period. Phys Ther Sport 2024; 66:85-92. [PMID: 38359730 DOI: 10.1016/j.ptsp.2024.01.006] [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: 09/05/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVES We aimed to analyze injury trends and the possible effects of the coronavirus disease (COVID-19) pandemic on the incidence rates of injury in young elite football players. DESIGN A prospective cohort study design was adopted. PARTICIPANTS Our study included 832 male football players who suffered an injury during any of the six competitive seasons. SETTING An elite youth football academy. MAIN OUTCOME MEASURE Descriptive data and the incidence of injury were calculated. A generalized linear mixed model was used to assess differences in the occurrence of injury among the various age groups. Joinpoint regression was used to analyze injury trends. RESULTS Joinpoint regression models showed a statistically significant decrease in the incidence of injury in all age groups with an average annual percent change (AAPC) of 13.9 (95 %Confidence Interval [CI]:-23.2 - 3.4) and -13.5 (95 %CI:-24.5 to -0.9) for models with zero and one joinpoint, respectively. Football players in older age groups sustain a higher number of injuries, probably due to a higher number of matches and greater training intensity. CONCLUSION This study showed a downward trend in injuries in the participants prior to the pandemic, with an evident increase in the incidence rate of injury during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Jakša Škomrlj
- HNK Hajduk Split, Split, 21000, Croatia; University of Split, Faculty of Kinesiology, Split, 21000, Croatia.
| | - Toni Modrić
- University of Split, Faculty of Kinesiology, Split, 21000, Croatia; High Performance Sport Center, Croatian Olympic Committee, Zagreb, 10000, Croatia.
| | - Damir Sekulić
- University of Split, Faculty of Kinesiology, Split, 21000, Croatia; High Performance Sport Center, Croatian Olympic Committee, Zagreb, 10000, Croatia.
| | - Ante Bandalović
- HNK Hajduk Split, Split, 21000, Croatia; University Hospital Split, Surgery Clinic, Department of Orthopedics and Traumatology, 21000, Split, Croatia.
| | - Ante Turić
- HNK Hajduk Split, Split, 21000, Croatia; University Hospital Split, Surgery Clinic, Department of Orthopedics and Traumatology, 21000, Split, Croatia.
| | | | - Šime Veršić
- HNK Hajduk Split, Split, 21000, Croatia; University of Split, Faculty of Kinesiology, Split, 21000, Croatia; High Performance Sport Center, Croatian Olympic Committee, Zagreb, 10000, Croatia.
| |
Collapse
|
21
|
Mohammadi H, Ghaffari R, Kazemi A, Behm DG, Hosseinzadeh M. Evaluation of the lower extremity functional test to predict lower limb injuries in professional male footballers. Sci Rep 2024; 14:2596. [PMID: 38297107 PMCID: PMC10831056 DOI: 10.1038/s41598-024-53223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/30/2024] [Indexed: 02/02/2024] Open
Abstract
The Lower Extremity Functional Test (LEFT) is a reliable and valid test for the measurement of athletic fitness, fatigue resistance, and speed performance. Contradictory results exist regarding the screening value of the LEFT in predicting lower limb injuries. The purpose of this study was to investigate the screening value of the LEFT in predicting lower limb injuries in professional male footballers. One hundred and twenty-one professional male football players participated in the study. LEFT was recorded pre-season and the lower-limb injuries were recorded during a 9-month season. Logistic regression analysis was used to determine the accuracy of the prognosis of LEFT. A total of twenty-five lower limb injuries were recorded. The model explained 53% of the variance in lower limb injury, showing that predictions by LEFT score is reliable, and correctly predicted 89.3% of cases, which is a large improvement. ROC analysis showed significant accuracy of the LEFT score (AUC 0.908, 95% CI 1.126-1.336, p = 0.001, OR = 1.227) in discriminating between injured and uninjured players. The optimum cut-off level of the LEFT score was 90.21 s; Our findings showed that the LEFT score was able to predict lower limb injuries in professional male footballers. The slower an athlete's LEFT scores, the more susceptible they are to future injury risk. Sports medicine specialists, football coaches and managers are suggested to use LEFT as a pre-season screening test to identify and prevent the weakness and functional imbalance of the athletes before the injury occurs by conducting this test.
Collapse
Affiliation(s)
- Haniyeh Mohammadi
- Department of Sport Injuries and Corrective Exercises, Faculty of Physical Education and Sports Sciences, Shomal University, Amol, Iran
| | - Raheleh Ghaffari
- Department of Sport Injuries and Corrective Exercises, Faculty of Physical Education and Sports Sciences, Shomal University, Amol, Iran
| | - Abdolreza Kazemi
- Department of Physical Education, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Mahdi Hosseinzadeh
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, No. 3, 5th Alley, Miremad Street, Motahhari Street, PO Box: 1587958711, Tehran, Iran.
| |
Collapse
|
22
|
Sato VN, Moriwaki TL, Ikawa MH, Sugawara LM, da Rocha Correa Fernandes A, Skaf AY, Yamada AF. Apophyseal injuries in soccer players. Skeletal Radiol 2024:10.1007/s00256-023-04542-x. [PMID: 38224380 DOI: 10.1007/s00256-023-04542-x] [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: 07/19/2023] [Revised: 11/05/2023] [Accepted: 12/05/2023] [Indexed: 01/16/2024]
Abstract
Soccer is the most popular sport worldwide, and it is associated with high injury rates, with most of these injuries occurring in the lower extremities. Particularly, in youth soccer players with immature skeleton, the physeal plate is two to five times weaker than the surrounding fibrous structures, and therefore more vulnerable to injury. The physeal plate consists of epiphyses and apophyses, with the former serving as tendon attachment sites and being subject to traction forces. There are two types of apophyseal injury: (i) apophyseal avulsion, which consists of an acute separation across the physeal plate; and (ii) apophysitis, an injury caused by chronic and repetitive contraction of musculotendon unit, leading to inflammation of the growth plate cartilage. Apophyses of the hip and pelvis are the most commonly injured in youth soccer players, due to vigorous contractions during sports activities and the fact that they tend to fuse later compared to other epiphyseal centers, making them more susceptible to injury. In this review, we will discuss the anatomy of lower limb apophyses and clinical and imaging findings of apophyseal injuries in youth soccer players, as well as briefly review treatment options and complications.
Collapse
Affiliation(s)
- Vitor Neves Sato
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - Tatiane Lumi Moriwaki
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - Marcos Hiroyuki Ikawa
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - Leonardo Massamaro Sugawara
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - Artur da Rocha Correa Fernandes
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Radiology Department - Grupo de Radiologia e Diagnóstico por Imagem da Rede D'Or, São Paulo, SP, Brazil
| | - Abdalla Youssef Skaf
- Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - André Fukunishi Yamada
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil.
- Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil.
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil.
| |
Collapse
|
23
|
Nguyen JC, Caine D. Youth soccer players: patterns of injury involving the primary growth plates of epiphyses. Skeletal Radiol 2024:10.1007/s00256-023-04541-y. [PMID: 38175258 DOI: 10.1007/s00256-023-04541-y] [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: 07/12/2023] [Revised: 09/08/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
Youth soccer (football) is immensely popular internationally. Earlier participation, sport sub-specialization, and year-around practice have led to an increased incidence of injury from both acute trauma and repetitive overuse. The growth plates (physes) of the immature skeleton are particularly vulnerable to injury and delayed diagnosis can lead to future growth disturbance and long-term morbidity. Familiarity with the various components of the growth plate complex necessary for ensuring normal endochondral ossification is fundamental in understanding the various patterns of imaging findings following injury. This review discusses the zonal columnar arrangement of the growth plate proper and the contrasting function of the vasculature within the subjacent epiphysis and metaphysis. This is followed by an evidence-based discussion of the common patterns of injury involving the epiphyseal primary growth plate observed among youth soccer players: subcategorized into physeal fractures (direct injury) and physeal stress injuries (indirect insult to subjacent metaphysis). In this section, the role of imaging and characteristic imaging features will be discussed. While the normal physiologic and pathophysiologic mechanisms can be applied to other growth plates, such as primary growth plates underlying the apophyses and secondary growth plates surrounding the secondary ossificiation centers, which also undergo endochondral ossification, the current review is focused on injuries involving the primary growth plates underlying epiphyses.
Collapse
Affiliation(s)
- Jie C Nguyen
- Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Dennis Caine
- Kinesiology and Public Health Education, Division of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, 58202-8235, USA
| |
Collapse
|
24
|
Andersen TR, Drevsfeldt A, Möller S, Møller M. Injuries in male youth football: a one season prospective cohort study of 223 Danish elite players. Front Sports Act Living 2023; 5:1250223. [PMID: 38164442 PMCID: PMC10757927 DOI: 10.3389/fspor.2023.1250223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/22/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives This study prospectively investigated injury prevalence, incidence, and burden in male elite under-17 football players (N = 223) during a full season. Methods The players weekly completed a standardized web-based injury survey (OSTRC-H2) and a physical exposure report throughout the study. Results Average weekly response rate was 89.5%. Football exposure accounted for 52.4% of total physical exposure. On average (±SD), the players participated in individual football, strength, and rehabilitation practices for 1.2 ± 1.5, 3.0 ± .2.1, and 1.9 ± 3.4 h/week, respectively. In total, 742 health problems were reported. Mean weekly prevalence of health problems, injuries and illnesses were 20.1%, 16.5% and 3.8%, respectively. The injury incidence per 1,000 h of football exposure, match play and team practice were 8.28 (95% CI: 7.54-9.08), 16.77 (95% CI: 13.65-20.4), and 7.24 (95% CI: 6.5-8.04), respectively. Sudden-onset and gradual-onset injuries accounted for 36.7% and 43.4% of the total proportion of health problems. Hip/groin injuries had the highest incidence (1.58/1,000 h), whereas knee injuries had the highest burden (20.86 days lost/1,000 h). On average, the players experienced 3.33 health problems (average duration: 7.8 days). On average pr. player, 2.7 (95% CI: 2.2-3.3) wks of football exposure were lost. Conclusion Sudden and gradual-onset injuries influenced player availability during the season. Health problem prevalence fluctuated markedly, and injury incidence was higher during match play than training. The players had substantial volumes of training beyond football-specific training and matches. Our findings could assist medical and sports science practitioneers in enhancing training and recovery processes to maximize player availability.
Collapse
Affiliation(s)
- Thomas Rostgaard Andersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Danish Football Association, Brondby, Denmark
| | - Andreas Drevsfeldt
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Merete Møller
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| |
Collapse
|
25
|
Tamura A, Shimura K, Inoue Y. Leg and Joint Stiffness of the Supporting Leg during Side-Foot Kicking in Soccer Players with Chronic Ankle Instability. Sports (Basel) 2023; 11:218. [PMID: 37999435 PMCID: PMC10674260 DOI: 10.3390/sports11110218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
Soccer players with chronic ankle instability (CAI) may stabilize their supporting leg by the proximal joint to compensate for the ankle instability during kicking motion. This study aimed to investigate the characteristics of leg and joint stiffness of the supporting leg during side-foot kicking in soccer players with CAI. Twenty-four male collegiate-level soccer players with and without CAI participated in this study. The kinematic and kinetic data were obtained using a three-dimensional motion analysis system. Leg stiffness and joint (hip, knee, and ankle) stiffness in the sagittal and frontal planes were calculated and analyzed. The results clarified that soccer players with CAI (0.106 ± 0.053 Nm/°) had greater knee stiffness in knee adduction during the kicking cycle compared to those without CAI (0.066 ± 0.030 Nm/°; p = 0.046), whereas no characteristic differences were observed in knee stiffness in knee flexion and hip and ankle stiffness (p > 0.05). Knee stiffness is believed to occur to compensate for ankle joint instability in the supporting leg. Therefore, adjusting knee stiffness to accommodate ankle joint instability is crucial for maintaining kicking performance. Based on results of this study, it may be important to consider training and exercises focused on joint coordination to improve knee stiffness in soccer players with CAI.
Collapse
Affiliation(s)
- Akihiro Tamura
- Research Institute for Health and Sport Science, Nippon Sport Science University, Setagaya, Tokyo 158-8508, Japan
| | - Keita Shimura
- School of Health Sciences, Tokyo International University, Kawagoe 350-1197, Saitama, Japan;
| | - Yuri Inoue
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe 658-0001, Hyogo, Japan;
| |
Collapse
|
26
|
Teahan C, Whyte EF, O'Connor S. Gaelic games players' awareness and use of, and attitudes towards injury prevention exercise programmes. Phys Ther Sport 2023; 64:17-26. [PMID: 37647826 DOI: 10.1016/j.ptsp.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE The aim was to determine the awareness of and use of injury prevention exercise programmes (IPEPs) among adult Gaelic games players and to investigate Gaelic games players' attitudes to injury prevention and barriers and facilitators to successful IPEPs use. METHODS A recruitment email was sent to all clubs and county boards throughout Ireland (whose email was available online) and the survey was advertised on social media platforms. Adult players completed an anonymous survey, including awareness, use, and attitudes towards injury prevention and injuries. Frequencies and descriptive statistics were conducted, a chi-squared test was used to assess any differences in awareness and use of IPEPs, a Mann-Whitney U test was used to examine differences between groups for attitudes to injury prevention (men vs women; elite vs non-elite). RESULTS A third of players (32.4%) stated awareness of IPEPs. However, only 13.4% correctly identified one. A significantly greater number of men (35.7%) used IPEPs compared to women (26.5%) (p = 0.04). The Activate (65.5%) and GAA15 (32.5%) were most used. Players had a positive attitude towards injury prevention but agreed that injuries were an issue (68.2%) and stated that their coach didn't have enough knowledge how to use IPEPs was a large barrier (41.6%). CONCLUSION Despite this positive attitude to injury prevention and believing injuries are an issue, adoption remains low. Organisations/clubs should educate players on the benefits of using IPEPs and support structures put in place to gain greater implementation, which is critical to mitigating the risk of injury.
Collapse
Affiliation(s)
- Calvin Teahan
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland.
| | - Enda F Whyte
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Siobhán O'Connor
- Centre for Injury Prevention and Performance, School of Health and Human Performance, Dublin City University, Dublin, Ireland
| |
Collapse
|
27
|
Jordt I, Thygesen MM, Johansen TA, Jensen KH, Agger P. Field conditions is a risk factor for traumatic injury in youth football-A joint venture of medicine and hydrology. Scand J Med Sci Sports 2023; 33:2351-2359. [PMID: 37534783 DOI: 10.1111/sms.14461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 05/23/2023] [Accepted: 07/21/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION The risk of traumatic injury in football has been suggested to be affected by field conditions. This study, therefore, aimed to investigate whether near surface water content of the football field, influenced the risk of traumatic injuries during a youth football tournament. METHODS At Dana Cup, an annual international youth football tournament in Denmark, all injuries were registered and classified at the on-site emergency department over 7 years. The incidence rate of traumatic injury was computed. Meteorological data and soil characteristics were used to simulate near surface water content of the playing fields. The incidence rate ratio (IRR) between water content and injury incidence rate was analyzed using a multivariate Poisson regression, controlling for tournament stage and demographical parameters. RESULTS About 2704 injuries were recorded corresponding to a risk time of 284 905 player hours. An inverse relation between water contents and the incidence rate of traumatic injury was found (IRR = 0.24 95% CI 0.1-0.7, p = 0.01). The incidence rate of traumatic injury increased with advancing tournament stage, that is, for the finals (IRR = 4.30 95% CI 2.8-6.6, p < 0.001). Also we found an interaction between dry fields and the final stage of tournament, further exacerbating this effect. CONCLUSIONS Our data suggest that the incidence rate of traumatic injury is increased with drier field conditions and advanced tournament stages.
Collapse
Affiliation(s)
- Ida Jordt
- Department of Clinical Medicine, Comparative Medicine Lab, Aarhus University, Aarhus, Denmark
| | - Mathias Møller Thygesen
- Department of Clinical Medicine, Comparative Medicine Lab, Aarhus University, Aarhus, Denmark
| | - Tau Alfred Johansen
- Department of Geosciences and Natural Resource Management, Section for Geology, Copenhagen University, Copenhagen, Denmark
| | - Karsten Høgh Jensen
- Department of Geosciences and Natural Resource Management, Section for Geology, Copenhagen University, Copenhagen, Denmark
| | - Peter Agger
- Department of Clinical Medicine, Comparative Medicine Lab, Aarhus University, Aarhus, Denmark
| |
Collapse
|
28
|
Robles-Palazón FJ, Comfort P, Ripley NJ, Herrington L, Bramah C, McMahon JJ. Force plate methodologies applied to injury profiling and rehabilitation in sport: A scoping review protocol. PLoS One 2023; 18:e0292487. [PMID: 37812631 PMCID: PMC10561863 DOI: 10.1371/journal.pone.0292487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023] Open
Abstract
Musculoskeletal injuries are a common health problem among sporting populations. Such injuries come with a high financial burden to the involved organisations and can have a detrimental impact on the career attainment of injured individuals. Force plates are now a common tool available to sport and exercise science and medicine professionals to enable them to profile injury risk predisposition and modulate the rehabilitation process within sporting environments. This is because contemporary force plate technology is portable and affordable and often comes with software that enables the automatic and immediate feedback of test variables to key stakeholders. However, to our knowledge, to date, there has been no comprehensive review of the scientific literature pertaining to clinical applications of force plate technology. Therefore, this article presents a protocol and a methodological framework to perform a scoping review to identify and map the available scientific literature in which force plates have been applied to the injury profiling and rehabilitation of athletes. The specific aims of the scoping review are 1) to identify and describe the force plate tests, methodologies, and metrics used to screen for injury risk and guide the return of injured athletes to full-time training and competition, 2) to identify potential trends and/or differences by participants' age, sex, and/or level of performance in tests, methodologies, and metrics selected, and 3) to identify key gaps in the existing evidence base and new questions that should be addressed in future research. The global aim of the scoping review is to improve practitioner decision-making around force plate test and variable selection when applied to the injury prevention and rehabilitation of sporting populations.
Collapse
Affiliation(s)
- Francisco Javier Robles-Palazón
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
- Faculty of Sport Sciences, Department of Physical Activity and Sport, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
| | - Paul Comfort
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
- Centre for Exercise and Sport Science Research, Edith Cowan University, Joondalup, WA, Australia
| | - Nicholas J. Ripley
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| | - Lee Herrington
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| | - Christopher Bramah
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| | - John J. McMahon
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, United Kingdom
| |
Collapse
|
29
|
Sonesson S, Lindblom H, Hägglund M. Higher age and present injury at the start of the season are risk factors for in-season injury in amateur male and female football players-a prospective cohort study. Knee Surg Sports Traumatol Arthrosc 2023; 31:4618-4630. [PMID: 37542529 PMCID: PMC10471640 DOI: 10.1007/s00167-023-07517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/14/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE To describe the injury prevalence, injury pattern, and potential baseline risk factors for injuries in male and female adolescent and adult amateur football players. METHODS This prospective study followed adolescent and adult amateur football players over one season March-October 2020. The study was completed by 462 players (130 men, age 20.0 ± 5.7, 14-46 years) who answered a baseline survey and a weekly web survey during the season. A total of 1456 weekly surveys were registered from males and 5041 from females. Injuries were recorded with the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O2). Potential baseline risk factors (age, performance of strength/conditioning training, participation in other sports, perceived importance of sporting success, self-rated training and match load, perceived balance between training/match load and recovery, previous/present injury at start of season, and injury beliefs) and their association with injury were analysed with Poisson regressions within each sex. RESULTS Males reported 95 injuries (262 injury weeks, weekly prevalence 18.0% (95% CI 16.1-20.1)) and females 350 injuries (1206 injury weeks, weekly prevalence 23.9% (95% CI 22.8-25.1)). Gradual-onset injuries accounted for 57% of the injuries in males and 66% in females. For males, substantial injuries were most common in the hip/groin (weekly prevalence 3.8%), ankle (2.1%), posterior thigh (2.0%), and knee (2.0%); and for females, in the knee (4.3%), ankle (2.5%), and lower leg/Achilles tendon (2.0%). Significant risk factors for injury were higher age (rate ratio males 1.05 per year increase (95% CI 1.02-1.08), females 1.03 (95% CI 1.01-1.05)), and present injury at baseline (males 1.92 (95% CI 1.27-2.89), females 1.58 (95% CI 1.19-2.09)). CONCLUSION At any given week, almost one in five male and one in four female amateur football players reported new or ongoing injuries. Hip/groin injuries were more frequent in males, while female players had a higher prevalence of knee injuries. Older players and those with an existing injury at the start of the season were more prone to new injury during the season. Rehabilitation of pre-season injury and complaints are key to reduce the injury burden in amateur football. LEVEL OF EVIDENCE Level II. Trial registration number NCT04272047, Clinical trials.
Collapse
Affiliation(s)
- Sofi Sonesson
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Hanna Lindblom
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Martin Hägglund
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
30
|
Gurau TV, Gurau G, Musat CL, Voinescu DC, Anghel L, Onose G, Munteanu C, Onu I, Iordan DA. Epidemiology of Injuries in Professional and Amateur Football Men (Part II). J Clin Med 2023; 12:6293. [PMID: 37834937 PMCID: PMC10573283 DOI: 10.3390/jcm12196293] [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: 08/02/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Background (1): Men's football is a physically demanding contact sport that involves intermittent bouts of sprinting, jogging, walking, jumping and changes of direction. The physical demands of the game vary by level of play (amateur club, sub-elite and open club or international), but injury rates at all levels of the men's football game remain the highest of all sports. Objective: The aim of this study is to conduct a systematic review of data from the epidemiological literature regarding the profile, severity and mechanisms of injuries and the frequency of recurrent injuries in professional and amateur football players. Methods (2): A systematic review, according to PRISMA guidelines, was performed up to June 2023 in the databases of PubMed, Web of Science, Google academic, Google scholar and the Diva portal. Twenty-seven studies that reported data on the type, severity, recurrence and mechanisms of injury in professional and amateur men's football were selected and analyzed. Two reviewers independently audited data and assessed the study quality using the additional and adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): In professional male football players, the mean prevalence of muscle/tendon injuries was 39.78%, followed by joint and ligament injuries-21.13%, contusions-17.86%, and fractures-3.27%, and for amateur football players, the prevalence's were 44.56% (muscle/tendon injuries), 27.62% (joint and ligament injuries), 15.0% (contusions) and 3.05% (fracture), respectively. The frequency of traumatic injuries was higher in amateur football players (76.88%) compared to professional football players (64.16%), the situation being reversed in the case of overuse injuries: 27.62% in professional football players and 21.13% in amateur football players. Most contact injuries were found in professional footballers (50.70%), with non-contact injuries predominating in amateur footballers (54.04%). The analysis of the severity of injuries showed that moderate injuries dominated in the two categories of footballers; the severe injuries in amateur footballers exceeded the severe injuries recorded in professional footballers by 9.60%. Recurrence proportions showed an inverse relationship with the level of play, being higher in amateur footballers (16.66%) compared to professional footballers (15.25%). Conclusions (4): Football-related injuries have a significant impact on professional and amateur football players and their short- and long-term health status. Knowing the frequency of severe diagnoses, such as strains, tears and cramps of the thigh muscles, ankle ligament sprains and hip/groin muscle strain requires the establishment of adequate programs to prevent them, especially in amateur football players, who are more prone to serious injuries.
Collapse
Affiliation(s)
- Tudor Vladimir Gurau
- Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania;
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (L.A.)
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
| | - Lucretia Anghel
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Ar-seni”, 041915 Bucharest, Romania;
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Constantin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700454 Iasi, Romania;
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700454 Iasi, Romania;
| | - Daniel Andrei Iordan
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
- Center of Physical Therapy and Rehabilitation, ‘Dunărea de Jos’ University of Galati, 800008 Galati, Romania
| |
Collapse
|
31
|
Juch EEAE, van de Koppel VC, Blokland D, Wouters RA, Backx FJG, Goedhart EA, van der Horst N. Growth-related sports injuries among young male professional football players in the Netherlands: a prospective cohort study concerning injury incidence, severity and burden. SCI MED FOOTBALL 2023:1-12. [PMID: 37740902 DOI: 10.1080/24733938.2023.2261399] [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: 01/31/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVES To investigate the incidence, type and location of growth-related sports injuries (GRSI) in youth professional football in the Netherlands. Secondary, to gain more knowledge on the injury severity and burden of GRSI. METHODS In this prospective, longitudinal cohort study, 813 players aged 10-18 are included. Data collection is performed by instructing the medical staff of six professional football club academies to register GRSI by means of standardized forms. Training and match exposure are registered individually on a weekly basis. Injury incidence was calculated as number of GRSI per 1000 hours, injury severity as the median number of days lost in categories and injury burden as the number of days lost per 1000 hours. RESULTS A total of 62 GRSI were documented in the football season 2021-2022. The total incidence of GRSI was 0.62/1000 hours football exposure. Morbus Osgood Schlatter and Morbus Sever were most common types of GRSI, both with incidence rates of 0.22/1000 hours exposure. About 58.3% of the documented GRSI were classified as major (>28 days lost). Within this group, the mean severity was 55 days time-loss to football. CONCLUSIONS GRSI are relatively common in youth professional football. The most common types are Morbus Sever and Morbus Osgood Schlatter. Morbus Osgood Schlatter has the highest injury severity and burden compared to other types of GRSI.
Collapse
Affiliation(s)
| | | | - Donna Blokland
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Rudolf Magnus Institute of Neurosciences, Utrecht, the Netherlands
| | - Renko A Wouters
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Rudolf Magnus Institute of Neurosciences, Utrecht, the Netherlands
| | - Frank J G Backx
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Rudolf Magnus Institute of Neurosciences, Utrecht, the Netherlands
| | - Edwin A Goedhart
- FIFA Medical Centre of Excellence, Royal Netherlands Football Association (KNVB), Zeist, The Netherlands
| | | |
Collapse
|
32
|
Liu S, Yan H, Wang Z, Zhang Y, Johnson RS, Wei S, Pan J. Effects of shoe collar types on ankle and knee biomechanics characteristics when performing the side-step cutting task. Sports Biomech 2023:1-17. [PMID: 37736666 DOI: 10.1080/14763141.2023.2249860] [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: 10/26/2022] [Accepted: 08/10/2023] [Indexed: 09/23/2023]
Abstract
This study aimed to examine the effect of football shoes with different collar types on ankle and knee kinematic and kinetics features during 45° and 135° side-step cutting tasks. Fifteen healthy college football players volunteered for the study. Each participant was instructed to perform side-step cutting tasks with high, low, and no collar football shoes. The kinematic and ground reaction force data were measured using a Vicon motion capture system and a Kistler force plate, respectively. Two-way MANOVAs with repeated measures were used to examine the effect of shoe collar type and task conditions. There were no interaction effects. The high collar football shoe showed decreased ankle range of motion in the sagittal plane (p = 0.010) and peak ankle external rotation moment (p = 0.009) compared to the no collar football shoe. The high (p = 0.025) and low (p = 0.029) collar football shoes presented greater peak ankle external rotation angles than the no collar football shoe. These results imply that football shoes with high collars made of high intensity knitted fabric could be used to restrict ankle joint movement, with potential implications for decreasing the risk of ankle sprain injuries in football players.
Collapse
Affiliation(s)
- Shuangen Liu
- College of Physical Education, Jinzhong University, Jinzhong, China
| | - Hui Yan
- College of Physical Education, Jinzhong University, Jinzhong, China
| | - Zhikang Wang
- Center for Research & Innovation, 316º(CHINA) CO. LTD, Xiamen, China
| | - Yifang Zhang
- Center for Research & Innovation, 316º(CHINA) CO. LTD, Xiamen, China
| | - Rachel S Johnson
- Center for Orthopaedic & Biomechanics Research, Boise State University, Boise, Idaho, USA
| | - Shutao Wei
- Center for Research & Innovation, 316º(CHINA) CO. LTD, Xiamen, China
| | - Jiahao Pan
- Center for Orthopaedic & Biomechanics Research, Boise State University, Boise, Idaho, USA
| |
Collapse
|
33
|
Gurau TV, Gurau G, Voinescu DC, Anghel L, Onose G, Iordan DA, Munteanu C, Onu I, Musat CL. Epidemiology of Injuries in Men's Professional and Amateur Football (Part I). J Clin Med 2023; 12:5569. [PMID: 37685638 PMCID: PMC10488230 DOI: 10.3390/jcm12175569] [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: 08/01/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Background (1): Football is the most popular sport among men, associated with a certain risk of injury, which leads to short- and long-term health consequences. While the injury profile of professional footballers is known, little is known about the injury profile of amateur footballers; amateur football is a major and diverse area, the development of which should be a priority for football associations around the world and UEFA. The aim of this study was to perform a systematic review of epidemiological literature data on injuries in professional and amateur football players belonging to certain leagues. Methods (2): A systematic review according to the PRISMA guidelines was performed until June 2023 in the databases PubMed, Web of Science, Google Academic, Google Scholar, and Diva portal. Forty-six studies reporting injury incidence in professional and amateur men's football were selected and analyzed. Two reviewers independently extracted data and assessed study quality using an adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): The overall incidence of injuries in professional male football players was 7.75 ± 2.28, 95% confidence interval, injuries/1000 h of exposure and that of amateur football players was 7.98 ± 2.95, 95% confidence interval, injuries/1000 h of exposure. The incidence of match injuries (30.64 ± 10.28, 95% confidence interval, injuries/1000 exposure hours) was 7.71 times higher than the training injury incidence rate (3.97 ± 1.35, 95% confidence interval, injuries/1000 h) in professional football players and 5.45 times higher in amateurs (17.56 ± 6.15 vs. 3.22 ± 1.4, 95% confidence interval, injuries/1000 h). Aggregate lower extremity injuries had the highest prevalence in both categories of footballers, being 83.32 ± 4.85% in professional footballers and 80.4 ± 7.04% in amateur footballers: thigh, ankle, and knee injuries predominated. Conclusions (4): Professional and amateur football players are at substantial risk of injury, especially during matches that require the highest level of performance. Injury rates have implications for players, coaches, and sports medicine practitioners. Therefore, information on football injuries can help develop personalized injury risk mitigation strategies that could make football safer for both categories of football players. The current findings have implications for the management, monitoring, and design of training, competition, injury prevention, especially severe injury, and education programs for amateur football players.
Collapse
Affiliation(s)
- Tudor Vladimir Gurau
- Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Lucretia Anghel
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Ar-Seni”, 041915 Bucharest, Romania;
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Daniel Andrei Iordan
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
- Center of Physical Therapy and Rehabilitation, ‘Dunărea de Jos’ University of Galati, 800008 Galati, Romania
| | - Constantin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
| |
Collapse
|
34
|
Fu H, Li Z, Zhou X, Wang J, Chen Z, Sun G, Sun J, Zeng H, Wan L, Hu Y, Wang F, Zheng J. The profiles of single leg countermovement jump kinetics and sprinting in female soccer athletes. Heliyon 2023; 9:e19159. [PMID: 37664742 PMCID: PMC10469566 DOI: 10.1016/j.heliyon.2023.e19159] [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: 04/30/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023] Open
Abstract
The purposes were to evaluate kinetics in lower limbs using single leg countermovement jump (SLCMJ) and to identify the differences in SLCMJ kinetics between sprinting fast players and sprinting slow players in elite university female soccer players. Seventeen participants at the national tournament level completed the survey. SLCMJ and 30 m sprinting tests were performed. A force-plate was used to collect the data of the SLCMJ test. Significant differences of concentric maximum rate of force development (RFD), concentric RFD, concentric RFD/body weight (BW), peak net takeoff force/BW, peak power, and peak power/BW existed between both legs during the SLCMJ among all the participants. For further analysis, the participants were divided into fast group and slow group based on sprinting performance. Significant differences existed between the two groups in concentric peak velocity (nondominant, p = 0.028) and vertical velocity at takeoff (nondominant, p = 0.021). Concentric maximum RFD (p = 0.036) was significantly different between both legs in the slow group. Among elite university female soccer players, the players who presented more increased asymmetry of kinetic characteristics of jumping, also showed weak sprinting performance. Moreover, the players presented the best performance in velocity of the jumping variables and also had the best sprinting performance. Coaches and players should focus on keeping inter-limb balance and developing jumping velocity to improve sports performance. In future, the cause-and-effect relationship between jumping and sprinting should be identified.
Collapse
Affiliation(s)
- Honghao Fu
- School of Physical Education, Huazhong University of Science and Technology, China
| | - Zhiyuan Li
- Department of Public Physical and Art Education, Zhejiang University, China
| | - Xiao Zhou
- School of Physical Education, Huazhong University of Science and Technology, China
| | - Jiaoqin Wang
- Capital University of Physical Education and Sports, China
| | - Zhuo Chen
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Guanrong Sun
- Department of Public Physical and Art Education, Zhejiang University, China
| | - Jingbo Sun
- School of Physical Education, Huazhong University of Science and Technology, China
| | - Hongtao Zeng
- School of Physical Education, Huazhong University of Science and Technology, China
| | - Laihong Wan
- School of Physical Education, Huazhong University of Science and Technology, China
| | - Yueying Hu
- School of Physical Education, Huazhong University of Science and Technology, China
| | - Feng Wang
- School of Physical Education, Huazhong University of Science and Technology, China
| | - Junyi Zheng
- School of Physical Education, Huazhong University of Science and Technology, China
| |
Collapse
|
35
|
Nyhus Hagum C, Tønnessen E, Hisdal J, Shalfawi SAI. The effect of progressive and individualised sport-specific training on the prevalence of injury in football and handball student athletes: a randomised controlled trial. Front Sports Act Living 2023; 5:1106404. [PMID: 37346384 PMCID: PMC10279870 DOI: 10.3389/fspor.2023.1106404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/22/2023] [Indexed: 06/23/2023] Open
Abstract
Objective To evaluate the effectiveness of communication and coordination combined with designing a progressive and individualised sport-specific training program for reducing injury prevalence in youth female and male football and handball players transitioning to a sports academy high school. An additional aim was to investigate the characteristics of the reported injuries. Methods Forty-two Norwegian athletes were randomised into an intervention or control group. Mean age, height, weight and BMI was 15.5 ± 0.5 years, 178.6 cm ± 6.3 cm, 71.3 ± 9.8 kg, 22.3 ± 2.7 BMI for the intervention group (IG) (n = 23), and 15.4 ± 0.5 years, 175.6 cm ± 6.6 cm, 67.1 ± 9.8 kg, 21.7 ± 2.4 BMI for the control group (CG) (n = 19). During the summer holiday, the intervention group received weekly progressive, individualised sport-specific training programs and weekly follow-up telephone calls from the researchers. All athletes completed a baseline questionnaire and a physical test battery. Training data and injuries were recorded prospectively for 22 weeks using the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2). A two-way chi-square (χ2) test of independence was conducted to examine the relationship between groups and injury. Results Average weekly prevalence of all injuries was 11% (95% CI: 8%-14%) in IG and 19% (95% CI: 13%-26%) in CG. Average weekly prevalence of substantial injuries was 7% (95% CI: 3%-10%) in IG and 10% (95% CI: 6%-13%) in CG. The between-group difference in injuries was significant: χ2 (1, N = 375) = 4.865, p = .031, φ = .114, with 1.8 times higher injury risk in CG vs. IG during the first 12 weeks after enrolment. Conclusions For student athletes transitioning to a sports academy high school, progressive individualised, sport-specific training programs reduced the prevalence of all-complaint injuries following enrolment. Clubs and schools should prioritise time and resources to implement similar interventions in periods where student athletes have less supervision, such as the summer holidays, to facilitate an optimal transition to a sports academy high school.
Collapse
Affiliation(s)
- Cathrine Nyhus Hagum
- Department of Education and Sports Science, University of Stavanger, Stavanger, Norway
| | - Espen Tønnessen
- Faculty of Health Sciences, Kristiania University College, Oslo, Norway
| | - Jonny Hisdal
- Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway
| | - Shaher A. I. Shalfawi
- Department of Education and Sports Science, University of Stavanger, Stavanger, Norway
| |
Collapse
|
36
|
Fältström A, Skillgate E, Tranaeus U, Weiss N, Källberg H, Lyberg V, Nomme M, Thome N, Omsland T, Pedersen E, Hägglund M, Waldén M, Asker M. Normative values and changes in range of motion, strength, and functional performance over 1 year in adolescent female football players: Data from 418 players in the Karolinska football Injury Cohort study. Phys Ther Sport 2022; 58:106-116. [DOI: 10.1016/j.ptsp.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/28/2022]
|
37
|
Robles-Palazón FJ, Ruiz-Pérez I, Aparicio-Sarmiento A, Cejudo A, Ayala F, Sainz de Baranda P. Incidence, burden, and pattern of injuries in Spanish male youth soccer players: A prospective cohort study. Phys Ther Sport 2022; 56:48-59. [PMID: 35816871 DOI: 10.1016/j.ptsp.2022.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To explore the incidence, burden, and pattern of injuries in Spanish male youth soccer players during a 9-month competitive season (from September to May-June). DESIGN Prospective cohort study. PARTICIPANTS 314 young (10-19 years) soccer players. MAIN OUTCOME MEASURES Incidence, burden, location, type, severity, mechanism, and circumstance of injuries, as well as potential differences by tactical position, month of the year, age group, and maturity status. RESULTS A total of 146 time-loss injuries were sustained by 101 different players. This resulted in an overall injury incidence of 3.1 injuries per 1000 h, a training injury incidence of 1.8 injuries per 1000 h, and a match injury incidence of 11.2 injuries per 1000 h. The probability of injury over the season was 34%. Most of the injuries affected the lower extremity and were classified as muscle/tendon injuries, with hamstring muscle injuries representing the most burdensome diagnosis. The incidence of injuries increased with age and maturation, but a heightened risk of overuse injuries during periods around peak height velocity was also identified. CONCLUSIONS These findings suggest a need for implementing specific injury prevention measures. Due to the high burden shown, these measures should mainly focus on reducing the number and severity of hamstring muscle injuries.
Collapse
Affiliation(s)
- Francisco Javier Robles-Palazón
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain; Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
| | - Iñaki Ruiz-Pérez
- Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain; Faculty of Health Sciences, University Isabel I, Burgos, Spain
| | - Alba Aparicio-Sarmiento
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain; Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
| | - Antonio Cejudo
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain; Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
| | - Francisco Ayala
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain; Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain.
| | - Pilar Sainz de Baranda
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain; Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, Murcia, Spain
| |
Collapse
|
38
|
Orhant E, Carling C, Chapellier JF, Marchand JL, Pradat PF, Elbaz A, Maniez S, Moisan F, Rochcongar P. A retrospective analysis of all-cause and cause-specific mortality rates in French male professional footballers. Scand J Med Sci Sports 2022; 32:1389-1399. [PMID: 35611613 DOI: 10.1111/sms.14195] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 04/19/2022] [Accepted: 05/06/2022] [Indexed: 10/18/2022]
Abstract
This study retrospectively compared all-cause and cause-specific mortality in French male professional football players with data from France's national population. Altogether, 6114 individuals born in Metropolitan France or in one of its overseas territories who played at least one competitive match in France's professional football championships between January 1, 1968 and December 31, 2015, were identified and followed up for vital status obtained from a national reference database until December 31, 2015. Data on all-cause and cause-specific mortality were subsequently compared to the expected number of deaths for the national population after standardization for the year, age, and sex. Ratios between observed and expected deaths provided standardized mortality ratios (SMR) along with 95% confidence intervals (95% CI). Linear trends were investigated using the Poisson trend test. Altogether, 662 player deaths were observed. All-cause mortality overall was lower than that of the national population (SMR: 0.69, 95% CI 0.64-0.75). An excess of deaths from dementia was observed in the players (SMR: 3.38, 95% CI: 2.49-4.50) whereas mortality from diseases of the nervous (SMR: 0.64, 95% CI: 0.35-1.08) and cardiovascular systems (SMR: 0.82, 95% CI: 0.70-0.96), and cancer (SMR: 0.67, 95% CI: 0.58-0.76) was lower. Lower overall mortality and that owing to common cardiovascular and cancer-related diseases were reported in French professional football players compared to France's national population. In line with previous studies, however, excess mortality from dementia was observed in the players. Career length was not associated with all-cause or cause-specific mortality. Prospective matched-cohort studies are necessary to identify the neurologic impact of participation in professional football.
Collapse
Affiliation(s)
| | | | | | - Jean-Luc Marchand
- Direction santé environnement travail, Santé publique France, Saint-Maurice, 94415, France
| | - Pierre-François Pradat
- Inserm, CNRS, Laboratoire d'Imagerie Biomedicale, Sorbonne Universite, Paris, France.,Département de Neurologie, Centre Référent SLA, Hôpital Pitié-Salpêtrière, Paris, France
| | - Alexis Elbaz
- Team "Exposome, heredity, cancer and health", Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, CESP, Villejuif, 94807, France
| | - Sandrine Maniez
- Hôpital Pitié Salpetriere, APHP, Sorbonne Université, Paris, France
| | - Frédéric Moisan
- Direction santé environnement travail, Santé publique France, Saint-Maurice, 94415, France
| | | |
Collapse
|
39
|
Llurda-Almuzara L, Pérez-Bellmunt A, Labata-Lezaun N, López-de-Celis C, Moran J, Clark NC. Sex Differences in Pre-Season Anthropometric, Balance and Range-of-Motion Characteristics in Elite Youth Soccer Players. Healthcare (Basel) 2022; 10:819. [PMID: 35627956 PMCID: PMC9140908 DOI: 10.3390/healthcare10050819] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/18/2022] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Abstract
In soccer, injury epidemiology differs between males and females. It is clinically useful to know whether there are between-sex differences in selected characteristics relevant to primary injury risk and injury prevention practices. The purpose of this study was to explore between-sex differences in anthropometric, balance, and range-of-motion characteristics in Spanish elite male and female youth soccer players. This was a pre-season cross-sectional study. Sixty-nine males (age 16.8 ± 0.9 yr; height 175.9 ± 6.8 cm; mass 67.9 ± 6.3 kg) and thirty-seven females (age 17.2 ± 1.7 yr; height 164.0 ± 6.3 cm; mass 59.0 ± 5.8 kg) participated. Anthropometrics (standing/sitting height, bodymass, right/left leg length) and right/left anterior reach test (ART), hip internal/external active range of motion, active knee extension (AKE), and weightbearing lunge test (WBLT) were measured. Between-sex differences were assessed with Bonferroni-corrected Mann−Whitney U tests and Cliff’s delta (d). Between-sex significant differences (p < 0.003, d ≥ 0.50) were observed for anthropometric data and for hip internal rotation. No between-sex significant differences were observed for ART/AKE/WBLT measures. Between-sex significant differences with large effect sizes were identified for anthropometric data and right/left hip internal rotation. The present study adds new data to the literature for young Spanish male and female soccer players. The present findings will help inform clinical reasoning processes and future injury prevention research for elite male and female youth soccer players.
Collapse
Affiliation(s)
- Luis Llurda-Almuzara
- Departamento de Ciencias Básicas, Universitat Internacional de Catalunya, 08195 Sant Cugat, Barcelona, Spain; (L.L.-A.); (A.P.-B.); (N.L.-L.)
| | - Albert Pérez-Bellmunt
- Departamento de Ciencias Básicas, Universitat Internacional de Catalunya, 08195 Sant Cugat, Barcelona, Spain; (L.L.-A.); (A.P.-B.); (N.L.-L.)
| | - Noé Labata-Lezaun
- Departamento de Ciencias Básicas, Universitat Internacional de Catalunya, 08195 Sant Cugat, Barcelona, Spain; (L.L.-A.); (A.P.-B.); (N.L.-L.)
| | - Carlos López-de-Celis
- Departamento de Fisioterapia, Universitat Internacional de Catalunya, 08195 Sant Cugat, Barcelona, Spain;
| | - Jason Moran
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, Essex, UK;
| | - Nicholas C. Clark
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester CO4 3SQ, Essex, UK;
| |
Collapse
|