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Hansoulle T, Peters-Dickie JL, Mahaudens P, Nguyen AP. Do we underestimate the frequency of ankle sprains in running? A systematic review and meta-analysis. Phys Ther Sport 2024; 68:60-70. [PMID: 38963954 DOI: 10.1016/j.ptsp.2024.06.009] [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: 04/15/2024] [Revised: 06/28/2024] [Accepted: 06/29/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE To provide a systematic review and meta-analysis of the proportion of ankle sprains in running practices. DESIGN Systematic review and meta-analysis. MAIN OUTCOME MEASURES We calculated the weighted summary proportion and conducted meta-analyses for runners, considering levels (elite/recreational) and disciplines (distance, track, cross-country, trail, and orienteering). RESULTS 32 studies were included in the systematic review and 19 were included in the meta-analysis with a level of quality ranging from poor to good. Proportion of ankle sprains in runners was 13.69% (95%CI = 7.40-21.54; I2 = 98.58%) in global, 12.20% (95%CI = 5.24-21.53; I2 = 89.31%) in elite, 19.40% (95%CI = 10.05-30.90; I2 = 99.09%) in recreational, 8.51% (95%CI = 4.22-14.12; I2 = 96.15%) in distance, 67.42% (95%CI = 0.50-82.85; I2 = 99.36%) in track, 27.07% (95%CI = 12.48-44.81; I2 = 97.97%) in cross-country, and 25.70% (95%CI = 19.87-32.14; I2 = 0.00) in orienteering. CONCLUSIONS Running practice results in significant proportion rate of ankle sprains. Recreational runners exhibit higher proportion than elite. Running disciplines, especially track, cross-country, and orienteering, influence reported ankle sprain rates, surpassing those of distance runners.
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Affiliation(s)
- Thomas Hansoulle
- Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 52, B-1200, Brussels, Belgium.
| | - Jean-Louis Peters-Dickie
- Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 52, B-1200, Brussels, Belgium; Katholieke Universiteit Leuven, Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Spoorwegstraat 12, B-8200, Sint-Michiels, Belgium; KU Leuven, Universitary Hospital Pellenberg, Clinical Motion Analysis Laboratorium (CMAL), Weligerveld 1, B-3212, Lubbeek, Belgium.
| | - Philippe Mahaudens
- Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 52, B-1200, Brussels, Belgium.
| | - Anh Phong Nguyen
- Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 52, B-1200, Brussels, Belgium; The Running Clinic, lac Beauport, Quebec, Canada.
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Gureck AE, Crockett Z, Barsky BW, Samuels S, Frank JS, Storer SK, Fazekas ML. Do Differences Exist in Impact Test Domains between Youth Athletes with and without an Anterior Cruciate Ligament Injury? Healthcare (Basel) 2023; 11:2764. [PMID: 37893838 PMCID: PMC10606848 DOI: 10.3390/healthcare11202764] [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: 09/13/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Poor baseline reaction time, as measured via the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), has been associated with anterior cruciate ligament (ACL) injury risk in adult athletes. Our study sought to determine whether the reaction time and impulse control ImPACT test domains differed between ACL injured and uninjured pediatric athletes. A total of 140 high-school aged athletes comprising 70 athletes who went on to sustain an ACL injury between 2012 and 2018 and 70 age- and sex-matched uninjured controls were included in the study. Mean reaction times were similar for the injured (0.67 s) and uninjured (0.66 s) athletes (p = 0.432), and the impulse control scores were also similar for those with (5.67) and without (6.07) an ACL injury (p = 0.611). Therefore, neurocognitive risk factors for sustaining an ACL injury in adults cannot necessarily be extrapolated to adolescent athletes. Further research is needed to understand why differences exist between injury risk in youth and adult athletes.
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Affiliation(s)
- Ashley E. Gureck
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
| | - Zack Crockett
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
| | - Brandon W. Barsky
- Department of Sports Medicine, Kettering Health, Kettering, OH 45429, USA
| | - Shenae Samuels
- Memorial Healthcare System, Office of Human Research, Hollywood, FL 33021, USA
| | - Jeremy S. Frank
- Department of Orthopaedic Surgery and Sports Medicine, JoeDiMaggio Children’s Hospital, Hollywood, FL 33021, USA
| | - Stephen K. Storer
- Department of Orthopaedic Surgery and Sports Medicine, JoeDiMaggio Children’s Hospital, Hollywood, FL 33021, USA
| | - Matthew L. Fazekas
- Department of Orthopaedic Surgery and Sports Medicine, JoeDiMaggio Children’s Hospital, Hollywood, FL 33021, USA
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Biomechanical and Musculoskeletal Measurements as Risk Factors for Running-Related Injury in Non-elite Runners: A Systematic Review and Meta-analysis of Prospective Studies. SPORTS MEDICINE - OPEN 2022; 8:38. [PMID: 35254562 PMCID: PMC8901814 DOI: 10.1186/s40798-022-00416-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 01/31/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Running-related injury (RRI) is highly prevalent among recreational runners and is a key barrier to participation. Atypical lower limb alignment and mechanical function have been proposed to play a role in development of lower extremity injury. The purpose of this study was to investigate relationships between incidence of running-related injury (RRI) in non-elite runners with biomechanical and musculoskeletal variables. METHODS A systematic review and meta-analysis of prospective studies. Published research indexed in MEDLINE, EMBASE, CINAHL, SPORTDiscus, AMED, and The Cochrane library until 13th January 2021, grey literature, and reference lists of included studies were screened to identify prospective studies of non-elite adult runners that measured a relationship between biomechanical or musculoskeletal measures and incidence of RRI. RESULTS Thirty studies (3404 runners), testing over 100 discrete biomechanical and musculoskeletal risk factors for RRI, were included. Nineteen studies were pooled in twenty-five separate meta-analyses. Meta-analysis of four studies detected significantly less knee extension strength among runners who developed a RRI (SMD - 0.19, 95% CI - 0.36 to - 0.02, p = 0.03), though this may not be clinically important. A meta-analysis of two studies detected significantly lower hip adduction velocity among runners who developed a RRI (MD - 12.80, 95% CI - 25.22 to - 0.38, p = 0.04). Remaining meta-analyses found no significant relationship between biomechanical or musculoskeletal variables and RRI. CONCLUSION This systematic review and meta-analysis found the currently available literature does not generally support biomechanical or musculoskeletal measures as risk factors for RRI in non-elite runners. While meta-analysis findings for knee extension strength and hip adduction velocity as risk factors for RRI were statistically significant, the associated trivial to small effects sizes suggest these findings should be treated with caution. Until further evidence emerges, recommendations for injury prevention in non-elite runners cannot be made based on biomechanical and musculoskeletal measurements alone.
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Tao H, Thompson C, Weber S. Can a Modified Y-Balance Test Predict Running Overuse Injuries over the Course of a Division I Collegiate Cross-Country Season? Int J Sports Phys Ther 2021; 16:1434-1441. [PMID: 34909250 PMCID: PMC8637294 DOI: 10.26603/001c.29871] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/28/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Collegiate distance runners often suffer from running overuse injuries (ROI). The Y-Balance Test (YBT) has the potential to predict ROI risk in collegiate runners. PURPOSE To investigate whether a preseason clinical assessment of dynamic balance, through a modified version of the YBT (mYBT), can predict risk of ROIs during one NCAA Division I cross-country (XC) season. STUDY DESIGN Prospective case-control study. METHODS Participants from a Division I XC team were screened for mYBT performance in four directions: anterior (AN), posteromedial (PM), posterolateral (PL), and posterior (PO). ROIs were tracked over the course of the XC season. Receiver operating characteristic (ROC) curve analysis (α = 0.05) was utilized to investigate the effectiveness of the mYBT in predicting injury risk. RESULTS Nine (5 female, 4 male) of 29 runners developed an ROI during the XC season. Five components of the mYBT were found to predict injuries, including normalized nondominant PO score (AUC = 0.756, p = 0.03; RR = 1.90), AN raw difference and limb asymmetry (AUC = 0.808, p = 0.01), and PM raw difference and limb asymmetry in males (AUC = 0.958, p = 0.02). CONCLUSION Specific components of the mYBT can help predict the risk of developing a running overuse injury over one Division I XC season. LEVEL OF EVIDENCE Screening, Level 3.
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Affiliation(s)
- Hanz Tao
- Physical Therapy, University of South Dakota
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Schweda S, Leyhr D, Krauß I. The Functional Movement Screen as an injury prediction tool for German physical education and exercise science students: a prospective cohort-study. PHYSIOSCIENCE 2021. [DOI: 10.1055/a-1307-1459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Background Several studies have evaluated the applicability of the Functional Movement Screen (FMS) as a screening tool for injury prediction. However, only few studies investigate gender differences for FMS as a screening tool for female and male college students.
Objective To evaluate gender differences in FMS single items and the overall score. In addition, the applicability of FMS as a diagnostic tool for injury prevention of German exercise students will be investigated.
Method N = 99 college students performed an FMS at the beginning of the semester. Injuries were recorded for the entire term. Gender differences of FMS single items were assessed using the Mann-Whitney-U-Test. Differences in injury prediction were calculated using logistic regression. If the model was statistically significant, diagnostic accuracy was calculated using receiver operating characteristic (ROC) curves and the area under the curve (AUC). The Youden index was used to identify a cut-off score. 2 × 2 contingency tables, sensitivity and specifity, positive/negative predictive values, and likelihood ratios were assessed.
Results There were significant gender differences for Deep Squat, Shoulder Mobility, Trunk Stability Push Up, and Active Straight Leg Raise. The logistic regression showed that the composite score was statistically significant in clarifying the model for females (p = 0.005, RN
2 = 0.14), but not for males (p = 0.18, RN
2 = 0.04). The ROC curve indicated acceptable injury prediction in females (AUC: 0.66, p = 0.02) and poor injury prediction in males (AUC: 0.40, p = 0.19). The cut-off score of ≤ 16 for females resulted in a sensitivity of 63 % and specificity of 54 %. No cut-off score was calculated for males.
Conclusion Females performed better on flexibility items, while males scored higher on strength exercises. Results of the study indicate low predictive accuracy. Therefore, no solid recommendation can be made for the use of the FMS as an injury screening tool for either female or male German exercise science students.
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Affiliation(s)
- Simone Schweda
- Medical Clinic Tuebingen, Department of Sports Medicine, Germany
| | - Daniel Leyhr
- Eberhard Karls University Tuebingen, Faculty of Economic and Social Science, Department of Sport Science, Germany
| | - Inga Krauß
- Interfaculty Research Institute for Sports and Physical Activity Tuebingen, Germany
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Camelio K, Gruber AH, Powell DW, Paquette MR. Influence of Prolonged Running and Training on Tibial Acceleration and Movement Quality in Novice Runners. J Athl Train 2020; 55:1292-1299. [PMID: 32946571 DOI: 10.4085/1062-6050-0491.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Changes in lower limb loading and movement quality after prolonged running and training periods might influence injury risks in runners. OBJECTIVES To assess (1) the effects of a single prolonged run and a 3-week running training program on peak tibial acceleration (PTA) during running and Functional Movement Screen (FMS) criterion tests, and (2) the relationship between running volume during the 3-week training program and changes in PTA and FMS scores after training. DESIGN Case series. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Ten novice runners (age = 27 ± 7 years) with 15 ± 14 months of running experience, who ran on average 19.6 ± 4.8 km per week at a preferred pace of 7:05 ± 1:30 minutes per km. MAIN OUTCOME MEASURE(S) Participants completed a 30-minute submaximal prolonged treadmill run and 3-week training program with 25% increases in weekly running volume. Peak tibial acceleration and the deep-squat and active straight-leg-raise criterion FMS test scores were assessed before and after the prolonged run at enrollment and after the training program (ie, 3 testing sessions). RESULTS No differences in PTA or FMS scores were observed among the 3 testing times. Although the changes in PTA (r = 0.57) and FMS aggregate score (r = 0.15) were not significantly correlated with training volume, training volume explained 32% of the variance in the PTA change from before to after training. CONCLUSIONS Our findings suggest that tibial acceleration and movement quality were not influenced by a single submaximal-effort prolonged run or a 3-week training period. However, novice runners who have a greater increase in running volume might be more susceptible to training-related changes in tibial acceleration than those whose running volume is less.
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Affiliation(s)
- Kris Camelio
- College of Health Sciences, University of Memphis, TN
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Moore E, Chalmers S, Milanese S, Fuller JT. Factors Influencing the Relationship Between the Functional Movement Screen and Injury Risk in Sporting Populations: A Systematic Review and Meta-analysis. Sports Med 2020; 49:1449-1463. [PMID: 31104227 DOI: 10.1007/s40279-019-01126-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Studies investigating the association between the Functional Movement Screen (FMS) and sports injury risk have reported mixed results across a range of athlete populations. OBJECTIVES The purpose of this systematic review was to identify whether athlete age, sex, sport type, injury definition and mechanism contribute to the variable findings. STUDY DESIGN Systematic review and meta-analysis. METHODS A systematic search was conducted in October 2018 using PubMed, EBSCOhost, Scopus, EmBase and Web of Science databases. Studies were included if they were peer reviewed and published in English language, included athletes from any competition level, performed the FMS at baseline to determine risk groups based on FMS composite score, asymmetry or pain, and prospectively observed injury incidence during training and competition. Study eligibility assessment and data extraction was performed by two reviewers. Random effects meta-analyses were used to determine odds ratio (OR), sensitivity and specificity with 95% confidence intervals. Sub-group analyses were based on athlete age, sex, sport type, injury definition, and injury mechanism. RESULTS Twenty-nine studies were included in the FMS composite score meta-analysis. There was a smaller effect for junior (OR = 1.03 [0.67-1.59]; p = 0.881) compared to senior athletes (OR = 1.80 [1.17-2.78]; p = 0.008) and for male (OR = 1.79 [1.08-2.96]; p = 0.024) compared to female (OR = 1.92 [0.43-8.56]; p = 0.392) athletes. FMS composite scores were most likely to be associated with increased injury risk in rugby (OR = 5.92 [1.67-20.92]; p = 0.006), and to a lesser extent American football (OR = 4.41 [0.94-20.61]; p = 0.059) and ice hockey (OR = 3.70 [0.89-15.42]; p = 0.072), compared to other sports. Specificity values were higher than sensitivity values for FMS composite score. Eleven studies were included in the FMS asymmetry meta-analysis with insufficient study numbers to generate sport type subgroups. There was a larger effect for senior (OR = 1.78 [1.16-2.73]; p = 0.008) compared to junior athletes (OR = 1.21 [0.75-1.96]; p = 0.432). Sensitivity values were higher than specificity values for FMS asymmetry. For all FMS outcomes, there were minimal differences across injury definitions and mechanisms. Only four studies provided information about FMS pain and injury risk. There was a smaller effect for senior athletes (OR = 1.28 [0.33-4.96]; p = 0.723) compared to junior athletes (OR = 1.71 [1.16-2.50]; p = 0.006). Specificity values were higher than sensitivity values for FMS pain. CONCLUSION Athlete age, sex and sport type explained some of the variable findings of FMS prospective injury-risk studies. FMS composite scores and asymmetry were more useful for estimating injury risk in senior compared to junior athletes. Effect sizes tended to be small except for FMS composite scores in rugby, ice hockey and American football athletes. PROTOCOL REGISTRATION CRD42018092916.
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Affiliation(s)
- Emma Moore
- International Centre for Allied Health Evidence (iCAHE), University of South Australia, GPO Box 2471, Adelaide, SA, 5000, Australia.
| | - Samuel Chalmers
- Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia.,Sport and Exercise Science, School of Science and Health, Western Sydney University, Sydney, NSW, Australia
| | - Steve Milanese
- International Centre for Allied Health Evidence (iCAHE), University of South Australia, GPO Box 2471, Adelaide, SA, 5000, Australia
| | - Joel T Fuller
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
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