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Puga TB, Schafer J, Thiel G, Scigliano N, Ruan T, Toledo A, Agbedanu PN, Treffer K. COVID-19 National Football League (NFL) Injury Analysis: Follow-Up Study. JMIRX MED 2024; 5:e45688. [PMID: 38462739 PMCID: PMC10985286 DOI: 10.2196/45688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/24/2023] [Accepted: 12/27/2023] [Indexed: 03/12/2024]
Abstract
Background In 2020, COVID-19 spread across the world and brought normal daily life to a halt, causing the shutdown of nearly everything in order to prevent its spread. The National Football League (NFL) similarly experienced shutdowns and the resulting effects, leaving athletes unable to train in some of the most advanced facilities with many of the best trainers in the world. A previous study, titled COVID-19 Return to Sport: NFL Injury Prevalence Analysis, determined that there was increased injury prevalence during the 2020 season, likely due to decreased physiological adaptations within athletes' bodies as a result of facility shutdowns. Understanding injury epidemiology is vital to the prevention of injuries and the development of return-to-play protocols. Objective The objective of this study is to perform a follow-up study to COVID-19 Return to Sport: NFL Injury Prevalence Analysis in order to examine the longitudinal effects of the COVID-19 pandemic on injury epidemiology. This study examines if there was a recovery to baseline levels of injuries or if there are still lingering effects from the COVID-19 pandemic-induced spike in injuries. Methods To determine if there was change in the number of injuries for each season, injury tallies collected from the 17-week-long 2018, 2019, and 2020 NFL regular seasons were compared with those from the 18-week-long 2021 and 2022 NFL regular seasons. A Kruskall-Wallis test with post hoc Dunn analysis was conducted to compare the rate of injuries per team per week between each of the 2018, 2019, 2020, 2021, and 2022 regular seasons. Results The Kruskall-Wallis test revealed an H statistic of 32.61 (P<.001) for the comparison of the injury rates across the 5 seasons. The post hoc Dunn analysis showed that 2020 had a statistically significant difference when compared with each of the 2018 (P<.001), 2019 (P=.04), 2021 (P=.02), and 2022 (P=.048) seasons. The 2019 season showed no statistical significance when compared with the 2021 (P=.23) and 2022 (P=.13) seasons. Conclusions The results of this follow-up study, combined with the previous study, show that extended training interruptions stemming from COVID-19 in 2020 induced detraining and led to increased injuries. Additionally, the results of this study show that retraining can occur, resulting in the development of injury protective factors, as injury rates returned to baseline levels after 2020. This is the first large-scale and long-term opportunity to demonstrate the effects of these principles and how they are important to understanding injury epidemiology.
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Affiliation(s)
- Troy B Puga
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO, United States
| | - Joshua Schafer
- School of Medicine, University of Kansas, Kansas City, KS, United States
| | - Grace Thiel
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO, United States
| | - Nicholas Scigliano
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO, United States
| | - Tiffany Ruan
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO, United States
| | - Andres Toledo
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO, United States
| | - Prince N Agbedanu
- Division of Science, Technology, Engineering, and Math, Department of Health Sciences, Friends University, Wichita, KS, United States
| | - Kevin Treffer
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Kansas City University, Kansas City, MO, United States
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Pfab F, Sieland J, Haser C, Banzer W, Kocher T. [Genetics in sports-muscle injuries]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:889-896. [PMID: 37773215 DOI: 10.1007/s00132-023-04439-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND The human genome is the complete set of genetic instructions encoded in an individual's DNA. Genetics plays an important role in the development and progression of muscle injuries. Many genes are involved in muscle development, growth, and repair, and variations in these genes can affect an athlete's susceptibility to muscle injury. SPECIFIC GENES Several genes have been linked to muscle injury, such as myostatin (MSTN), insulin-like growth factor 1 (IGF-1), and several collagen genes (COL). In addition to genes involved in muscle development, growth, and repair, genes involved in inflammation and pain signaling, such as tumor necrosis factor alpha (TNF-α), mu opioid receptor (OPRM1), and interleukin (IL) genes, may also play a role in the development and progression of muscle injury. GENETIC TESTS Genetic testing can be a helpful tool in the prevention of muscle injuries in athletes. Testing for variations in genes associated with muscle development, repair, and growth, as well as collagen formation, can provide valuable information about an athlete's susceptibility to muscle injury. It is important to note that while genetic testing can provide valuable information for injury prevention, it is only one piece of the puzzle. Other factors such as an individual's training history, general health, and lifestyle habits also play a role in injury risk. Therefore, all injury prevention strategies should be individualized and based on a comprehensive assessment of all relevant factors.
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Affiliation(s)
- Florian Pfab
- Technische Universität München, München, Deutschland.
- MedZentrum Residenz, Residenzstr. 9, 80333, München, Deutschland.
- Eintracht Frankfurt Fußball AG, Frankfurt am Main, Deutschland.
- DNathlete AG, Schaan, Liechtenstein.
| | - Johanna Sieland
- Eintracht Frankfurt Fußball AG, Frankfurt am Main, Deutschland
| | - Christian Haser
- Eintracht Frankfurt Fußball AG, Frankfurt am Main, Deutschland
| | - Winfried Banzer
- Abteilung Präventiv- und Sportmedizin, Institut für Arbeits‑, Sozial- und Umweltmedizin, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Thomas Kocher
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020, Salzburg, Österreich
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Konopka MJ, Sperlich B, Rietjens G, Zeegers MP. Genetics and athletic performance: a systematic SWOT analysis of non-systematic reviews. Front Genet 2023; 14:1232987. [PMID: 37621703 PMCID: PMC10445150 DOI: 10.3389/fgene.2023.1232987] [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: 06/08/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
Exercise genetics/genomics is a growing research discipline comprising several Strengths and Opportunities but also deals with Weaknesses and Threats. This "systematic SWOT overview of non-systematic reviews" (sSWOT) aimed to identify the Strengths, Weaknesses, Opportunities, and Threats linked to exercise genetics/genomics. A systematic search was conducted in the Medline and Embase databases for non-systematic reviews to provide a comprehensive overview of the current literature/research area. The extracted data was thematically analyzed, coded, and categorized into SWOT clusters. In the 45 included reviews five Strengths, nine Weaknesses, six Opportunities, and three Threats were identified. The cluster of Strengths included "advances in technology", "empirical evidence", "growing research discipline", the "establishment of consortia", and the "acceptance/accessibility of genetic testing". The Weaknesses were linked to a "low research quality", the "complexity of exercise-related traits", "low generalizability", "high costs", "genotype scores", "reporting bias", "invasive methods", "research progress", and "causality". The Opportunities comprised of "precision exercise", "omics", "multicenter studies", as well as "genetic testing" as "commercial"-, "screening"-, and "anti-doping" detection tool. The Threats were related to "ethical issues", "direct-to-consumer genetic testing companies", and "gene doping". This overview of the present state of the art research in sport genetics/genomics indicates a field with great potential, while also drawing attention to the necessity for additional advancement in methodological and ethical guidance to mitigate the recognized Weaknesses and Threats. The recognized Strengths and Opportunities substantiate the capability of genetics/genomics to make significant contributions to the performance and wellbeing of athletes.
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Affiliation(s)
- Magdalena Johanna Konopka
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
| | - Billy Sperlich
- Integrative and Experimental Exercise Science and Training, Institute of Sport Science, University of Würzburg, Würzburg, Germany
| | - Gerard Rietjens
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maurice Petrus Zeegers
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
- School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
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Semenova EA, Hall ECR, Ahmetov II. Genes and Athletic Performance: The 2023 Update. Genes (Basel) 2023; 14:1235. [PMID: 37372415 DOI: 10.3390/genes14061235] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Phenotypes of athletic performance and exercise capacity are complex traits influenced by both genetic and environmental factors. This update on the panel of genetic markers (DNA polymorphisms) associated with athlete status summarises recent advances in sports genomics research, including findings from candidate gene and genome-wide association (GWAS) studies, meta-analyses, and findings involving larger-scale initiatives such as the UK Biobank. As of the end of May 2023, a total of 251 DNA polymorphisms have been associated with athlete status, of which 128 genetic markers were positively associated with athlete status in at least two studies (41 endurance-related, 45 power-related, and 42 strength-related). The most promising genetic markers include the AMPD1 rs17602729 C, CDKN1A rs236448 A, HFE rs1799945 G, MYBPC3 rs1052373 G, NFIA-AS2 rs1572312 C, PPARA rs4253778 G, and PPARGC1A rs8192678 G alleles for endurance; ACTN3 rs1815739 C, AMPD1 rs17602729 C, CDKN1A rs236448 C, CPNE5 rs3213537 G, GALNTL6 rs558129 T, IGF2 rs680 G, IGSF3 rs699785 A, NOS3 rs2070744 T, and TRHR rs7832552 T alleles for power; and ACTN3 rs1815739 C, AR ≥21 CAG repeats, LRPPRC rs10186876 A, MMS22L rs9320823 T, PHACTR1 rs6905419 C, and PPARG rs1801282 G alleles for strength. It should be appreciated, however, that elite performance still cannot be predicted well using only genetic testing.
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Affiliation(s)
- Ekaterina A Semenova
- Department of Molecular Biology and Genetics, Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, 119435 Moscow, Russia
- Research Institute of Physical Culture and Sport, Volga Region State University of Physical Culture, Sport and Tourism, 420138 Kazan, Russia
| | - Elliott C R Hall
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4UA, UK
| | - Ildus I Ahmetov
- Laboratory of Genetics of Aging and Longevity, Kazan State Medical University, 420012 Kazan, Russia
- Sports Genetics Laboratory, St Petersburg Research Institute of Physical Culture, 191040 St. Petersburg, Russia
- Department of Physical Education, Plekhanov Russian University of Economics, 115093 Moscow, Russia
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 5AF, UK
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Alvero-Cruz JR, Alarcón-Martín E, García-Romero J, Ruiz-Galdon M, Carrillo-Albornoz-Gil M, Polvillo R, González I, Reyes-Engel A, Royo JL. Moderate exercise reveals the influence of ACTN3 R577X and ACE I/D polymorphisms on physical performance in non-athlete active subjects. Gene 2023; 850:146958. [DOI: 10.1016/j.gene.2022.146958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/13/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
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de Almeida KY, Cetolin T, Marrero AR, Aguiar Junior AS, Mohr P, Kikuchi N. A Pilot Study on the Prediction of Non-Contact Muscle Injuries Based on ACTN3 R577X and ACE I/D Polymorphisms in Professional Soccer Athletes. Genes (Basel) 2022; 13:2009. [PMID: 36360246 PMCID: PMC9690673 DOI: 10.3390/genes13112009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 09/28/2023] Open
Abstract
Muscle injuries are among the main reasons for medical leavings of soccer athletes, being a major concern within professional teams and their prevention associated with sport success. Several factors are associated with a greater predisposition to injury, and genetic background is increasingly being investigated. The aim of this study was to analyze whether ACTN3 R577X and ACE I/D polymorphisms are predictors of the incidence and severity of muscle injury in professional soccer athletes from Brazil, individually and in association. Eighty-three professional athletes from the first and second divisions of the Brazilian Championship were evaluated regarding the polymorphisms through blood samples. Nighty-nine muscle injuries were identified during the seasons of 2018, 2019 and 2020 and categorized according to severity. ACTN3 XX individuals had a higher frequency of severe injuries compared to the RX and RR genotypes (p = 0.001), and in the dominant model (compared to RX+RR), with p < 0.001. The trend p-value test showed an increased number of injuries/season following the order XX > RX > RR (p = 0.045). Those with the ACE II genotype had almost 2 fold the number of injuries per season compared to those with the ID+DD genotypes (p = 0.03). Logistic regression showed that the polymorphisms are predictors of the development of severe injury (ACTN3 R577X model with p = 0.004, R2: 0.259; ACE I/D model with p = 0.045, R2: 0.163), where ACTN3 XX individuals were more likely to suffer from severe injury (OR: 5.141, 95% CI: 1.472-17.961, p = 0.010). The combination of the ACTN3 577X allele and the ACE II genotype showed an increased number of injuries per season, enhanced by 100% (1.682 injuries/season versus 0.868 injuries/season, p = 0.016). Our findings suggest that both polymorphisms ACTN3 R577X and ACE I/D (and their interaction) are associated with the susceptibility and severity of non-contact muscle injury in soccer players.
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Affiliation(s)
- Kathleen Y. de Almeida
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan
| | - Tiago Cetolin
- Graduate Program in Neurosciences, Federal University of Santa Catarina, Araranguá 88905-120, Brazil
| | - Andrea Rita Marrero
- Graduate Program in Cell and Developmental Biology, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | | | - Pedro Mohr
- Sports Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Naoki Kikuchi
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan
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Jacob Y, Anderton RS, Cochrane Wilkie JL, Rogalski B, Laws SM, Jones A, Spiteri T, Hince D, Hart NH. Genetic Variants within NOGGIN, COL1A1, COL5A1, and IGF2 are Associated with Musculoskeletal Injuries in Elite Male Australian Football League Players: A Preliminary Study. SPORTS MEDICINE - OPEN 2022; 8:126. [PMID: 36219268 PMCID: PMC9554075 DOI: 10.1186/s40798-022-00522-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/29/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Australian Football is a dynamic team sport that requires many athletic traits to succeed. Due to this combination of traits, as well as technical skill and physicality, there are many types of injuries that could occur. Injuries are not only a hindrance to the individual player, but to the team as a whole. Many strength and conditioning personnel strive to minimise injuries to players to accomplish team success. PURPOSE To investigate whether selected polymorphisms have an association with injury occurrence in elite male Australian Football players. METHODS Using DNA obtained from 46 elite male players, we investigated the associations of injury-related polymorphisms across multiple genes (ACTN3, CCL2, COL1A1, COL5A1, COL12A1, EMILIN1, IGF2, NOGGIN, SMAD6) with injury incidence, severity, type (contact and non-contact), and tissue (muscle, bone, tendon, ligament) over 7 years in one Australian Football League team. RESULTS A significant association was observed between the rs1372857 variant in NOGGIN (p = 0.023) and the number of total muscle injuries, with carriers of the GG genotype having a higher estimated number of injuries, and moderate, or combined moderate and high severity rated total muscle injuries. The COL5A1 rs12722TT genotype also had a significant association (p = 0.028) with the number of total muscle injuries. The COL5A1 variant also had a significant association with contact bone injuries (p = 0.030), with a significant association being found with moderate rated injuries. The IGF2 rs3213221-CC variant was significantly associated with a higher estimated number of contact tendon injuries per game (p = 0.028), while a higher estimated number of total ligament (p = 0.019) and non-contact ligament (p = 0.002) injuries per game were significantly associated with carriage of the COL1A1 rs1800012-TT genotype. CONCLUSIONS Our preliminary study is the first to examine associations between genetic variants and injury in Australian Football. NOGGIN rs1372857-GG, COL5A1 rs12722-TT, IGF2 rs3213221-CC, and COL1A1 rs1800012-TT genotypes held various associations with muscle-, bone-, tendon- and ligament-related injuries of differing severities. To further increase our understanding of these, and other, genetic variant associations with injury, competition-wide AFL studies that use more players and a larger array of gene candidates is essential.
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Affiliation(s)
- Ysabel Jacob
- grid.1038.a0000 0004 0389 4302School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Ryan S. Anderton
- grid.266886.40000 0004 0402 6494Institute for Health Research, University of Notre Dame Australia, Perth, WA Australia ,grid.266886.40000 0004 0402 6494School of Health Science, University of Notre Dame Australia, Perth, WA Australia
| | - Jodie L. Cochrane Wilkie
- grid.1038.a0000 0004 0389 4302School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia ,grid.1038.a0000 0004 0389 4302Exercise Medicine Research Institute, Edith Cowan University, WA Perth, Australia
| | | | - Simon M. Laws
- grid.1038.a0000 0004 0389 4302Centre for Precision Health, Edith Cowan University, Perth, WA Australia ,grid.1038.a0000 0004 0389 4302Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia ,grid.1032.00000 0004 0375 4078School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA Australia
| | - Anthony Jones
- West Coast Eagles Football Club, Perth, WA Australia
| | - Tania Spiteri
- grid.1038.a0000 0004 0389 4302School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia
| | - Dana Hince
- grid.266886.40000 0004 0402 6494Institute for Health Research, University of Notre Dame Australia, Perth, WA Australia
| | - Nicolas H. Hart
- grid.1038.a0000 0004 0389 4302School of Medical and Health Sciences, Edith Cowan University, Perth, WA Australia ,grid.266886.40000 0004 0402 6494Institute for Health Research, University of Notre Dame Australia, Perth, WA Australia ,grid.1038.a0000 0004 0389 4302Exercise Medicine Research Institute, Edith Cowan University, WA Perth, Australia ,grid.1014.40000 0004 0367 2697Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia ,grid.1024.70000000089150953Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, QLD Australia
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