1
|
Crotti M, Heering T, Lander N, Fox A, Barnett LM, Duncan MJ. Extrinsic Risk Factors for Primary Noncontact Anterior Cruciate Ligament Injury in Adolescents Aged between 14 and 18 years: A Systematic Review. Sports Med 2024; 54:875-894. [PMID: 38236505 DOI: 10.1007/s40279-023-01975-1] [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: 11/20/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Adolescents present a high incidence of ACL injury compared with other age groups. Examining the risk factors that predispose adolescents to primary noncontact ACL injury is a key strategy to decrease the number of injuries in this population. OBJECTIVE The aim of this systematic review was to summarise the existing literature investigating extrinsic risk factors that have been linked with primary noncontact ACL injury risk (identified either using ACL injury occurrence or using screening tests measuring biomechanical mechanisms for noncontact ACL injury) in adolescents including research investigating: (1) the association between extrinsic risk factors and primary noncontact ACL injury risk; and (2) whether primary noncontact ACL injury risk was different in populations or groups exposed to different extrinsic risk factors in adolescents. METHODS The same search strategy was used in MEDLINE, SPORTDiscus, CINAHL, PubMed and Embase. Articles were included if: written in English; published in peer-reviewed journals; investigating and discussing primary noncontact ACL injury risk associated with extrinsic risk factors; they were original research articles with an observational design; and participants presented a mean age ranging between 14 and 18 years. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies (QATOCCS) was used to assess the quality and risk of bias of the articles included in this systematic review. RESULTS The systematic review included 16 eligible articles published up to August 2022 about extrinsic risk factors for primary noncontact ACL injury including: sport (8 studies); sport exposure amount (5); sport level (3); sport season (1); environment (2); equipment (1). Differences in biomechanical risk factors predisposing to ACL injury were reported by sport in female adolescents playing basketball and soccer; however, no good evidence of differences in primary noncontact ACL injury rate by sport was reported in both male and female adolescents. There was contrasting evidence about associations between sport exposure and biomechanical and neuromuscular risk factors predisposing to ACL injury or primary noncontact ACL injury rate in both male and female adolescent players from different sports. There was weak evidence of differences in biomechanical risk factors predisposing to ACL injury by environmental condition in both male and female adolescents playing soccer and season phase in male adolescents playing basketball. Lastly, few good-quality articles suggested that higher sport level might be associated with increased primary noncontact ACL injury rate in female adolescents playing basketball and floorball and that bracing might not prevent primary noncontact ACL injuries in both male and female adolescent players from different sports. DISCUSSION The findings emphasise the need for further research to clarify the evidence about extrinsic risk factors and primary noncontact ACL injury in adolescents to develop ACL injury prevention guidelines that would help practitioners and researchers identify adolescents at risk and design future interventions. Future epidemiological studies should collect data about extrinsic factors as well as data about primary noncontact injury separately from secondary injuries or contact injuries to better inform primary noncontact ACL injury prevention in adolescents. REGISTRATION https://doi.org/10.17605/OSF.IO/VM82F (11/08/2021).
Collapse
Affiliation(s)
- Matteo Crotti
- Centre for Physical Activity, Sport and Exercise Science, Coventry University, Coventry, UK.
| | - Theresa Heering
- Centre for Physical Activity, Sport and Exercise Science, Coventry University, Coventry, UK
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Natalie Lander
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Aaron Fox
- School of Exercise and Nutrition Science, Deakin University, Melbourne, VIC, Australia
| | - Lisa M Barnett
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Michael J Duncan
- Centre for Physical Activity, Sport and Exercise Science, Coventry University, Coventry, UK
| |
Collapse
|
2
|
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
|
3
|
Mohammadi H, Ghaffari R, Kazemi A, Bennett H, Hosseinzadeh M. Evaluation of the Value of the Y-Balance Test to Predict Lower Limb Injuries in Professional Male Footballers. J Sport Rehabil 2024; 33:33-39. [PMID: 37875255 DOI: 10.1123/jsr.2023-0139] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 10/26/2023]
Abstract
CONTEXT The aim of this prospective cohort study was to identify whether Y-Balance Test (YBT) performance and asymmetry are associated with lower limb injury in elite adult football athletes. DESIGN A prospective cohort study. METHODS Preseason YBT measures were obtained from 121 male footballers participating in National League One across the 2021-2022 season. Lower limb injuries were tracked across the season to determine the relationship between YBT variables and injury incidence using logistic regression analysis. The statistical significance level was .05. RESULTS The average YBT score was 111.0 (5.8) cm on the left limb and 112.0 (5.5) cm on the right limb, with an average asymmetry of 2.3 (1.4) cm. Athletes with lower YBT scores on both the left (odds ratio = 2.9; 95% confidence interval, 1.7 to 4.8: P ≤ .001) and right (odds ratio = 2.3; 95% confidence interval, 1.6 to 3.2: P ≤ .001) limbs were at a greater risk of injury. Similarly, athletes with greater amounts of asymmetry were also more likely to get injured (odds ratio = 2.1; 95% confidence interval, 1.3 to 3.3: P = .002). CONCLUSIONS Results indicate that lower and asymmetrical YBT scores have a significant relationship with future lower limb injuries in professional male footballers. The YBT offers a simple, reliable, and effective screening tool that can be used by practitioners in football to help identify players at a greater risk of injury before the season commences.
Collapse
Affiliation(s)
- Haniyeh Mohammadi
- 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
| | - Hunter Bennett
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Mahdi Hosseinzadeh
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran, Iran
| |
Collapse
|
4
|
Richardson MC, English B, Chesterton P. The use of sand as an alternative surface for training, injury prevention and rehabilitation in English professional football and barriers to implementation: a cross-sectional survey of medical staff. SCI MED FOOTBALL 2023; 7:413-421. [PMID: 36107139 DOI: 10.1080/24733938.2022.2125566] [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] [Accepted: 09/12/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE The purpose of the present study was to investigate the use of sand as an alternative surface for training, injury prevention and rehabilitation interventions in English professional football. A Secondary aim was to explore the potential barriers to implementation. MATERIALS AND METHODS All 92 teams from the male English professional football pyramid during the 2021-22 season were eligible to take part. A cross-sectional survey of the medical personnel (one per club) was conducted between June 2021 and December 2021 based on the RE-AIM framework. A total of 58 respondents (63% of all clubs) completed the survey. RESULTS AND CONCLUSIONS Only 18 (31%) of the clubs surveyed used sand-based interventions across the last 3 seasons. Respondents felt sand-based interventions would be effective at improving physiological gains (median 4, interquartile range [IQR] 4-5) and as part of injury prevention and rehabilitation strategies (4, IQR 3-4) but were indifferent in relation to its potential to improve sporting performance (3, IQR 3-4). Barriers to implementation of sand-based interventions within wider football were a lack of facilities, lack of awareness of its potential benefits, lack of high-quality evidence and the surface not being specific to the sport. Medical staff also did not perceive that coaches' positively viewed sand interventions as a training or injury management strategy.
Collapse
Affiliation(s)
- Mark C Richardson
- Allied Health Professions Department, School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Bryan English
- Head of Medicine, Leicester City Football Club Training Ground, Seagrave, Loughborough, UK
| | - Paul Chesterton
- Allied Health Professions Department, School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| |
Collapse
|
5
|
Hoppe MW, Brochhagen J, Tischer T, Beitzel K, Seil R, Grim C. Risk factors and prevention strategies for shoulder injuries in overhead sports: an updated systematic review. J Exp Orthop 2022; 9:78. [PMID: 35971013 PMCID: PMC9378805 DOI: 10.1186/s40634-022-00493-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The aim of this systematic review was to update the knowledge on risk factors and prevention strategies for shoulder injuries in overhead sports with special emphasis on methodological quality. METHODS All methodological procedures were performed in line with a previous systematic review by Asker et al. (2018). The literature search was conducted in the PubMed, Google Scholar, Cochrane, and SPORT-Discuss databases. Due to the risk of bias assessment, only studies with at least an acceptable methodological quality were included. A best-evidence synthesis was performed to clarify the evidence and direction of the risk factors and prevention strategies. RESULTS A total of nine studies were included in the data extraction process. One study had a high and eight studies had an acceptable methodological quality. Seven cohort studies investigated risk factors and two randomised controlled trails evaluated prevention strategies. Moderate evidence was found for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) that were associated with the shoulder injury risk. All further risk factors had moderate and no association with risk (shoulder rotational ROM, joint position sense) or limited (history of shoulder/elbow pain, age, training experience, training volume, school grade, playing level), and conflicting evidence (setting). CONCLUSIONS There is moderate evidence for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) being associated with the shoulder injury risk in overhead sports.
Collapse
Affiliation(s)
- Matthias Wilhelm Hoppe
- Movement and Training Science, Leipzig University, Jahnallee 59, 04109, Leipzig, Germany.
| | - Joana Brochhagen
- Movement and Training Science, Leipzig University, Jahnallee 59, 04109, Leipzig, Germany
| | - Thomas Tischer
- Clinic for Orthopaedics and Trauma Surgery, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany.,Department of Orthopaedics, University Medical Centre Rostock, Rostock, Germany
| | | | - Romain Seil
- Department of Orthopaedic Surgery, Centre Hospitalier Luxembourg and Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Casper Grim
- Centre for Musculoskeletal Surgery Osnabrück (OZMC), Klinikum Osnabrück, Osnabrück, Germany.,Institute for Health Research and Education (IGB), Osnabrück University, Osnabrück, Germany
| |
Collapse
|
6
|
Skouras AZ, Kanellopoulos AK, Stasi S, Triantafyllou A, Koulouvaris P, Papagiannis G, Papathanasiou G. Clinical Significance of the Static and Dynamic Q-angle. Cureus 2022; 14:e24911. [PMID: 35698708 PMCID: PMC9186474 DOI: 10.7759/cureus.24911] [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] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Q-angle represents the resultant force vector of the quadriceps and patellar tendons acting on the patella. An increased Q-angle has been considered a risk factor for many disorders and injuries. This literature review challenges the clinical value of static Q-angle and recommends a more dynamic movement evaluation for making clinical decisions. Although there are many articles about static Q-angle, few have assessed the value of dynamic Q-angle. We searched Scopus and PubMed (until September 2021) to identify and summarize English-language articles evaluating static and dynamic Q-angle, including articles for dynamic knee valgus (DKV) and frontal plane projection angle. We also used textbooks and articles from references to related articles. Although static Q-angle measurement is used systematically in clinical practice for critical clinical decisions, its interpretation and clinical translation present fundamental and intractable limitations. To date, it is acceptable that mechanisms that cause patellofemoral pain and athletic injuries have a stronger correlation with dynamic loading conditions. Dynamic Q-angle has the following three dynamic elements: frontal plane (hip adduction, knee abduction), transverse plane (hip internal rotation and tibia external rotation), and patella behavior. Measuring one out of three elements (frontal plane) illustrates only one-third of this concept. Static Q-angle lacks biomechanical meaning and utility for dynamic activities. Although DKV is accompanied by hip and tibia rotation, it remains a frontal plane measurement, which provides no information about the transverse plane and patella movement. However, given the acceptable reliability and the better differentiation capability, DKV assessment is recommended in clinical practice.
Collapse
Affiliation(s)
- Apostolos Z Skouras
- Sports Excellence, 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
- Biomechanics and Gait Analysis Laboratory "Sylvia Ioannou", Orthopaedic Research and Education Center "P.N.Soukakos", 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | | | - Sophia Stasi
- Laboratory of Neuromucsular and Cardiovascular Study of Motion (LANECASM), University of West Attica, Athens, GRC
- Department of Physiotherapy, University of West Attica, Athens, GRC
| | - Athanasios Triantafyllou
- Biomechanics and Gait Analysis Laboratory "Sylvia Ioannou", Orthopaedic Research and Education Center "P.N.Soukakos", 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
- Laboratory of Neuromucsular and Cardiovascular Study of Motion (LANECASM), University of West Attica, Athens, GRC
| | - Panagiotis Koulouvaris
- Sports Excellence, 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
- Biomechanics and Gait Analysis Laboratory "Sylvia Ioannou", Orthopaedic Research and Education Center "P.N.Soukakos", 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Georgios Papagiannis
- Laboratory of Neuromucsular and Cardiovascular Study of Motion (LANECASM), University of West Attica, Athens, GRC
- Department of Physiotherapy, University of the Peloponnese, Sparta, GRC
- Biomechanics and Gait Analysis Laboratory "Sylvia Ioannou", Orthopaedic Research and Education Center "P.N.Soukakos", 1st Department of Orthopaedic Surgery, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - George Papathanasiou
- Laboratory of Neuromucsular and Cardiovascular Study of Motion (LANECASM), University of West Attica, Athens, GRC
- Department of Physiotherapy, University of West Attica, Athens, GRC
| |
Collapse
|
7
|
Owoeye OBA, VanderWey MJ, Pike I. Reducing Injuries in Soccer (Football): an Umbrella Review of Best Evidence Across the Epidemiological Framework for Prevention. SPORTS MEDICINE - OPEN 2020; 6:46. [PMID: 32955626 PMCID: PMC7505904 DOI: 10.1186/s40798-020-00274-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/19/2020] [Indexed: 01/31/2023]
Abstract
Soccer is the most popular sport in the world. Expectedly, the incidence of soccer-related injuries is high and these injuries exert a significant burden on individuals and families, including health and financial burdens, and on the socioeconomic and healthcare systems. Using established injury prevention frameworks, we present a concise synthesis of the most recent scientific evidence regarding injury rates, characteristics, mechanisms, risk and protective factors, interventions for prevention, and implementation of interventions in soccer. In this umbrella review, we elucidate the most recent available evidence gleaned primarily from systematic reviews and meta-analyses. Further, we express the exigent need to move current soccer injury prevention research evidence into action for improved player outcomes and widespread impact through increased attention to dissemination and implementation research. Additionally, we highlight the importance of an enabling context and effective implementation strategies for the successful integration of evidence-based injury prevention programs into real-world soccer settings. This narrative umbrella review provides guidance to inform future research, practice, and policy towards reducing injuries among soccer players.
Collapse
Affiliation(s)
- Oluwatoyosi B A Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Allied Health Professions Building, 3437 Caroline Street, St. Louis, MO, 63104, USA.
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
| | - Mitchell J VanderWey
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Allied Health Professions Building, 3437 Caroline Street, St. Louis, MO, 63104, USA
| | - Ian Pike
- Department of Paediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC, Canada
| |
Collapse
|