1
|
Nimse A, Patel N, Pardiwala D. Criterion-Based Rehabilitation and Return to Play in Fast Bowlers Following Arthroscopic Bankart Repair: Recommendations Based on a Detailed Clinical Review. Indian J Orthop 2023; 57:1565-1574. [PMID: 37766945 PMCID: PMC10519911 DOI: 10.1007/s43465-023-00931-5] [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: 05/01/2023] [Accepted: 06/05/2023] [Indexed: 09/29/2023]
Abstract
Background Anterior shoulder instability due to labral tears in the dominant arm of cricket fast bowlers can be particularly disabling and results in significant match time loss. This often follows injuries sustained during fielding and training, although micro-instability following repetitive throwing progressing to overt anterior shoulder instability is also known. To ensure ball release speeds of over 140 km/h with different ball variations, these athletes require not only physical fitness and technical skill, but also a completely stable shoulder. Methods A literature search of "MEDLINE", "SPORT DISCUSS", and "GOOGLE SCHOLAR" was done to identify relevant articles published till the year 2023. Results A treatment approach that involves anatomic restoration of the shoulder via an arthroscopic Bankart capsulo-labral repair, followed by functional and biomechanical restoration via rehabilitation is the most predictable method to ensure a successful return to pre-injury fast-bowling status. A post-operative rehabilitation program that ensures a quick return to fast bowling without disrupting the surgical repair is crucial. Timely integration of exercises to recruit and strengthen the kinetic chain used for bowling and throwing plays a key role in this faster recovery. This current review provides a phase-wise, evidence-based rehabilitation guideline for return to competitive cricket after arthroscopic Bankart repair in a fast bowler. This review also highlights a structured return to bowling, throwing, and fielding program with a clinical decision-making process. Conclusion Exercise selection at an early stage that does not compromise the healing tissue, and timely integration of workouts to recruit and strengthen the kinetic chain used for bowling and throwing is the key strategy to allow faster recovery. Supplementary Information The online version contains supplementary material available at 10.1007/s43465-023-00931-5.
Collapse
Affiliation(s)
- Ashutosh Nimse
- Musculoskeletal Physiotherapy AUT, Auckland, New Zealand
- Centre for Sports Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
- Mumbai Indians Cricket Team, Indian Premier League, Mumbai, India
| | - Nitin Patel
- National Cricket Academy, Board of Control for Cricket in India (BCCI), Bangalore, India
- The Maharaja Sayajirao University of Baroda, Boroda, India
- University of Nottingham, Nottingham, UK
| | - Dinshaw Pardiwala
- Centre for Sports Medicine, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| |
Collapse
|
2
|
Dudley C, Johnston R, Jones B, Till K, Westbrook H, Weakley J. Methods of Monitoring Internal and External Loads and Their Relationships with Physical Qualities, Injury, or Illness in Adolescent Athletes: A Systematic Review and Best-Evidence Synthesis. Sports Med 2023; 53:1559-1593. [PMID: 37071283 PMCID: PMC10356657 DOI: 10.1007/s40279-023-01844-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND With the increasing professionalisation of youth sports, training load monitoring is increasingly common in adolescent athletes. However, the research examining the relationship between training load and changes in physical qualities, injury, or illness in adolescent athletes is yet to be synthesised in a systematic review. OBJECTIVE The aim of this review was to systematically examine the research assessing internal and external methods of monitoring training load and physical qualities, injury, or illness in adolescent athletes. METHODS Systematic searches of SPORTDiscus, Web of Science, CINAHL and SCOPUS were undertaken from the earliest possible records to March 2022. Search terms included synonyms relevant to adolescents, athletes, physical qualities, injury, or illness. To be eligible for inclusion, articles were required to (1) be original research articles; (2) be published in a peer-reviewed journal; (3) include participants aged between 10 and 19 years and participating in competitive sport; (4) report a statistical relationship between a measure of internal and/or external load and physical qualities, injury or illness. Articles were screened and assessed for methodological quality. A best-evidence synthesis was conducted to identify trends in the relationships reported. RESULTS The electronic search yielded 4125 articles. Following screening and a review of references, 59 articles were included. The most commonly reported load monitoring tools were session ratings of perceived exertion (n = 29) and training duration (n = 22). Results of the best-evidence synthesis identified moderate evidence of positive relationships between resistance training volume load and improvement in strength, and between throw count and injury. However, evidence for other relationships between training load and change in physical qualities, injury, or illness were limited or inconsistent. CONCLUSIONS Practitioners should consider monitoring resistance training volume load for strength training. Additionally, where appropriate, monitoring throw counts may be useful in identifying injury risk. However, given the lack of clear relationships between singular measures of training load with physical qualities, injury, or illness, researchers should consider multivariate methods of analysing training load, as well as factors that may mediate the load-response relationship, such as maturation.
Collapse
Affiliation(s)
- Charles Dudley
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo Campus, Brisbane, Australia.
- St Joseph's Nudgee College, Boondall, Brisbane, Australia.
| | - Rich Johnston
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo Campus, Brisbane, Australia
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Health through Physical Activity, Lifestyle and Sport Research Centre (HPALS), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Premiership Rugby, London, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
- England Performance Unit, The Rugby Football League, Leeds, UK
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
| | | | - Jonathon Weakley
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo Campus, Brisbane, Australia
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Brisbane, Australia
| |
Collapse
|
3
|
Sniffen K, Noel-London K, Schaeffer M, Owoeye O. Is Cumulative Load Associated with Injuries in Youth Team Sport? A Systematic Review. SPORTS MEDICINE - OPEN 2022; 8:117. [PMID: 36114374 PMCID: PMC9481825 DOI: 10.1186/s40798-022-00516-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/03/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
High cumulative external and internal load may predispose athletes to increased risk for injury across a variety of sports, competition levels, and age groups. However, evidence of an association between cumulative load and injury in youth sport remains inconclusive. The objective of this study was to determine the current evidence for cumulative load and injury risk relationships in youth team sport through a systematic review of the existing literature.
Methods
A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Literature searches were conducted in PubMed, Web of Science, SCOPUS, and CINAHL for relevant articles published between January 2010 and April 2021. The authors conducted independent review and quality assessment of the eligible studies. Eleven articles evaluating youth (less than 18 years old) team sport were included for qualitative synthesis.
Results
Fifty-nine percent (n = 39/66) of the relationships assessed revealed an association between cumulative load and injury across the team sports studied, including the presence of load–injury associations in 84% (n = 16/19) of assessments in youth soccer. Of those relationships where an association was present, 79% (n = 31/39) were positive associations between cumulative load and injury. Risk of bias assessment scores ranged from three to six out of seven possible (median = 5) for cohort studies and from four to seven out of 10 possible (median = 5.5) for cross-sectional studies.
Conclusions
There is some evidence for a positive association between load and injury in youth team sport. Youth soccer was the most studied team sport, and a substantial number of positive load–injury associations were reported. Current evidence lacks consistency in the measures and metrics used in defining load–injury relationships.
Trial Registration PRISMA ID - CRD42020203622.
Collapse
|
4
|
Keaney LC, Kilding AE, Merien F, Shaw DM, Dulson DK. Upper respiratory tract symptom risk in elite field hockey players during a dry run for the Tokyo Olympics. Eur J Sport Sci 2021; 22:1827-1835. [PMID: 34873991 DOI: 10.1080/17461391.2021.2009041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ABSTRACTThe primary aim of this study was to examine if biomarker and/or self-reported data could predict upper respiratory tract symptom (URTS) risk in elite field hockey players. The secondary aim was to investigate the effect of the additional stressor 'repeated heat exposure' on measures of thermoregulation and immunity. A prospective cohort repeated measures study design was used to collect URTS, household illness, self-reported wellness, biomarker and thermoregulatory data from elite male field hockey players (n = 19), during an 8-week training and competition period that simulated the preparatory and competition phases of the 2020 Tokyo Olympics. Heat response testing (HRT) was performed at the beginning of the study period, following heat acclimation (HA) and following an intensified competition period (ICP) played in hot and humid conditions (27-37°C and 53-80% relative humidity). Univariate frailty analysis demonstrated that illness in players' households (Hazard ratio (HR: 4.90; p < 0.001)) and self-reported stress (HR: 0.63; p = 0.043) predicted players' risk for URTS. Additionally, low baseline resting salivary secretory immunoglobulin A (SIgA) concentration predicted players' "potential" URTS risk (p = 0.021). The additional stressor "repeated heat exposure" was found to facilitate partial thermoregulatory adaptation without attenuating resting immune functions. In conclusion, lifestyle and behavioural factors (i.e. household illness and stress) influenced players risk for URTS more so than sport-related stressors. Furthermore, repeated heat exposure did not appear to compromise players resting immunity. To assess athletes' risk for URTS, baseline screening of SIgA concentration and regular monitoring of self-reported lifestyle and behavioural data are recommended.
Collapse
Affiliation(s)
- Lauren C Keaney
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Andrew E Kilding
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Fabrice Merien
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand.,AUT-Roche Diagnostics Laboratory, Auckland University of Technology, Auckland, New Zealand
| | - David M Shaw
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand.,School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Deborah K Dulson
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand.,School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| |
Collapse
|
5
|
Dovbysh T, Reid D, Shackel D. Injury incidence within male elite New Zealand cricket from the early T20 era: 2009-2015. BMJ Open Sport Exerc Med 2021; 7:e001168. [PMID: 34868632 PMCID: PMC8606773 DOI: 10.1136/bmjsem-2021-001168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives This study aimed to describe the injury epidemiology of domestic and international level male New Zealand cricketers from seasons 2009–2010 to 2014–2015 across all match formats given the increasing popularity of T20 cricket. Methods Match exposure and injury surveillance data collected prospectively by New Zealand Cricket was analysed using international consensus recommendations for injury surveillance and reporting in cricket. Relationships between playing level, role and injury were statistically analysed. Results A total of 268 elite male New Zealand cricketers from seasons 2009–2010 to 2014–2015 were analysed from the New Zealand Cricket injury surveillance system. Total new match injury incidence rates were 37.0 and 58.0 injuries per 10 000 player hours in domestic and international cricket, respectively. Total new and recurrent match injury incidence in international cricket was approximately 1.7 times higher than domestic cricket (277.6 vs 162.8 injuries per 1000 player days). Injury prevalence rates were 7.6% and 10.0% in domestic and international cricket. The hamstring (8.2%) in domestic cricket and the groin (13.5%) in international cricket were the most injured body sites. Most match days lost in domestic cricket were to the lumbar spine (417 days), and groin in international cricket (152 days). There were statistically significant differences in injury between domestic and international level cricketers (χ2=4.39, p=0.036), and playing role (χ2=42.29, p<0.0001). Conclusions Total injury incidence rates in elite New Zealand cricket increased in 2009–2015 compared with previous data. International-level players and pace bowlers were the most injured individuals.
Collapse
Affiliation(s)
- Timofei Dovbysh
- School of Clinical Sciences, School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Duncan Reid
- School of Clinical Sciences, School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.,Sports Performance Research Institute of New Zealand, Auckland, New Zealand.,Active Living and Rehabilitation Aotearoa (ALARA), Auckland, New Zealand
| | - Dayle Shackel
- High Performance Centre, New Zealand Cricket, Lincoln, New Zealand
| |
Collapse
|
6
|
Perrett C, Bussey M, Lamb P. External workload intensity in cricket fast bowlers across maximal and submaximal intensities: Modifying PlayerLoad and IMU location. J Sports Sci 2021; 40:527-533. [PMID: 34796781 DOI: 10.1080/02640414.2021.2003570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Workload is a commonly accepted risk factor for injury among fast bowlers, however many methods exist to characterise workload. Recently, automated intensity-sensitive measures like PlayerLoad have been used to improve the estimation of workload in fast bowlers. The purpose of this study was to determine whether similar variables could be extracted from a single inertial measurement unit (IMU) that highly correlate with intensity, according to release speed. Eight elite and pre-elite bowlers participated in the study, with each bowler bowling one over each at 60%, 80% and 100% intensity and repeating this across two sessions (36 balls per participant). IMUs were placed on the upper-back and non-bowling wrist and maximum PlayerLoad from each delivery (PLmax) was compared to the accumulated value across each delivery (PLacc). The strongest correlation with release speed was with PLacc from the non-bowling wrist (R = 0.74), followed by PLacc from the upper-back (R = 0.65) and PLmax from the upper back (R = 0.60). Consequently, an improved estimation of the intensity at which bowlers are working at could be gained by examining accumulated PlayerLoad values from an IMU on the non-bowling wrist.
Collapse
Affiliation(s)
- Corey Perrett
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.,Institute of Sport, University of Chichester, Chichester, UK
| | - Melanie Bussey
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Peter Lamb
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| |
Collapse
|
7
|
Bullock GS, Perera N, Murray A, Orchard J, Arden NA, Filbay SR. The relationship between cricket participation, health and wellbeing: A scoping review. Int J Sports Med 2021; 43:401-410. [PMID: 34734400 DOI: 10.1055/a-1686-6632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Summarising and synthesising the evidence on cricket health and wellbeing can help inform cricket stakeholders and navigate future research directions. The purpose of this study was to investigate the relationship between cricket participation, health and wellbeing at all ages and playing standards, and identify research gaps in the existing literature. A scoping review was performed from inception to March, 2020. Studies were included if they assessed a construct related to health and/or wellbeing in cricketers, available in English. 219 articles were eligible. Injury incidence per 1,000 player exposures ranged from 1.8-5.7 injuries. 48% of former cricketers experienced persistent joint pain. However, former cricketers reported greater physical activity levels and mental-components of quality of life compared to the general population. Heat injury/illness and skin cancer are concerns and require further research. Cricket participation is associated with an inherent injury risk, which may have negative implications for musculoskeletal health in later life. However, cricket participation is associated with high quality of life which can persist after retirement. Gaps in the literature include prospective studies on health and wellbeing of cricketers, female cricketers, injury prevention strategies, and the impact of cricket participation on metabolic health and lifetime physical activity.
Collapse
Affiliation(s)
- Garrett Scott Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, United States.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Nirmala Perera
- Sport Medicine, Australian Institute of Sport, Belconnen, Australia
| | - Andrew Murray
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - John Orchard
- Medicine, University of Sydney, Sydney, Australia
| | - Nigel A Arden
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland
| | - Stephanie R Filbay
- Physiotherapy, The University of Melbourne Department of Physiotherapy, Melbourne, Australia
| |
Collapse
|
8
|
Ekanayaka EMSB, Gunawardhana AAS, Mihirani MB, Silva P, Prins NW. Workload Management System for Cricketers. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:7292-7295. [PMID: 34892782 DOI: 10.1109/embc46164.2021.9631106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cricketers are dynamic players in the field and hence more vulnerable to injuries. The injury rate of Sri Lankan cricketers is very high, resulting in their careers being shortened. Therefore, we established a workload management system for cricketers to resolve this issue with wearable Inertial Measurement Unit (IMU) sensors mounted on their bodies. In order to mitigate their accidents, we evaluated kinds of the activities performed by an athlete using Convolutional Neural Network (CNN) and computed the workload parameters after the session. The expected results of our project were to develop a system to collect and analyze the critical workload parameters of cricketers and showcase results in a user-friendly manner.
Collapse
|
9
|
Myers NL, Farnsworth II JL, Knudson DV. Different external training workload models show no association with injury in competitive junior tennis players. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [DOI: 10.1007/s12662-021-00751-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
10
|
Bache-Mathiesen LK, Andersen TE, Dalen-Lorentsen T, Clarsen B, Fagerland MW. Not straightforward: modelling non-linearity in training load and injury research. BMJ Open Sport Exerc Med 2021; 7:e001119. [PMID: 34422292 PMCID: PMC8351477 DOI: 10.1136/bmjsem-2021-001119] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To determine whether the relationship between training load and injury risk is non-linear and investigate ways of handling non-linearity. METHODS We analysed daily training load and injury data from three cohorts: Norwegian elite U-19 football (n=81, 55% male, mean age 17 years (SD 1)), Norwegian Premier League football (n=36, 100% male, mean age 26 years (SD 4)) and elite youth handball (n=205, 36% male, mean age 17 years (SD 1)). The relationship between session rating of perceived exertion (sRPE) and probability of injury was estimated with restricted cubic splines in mixed-effects logistic regression models. Simulations were carried out to compare the ability of seven methods to model non-linear relationships, using visualisations, root-mean-squared error and coverage of prediction intervals as performance metrics. RESULTS No relationships were identified in the football cohorts; however, a J-shaped relationship was found between sRPE and the probability of injury on the same day for elite youth handball players (p<0.001). In the simulations, the only methods capable of non-linear modelling relationships were the quadratic model, fractional polynomials and restricted cubic splines. CONCLUSION The relationship between training load and injury risk should be assumed to be non-linear. Future research should apply appropriate methods to account for non-linearity, such as fractional polynomials or restricted cubic splines. We propose a guide for which method(s) to use in a range of different situations.
Collapse
Affiliation(s)
- Lena Kristin Bache-Mathiesen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
| | - Thor Einar Andersen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
| | - Torstein Dalen-Lorentsen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
| | - Benjamin Clarsen
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Morten Wang Fagerland
- Department of Sports Medicine, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
- Research Support Services, Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
11
|
A Cherry, Ripe for Picking: The Relationship Between the Acute-Chronic Workload Ratio and Health Problems. J Orthop Sports Phys Ther 2021; 51:162-173. [PMID: 33472501 DOI: 10.2519/jospt.2021.9893] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate whether the relationship between the acute-chronic workload ratio (ACWR) and health problems varies when different methodological approaches are used to quantify it. DESIGN Prospective cohort study. METHODS An online questionnaire was used to collect daily health and training information from 86 elite youth footballers for 105 days. The relationship between players' training load and health was analyzed using a range of different definitions of ACWR and health problems. We used 21-day and 28-day chronic periods, coupled and uncoupled calculations, and the exponentially weighted moving average and rolling average. Acute-chronic workload ratio data were categorized as low, medium, or high, using predefined categories and z scores. We compared medium to high, medium to low, and low to high categories. The outcome was defined in 3 ways: "all health problems," "all injuries," and "new noncontact injuries." We performed random-effects logistic regression analyses of all combinations, for a total of 108 analyses. RESULTS We recorded 6250 athlete-days and 196 health problems. Of the 108 analyses performed, 23 (21%) identified a statistically significant (P<.05) association between the ACWR and health problems. A greater proportion of significant associations were identified when using an exponentially weighted moving average (44% of analyses), when comparing low to high categories (33%), and when using the "all health problems" definition (33%). CONCLUSION The relationship between the ACWR and health problems was dependent on methodological approach. J Orthop Sports Phys Ther 2021;51(4):162-173. Epub 20 Jan 2021. doi:10.2519/jospt.2021.9893.
Collapse
|
12
|
Keaney LC, Kilding AE, Merien F, Shaw DM, Borotkanics RJ, Cupples B, Dulson DK. Predictors of upper respiratory tract symptom risk: Differences between elite rugby union and league players. J Sports Sci 2021; 39:1594-1601. [PMID: 33629651 DOI: 10.1080/02640414.2021.1888430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examined possible predictors of upper respiratory tract symptom (URTS) episodes in elite rugby union and league players (n = 51) during intensive pre-season training. Baseline saliva and blood samples were collected in the first week of pre-season training for analysis of salivary secretory immunoglobulin A (SIgA) and cytomegalovirus. Thereafter, SIgA, URTS, internal training load and self-reported wellness data were repeatedly measured throughout a 10-week pre-season training period. Univariate frailty model analysis, which included 502 observations, was performed for each rugby code for the following independent predictor variables: SIgA concentration, internal training load, total wellness, sleep quantity, sleep quality and stress. Rugby union and league players experienced a similar number of URTS episodes; however, predictors of URTS episodes differed between the codes. No biomarkers or self-reported measures significantly predicted URTS risk in rugby union players, while reductions in self-reported total wellness (HR: 0.731, p = 0.004) and sleep quality (HR: 0.345, p = 0.001) predicted increased URTS risk in rugby league players. The findings from this study highlight that factors influencing URTS risk are perhaps sport specific and this may be attributed to different sporting demands and/or different management of players by team-practitioners.
Collapse
Affiliation(s)
- Lauren Catherine Keaney
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Andrew E Kilding
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Fabrice Merien
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand.,AUT-Roche Diagnostics Laboratory, Auckland University of Technology, Auckland, New Zealand
| | - David M Shaw
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Robert J Borotkanics
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Balin Cupples
- Faculty of Education and Social Work, The University of Sydney, Sydney, Australia
| | - Deborah K Dulson
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
13
|
Impellizzeri FM, McCall A, Ward P, Bornn L, Coutts AJ. Training Load and Its Role in Injury Prevention, Part 2: Conceptual and Methodologic Pitfalls. J Athl Train 2021; 55:893-901. [PMID: 32991699 DOI: 10.4085/1062-6050-501-19] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
In part 2 of this clinical commentary, we highlight the conceptual and methodologic pitfalls evident in current training-load-injury research. These limitations make these studies unsuitable for determining how to use new metrics such as acute workload, chronic workload, and their ratio for reducing injury risk. The main overarching concerns are the lack of a conceptual framework and reference models that do not allow for appropriate interpretation of the results to define a causal structure. The lack of any conceptual framework also gives investigators too many degrees of freedom, which can dramatically increase the risk of false discoveries and confirmation bias by forcing the interpretation of results toward common beliefs and accepted training principles. Specifically, we underline methodologic concerns relating to (1) measure of exposures, (2) pitfalls of using ratios, (3) training-load measures, (4) time windows, (5) discretization and reference category, (6) injury definitions, (7) unclear analyses, (8) sample size and generalizability, (9) missing data, and (10) standards and quality of reporting. Given the pitfalls of previous studies, we need to return to our practices before this research influx began, when practitioners relied on traditional training principles (eg, overload progression) and adjusted training loads based on athletes' responses. Training-load measures cannot tell us whether the variations are increasing or decreasing the injury risk; we recommend that practitioners still rely on their expert knowledge and experience.
Collapse
Affiliation(s)
- Franco M Impellizzeri
- Faculty of Health, Human Performance Research Centre and School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia
| | - Alan McCall
- Arsenal Football Club, London, United Kingdom
| | | | | | - Aaron J Coutts
- Faculty of Health, Human Performance Research Centre and School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia
| |
Collapse
|
14
|
Kupperman N, Hertel J. Global Positioning System-Derived Workload Metrics and Injury Risk in Team-Based Field Sports: A Systematic Review. J Athl Train 2021; 55:931-943. [PMID: 32818957 DOI: 10.4085/1062-6050-473-19] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the current literature regarding the utility of global positioning system (GPS)-derived workload metrics in determining musculoskeletal injury risk in team-based field-sport athletes. DATA SOURCES PubMed entries from January 2009 through May 2019 were searched using terms related to GPS, player workload, injury risk, and team-based field sports. STUDY SELECTION Only studies that used GPS metrics and had injury as the main outcome variable were included. DATA EXTRACTION Total distance, high-speed running, and acute : chronic workload ratios were the most common GPS metrics analyzed, with the most frequent sports being soccer, rugby, and Australian rules football. DATA SYNTHESIS Many distinct workload metrics were associated with increased injury risk in individual studies performed in particular sport circumstances; however, the body of evidence was inconclusive as to whether any specific metrics could consistently predict injury risk across multiple team-based field sports. CONCLUSIONS Our results were inconclusive in determining if any GPS-derived workload metrics were associated with an increased injury risk. This conclusion is due to a myriad of factors, including differences in injury definitions, workload metrics, and statistical analyses across individual studies.
Collapse
Affiliation(s)
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, Charlottesville
| |
Collapse
|
15
|
McGrath J, Neville J, Stewart T, Clinning H, Cronin J. Can an inertial measurement unit (IMU) in combination with machine learning measure fast bowling speed and perceived intensity in cricket? J Sports Sci 2021; 39:1402-1409. [PMID: 33480328 DOI: 10.1080/02640414.2021.1876312] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study examined whether an inertial measurement unit (IMU), in combination with machine learning, could accurately predict two indirect measures of bowling intensity through ball release speed (BRS) and perceived intensity zone (PIZ). One IMU was attached to the thoracic back of 44 fast bowlers. Each participant bowled 36 deliveries at two different PIZ zones (Zone 1 = 24 deliveries at 70% to 85% of maximum perceived bowling effort; Zone 2 = 12 deliveries at 100% of maximum perceived bowling effort) in a random order. IMU data (sampling rate = 250 Hz) were downsampled to 125 Hz, 50 Hz, and 25 Hz to determine if model accuracy was affected by the sampling frequency. Data were analysed using four machine learning models. A two-way repeated-measures ANOVA was used to compare the mean absolute error (MAE) and accuracy scores (separately) across the four models and four sampling frequencies. Gradient boosting models were shown to be the most consistent at measuring BRS (MAE = 3.61 km/h) and PIZ (F-score = 88%) across all sampling frequencies. This method could be used to measure BRS and PIZ which may contribute to a better understanding of overall bowling load which may help to reduce injuries.
Collapse
Affiliation(s)
- Joseph McGrath
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand.,School of Sport, Manukau Institute of Technology, Auckland, New Zealand.,Paramedicine and Emergency Management, School of Health Care Practice, AUT University, Auckland, New Zealand
| | - Jonathon Neville
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Tom Stewart
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand.,Human Potential Centre, AUT University, Auckland, New Zealand
| | | | - John Cronin
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| |
Collapse
|
16
|
Jeffries AC, Wallace L, Coutts AJ, Cohen AM, McCall A, Impellizzeri FM. Injury, Illness, and Training Load in a Professional Contemporary Dance Company: A Prospective Study. J Athl Train 2020; 55:967-976. [PMID: 32818965 DOI: 10.4085/1062-6050-477-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Professional dance is a demanding physical activity with high injury rates. Currently, no epidemiologic data exist regarding the incidence of injury and illness together with training load (TL) over a long period of time. OBJECTIVE To provide a detailed description of injury, illness, and TL occurring in professional contemporary dancers. DESIGN Descriptive epidemiology study. SETTING A single professional contemporary dance company during a 1-year period. PATIENTS OR OTHER PARTICIPANTS A total of 16 male and female professional contemporary dancers. MAIN OUTCOME MEASURE(S) Injury data consisted of medical-attention injury (Med-Inj) and time-loss injury (Time-Inj). Illness was measured using the Wisconsin Upper Respiratory Tract Infection Survey. Training load was collected for each dance session using the session rating of perceived exertion and classified into 3 groups based on individual and group percentiles: low, medium, or high. RESULTS Reported injuries totaled 79 (86.1% new, 6.3% reinjury, and 7.6% exacerbation). The Med-Inj incidence rate was 4.6 per 1000 hours (95% confidence interval [CI] = 3.8, 5.8), and the Time-Inj rate was 1.4 per 1000 hours (95% CI = 0.8, 2.1). The median time until injury for Med-Inj and Time-Inj was 3 months. The number of days dancers experienced illness symptoms was 39.9 ± 26.9 (range = 1-96), with an incidence rate of 9.1 per 1000 hours (95% CI = 7.7, 10.7). Mean weekly TL was 6685 ± 1605 (4641-10 391; arbitrary units). Inconsistent results were found for the incidence of injury and illness based on individual and group categorizations of TL. CONCLUSIONS Professional dancing is associated with high injury and illness rates. This is worrying from a health perspective and underlines the need for further studies to understand how to decrease the risk. The TL is higher than in other sport disciplines, but whether the high incidence of injuries and illnesses is related to high training demands needs additional investigation, possibly conducted as international, multicenter collaborative studies.
Collapse
Affiliation(s)
- Annie C Jeffries
- Human Performance Research Centre, Faculty of Health, University of Technology Sydney, Australia
| | - Lee Wallace
- Human Performance Research Centre, Faculty of Health, University of Technology Sydney, Australia
| | - Aaron J Coutts
- Human Performance Research Centre, Faculty of Health, University of Technology Sydney, Australia
| | | | - Alan McCall
- Human Performance Research Centre, Faculty of Health, University of Technology Sydney, Australia.,Arsenal Performance and Research Team, Arsenal Football Club, London, United Kingdom
| | - Franco M Impellizzeri
- Human Performance Research Centre, Faculty of Health, University of Technology Sydney, Australia
| |
Collapse
|
17
|
Dalen-Lorentsen T, Bjørneboe J, Clarsen B, Vagle M, Fagerland MW, Andersen TE. Does load management using the acute:chronic workload ratio prevent health problems? A cluster randomised trial of 482 elite youth footballers of both sexes. Br J Sports Med 2020; 55:108-114. [PMID: 33036995 DOI: 10.1136/bjsports-2020-103003] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The acute:chronic workload ratio (ACWR) is commonly used to manage training load in sports, particularly to reduce injury risk. However, despite its extensive application as a prevention intervention, the effectiveness of load management using ACWR has never been evaluated in an experimental study. AIM To evaluate the effectiveness of a load management intervention designed to reduce the prevalence of health problems among elite youth football players of both sexes. METHODS We cluster-randomised 34 elite youth football teams (16 females, 18 males) to an intervention group (18 teams) and a control group (16 teams). Intervention group coaches planned all training based on published ACWR load management principles using a commercially available athlete management system for a complete 10-month season. Control group coaches continued to plan training as normal. The prevalence of health problems was measured monthly in both groups using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. RESULTS The between-group difference in health problem prevalence (primary outcome) was 1.8%-points (-4.1 to 7.7 %-points; p=0.55) with no reduction in the likelihood of reporting a health problem in the intervention group (relative risk 1.01 (95% CI 0.91 to 1.12); p=0.84) compared with the control group. CONCLUSIONS We observed no between-group difference, suggesting that this specific load management intervention was not successful in preventing health problems in elite youth footballers. TRIAL REGISTRATION NUMBER ISRCTN18177140.
Collapse
Affiliation(s)
- Torstein Dalen-Lorentsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - John Bjørneboe
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Markus Vagle
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Sports, Physical Education and Outdoor Studies, University of South-Eastern Norway, Horten, Norway
| | - Morten Wang Fagerland
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| |
Collapse
|
18
|
How Has Workload Been Defined and How Many Workload-Related Exposures to Injury Are Included in Published Sports Injury Articles? A Scoping Review. J Orthop Sports Phys Ther 2020; 50:538-548. [PMID: 32998614 DOI: 10.2519/jospt.2020.9766] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To describe how workload-related exposure variables have been defined in sports injury articles, and to identify the number of workload-related exposure variables included in comparative analyses. DESIGN Scoping review. LITERATURE SEARCH PubMed, SPORTDiscus, and Scopus were systematically searched on March 13, 2020. Two reviewers independently screened the retrieved literature and selected articles for inclusion. STUDY SELECTION CRITERIA Prospective cohort studies using workload-related variables as the primary exposure to sports injury were eligible for inclusion. DATA SYNTHESIS The type (eg, distance, balls bowled) and construct of workload-related exposure variables (eg, acute-chronic workload ratio) were extracted and summarized in frequency tables. RESULTS A total of 648 articles were identified, and 45 were eligible for inclusion. Workload definition differed greatly, as sports- and workload-related exposure variables could be, but were not limited to, distance, balls bowled, session rating of perceived exertion, accelerations, soreness, and sleep. Within and across articles, authors used different constructs for workload-related exposure variables. For example, distance was represented as total distance, distance per week, distance per 2 weeks, and acute-chronic workload ratio. The number of workload-related exposure variables included in comparative analyses ranged from 1 to 336. CONCLUSION Studies used different definitions of workload-related exposure variables. The number of workload-related exposure variables in a single study ranged from 1 to 336. J Orthop Sports Phys Ther 2020;50(10):538-548. doi:10.2519/jospt.2020.9766.
Collapse
|
19
|
McEwan K, Davy J, Christie CJA. Get sleep or get stumped: sleep behaviour in elite South African cricket players during competition. J Sports Sci 2020; 38:2225-2235. [PMID: 32921247 DOI: 10.1080/02640414.2020.1776928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Despite evidence supporting the positive affect sleep has on sport performance, there is limited application of sleep research in cricket. This study investigated the sleep behaviours of 26 elite South African cricket players (28.6 ± 4.0 years) during home and away competition. Players completed an altered version of the Core Consensus Sleep Diary every morning post-travel, pre-match and post-match. Linear mixed model regression was used to compare differences in sleep between time-periods, venues and formats. Spearman's correlations (rs) assessed the relationship of match performance and sleep. Post-match total sleep time (06:31 ± 01:09) was significantly (p < 0.05) shorter compared to post-travel (07:53 ± 01:07; g = 1.19) and pre-match (08:43 ± 01:03; g = 1.98). Post-travel sleep onset latency and sleep efficiency were significantly shorter (-20; g = 1.35) and higher (+10.4%; g = 0.74) at home than away respectively. Longer sleep onset latencies and shorter total sleep times were significantly associated with poorer One-Day International (rs = -0.57) and Test (rs = 0.59) batting performances respectively. The poor post-match sleep behaviour, and the sleep and performance correlations, provide motive for future interventions to focus on recovery and the use of sleep monitoring as a competitive advantage.
Collapse
Affiliation(s)
- Kayla McEwan
- Department of Human Kinetics and Ergonomics, Rhodes University , Grahamstown, South Africa
| | - Jonathan Davy
- Department of Human Kinetics and Ergonomics, Rhodes University , Grahamstown, South Africa
| | | |
Collapse
|
20
|
Tallent J, de Weymarn C, Ahmun R, Jones TW. The impact of all-rounders and team injury status on match and series success in international cricket. J Sports Sci 2020; 38:2754-2757. [DOI: 10.1080/02640414.2020.1798721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jamie Tallent
- School of Sport Health and Applied Science, St Mary’s University, Twickenham, UK
| | | | - Robert Ahmun
- England and Wales Cricket Board, Leicestershire, UK
| | - Thomas W. Jones
- Department of Sport Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK
| |
Collapse
|
21
|
Impellizzeri FM, Tenan MS, Kempton T, Novak A, Coutts AJ. Acute:Chronic Workload Ratio: Conceptual Issues and Fundamental Pitfalls. Int J Sports Physiol Perform 2020; 15:907-913. [PMID: 32502973 DOI: 10.1123/ijspp.2019-0864] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/08/2020] [Accepted: 03/14/2020] [Indexed: 11/18/2022]
Abstract
The number of studies examining associations between training load and injury has increased exponentially. As a result, many new measures of exposure and training-load-based prognostic factors have been created. The acute:chronic workload ratio (ACWR) is the most popular. However, when recommending the manipulation of a prognostic factor in order to alter the likelihood of an event, one assumes a causal effect. This introduces a series of additional conceptual and methodological considerations that are problematic and should be considered. Because no studies have even tried to estimate causal effects properly, manipulating ACWR in practical settings in order to change injury rates remains a conjecture and an overinterpretation of the available data. Furthermore, there are known issues with the use of ratio data and unrecognized assumptions that negatively affect the ACWR metric for use as a causal prognostic factor. ACWR use in practical settings can lead to inappropriate recommendations, because its causal relation to injury has not been established, it is an inaccurate metric (failing to normalize the numerator by the denominator even when uncoupled), it has a lack of background rationale to support its causal role, it is an ambiguous metric, and it is not consistently and unidirectionally related to injury risk. Conclusion: There is no evidence supporting the use of ACWR in training-load-management systems or for training recommendations aimed at reducing injury risk. The statistical properties of the ratio make the ACWR an inaccurate metric and complicate its interpretation for practical applications. In addition, it adds noise and creates statistical artifacts.
Collapse
|
22
|
Bowling loads and injury risk in male first class county cricket: Is ‘differential load’ an alternative to the acute-to-chronic workload ratio? J Sci Med Sport 2020; 23:569-573. [DOI: 10.1016/j.jsams.2020.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/13/2019] [Accepted: 01/05/2020] [Indexed: 01/08/2023]
|