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Alharbi BFH, Baker P, Pavey T, Alharbi MF. Investigating the beliefs of Saudi females regarding physical activity: a qualitative exploration. Int J Qual Stud Health Well-being 2024; 19:2296696. [PMID: 38127866 PMCID: PMC10763862 DOI: 10.1080/17482631.2023.2296696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Saudi women have been deprived of equal access to and opportunities for an active lifestyle due to sociocultural restrictions. Using the theory of planned behaviour, this elicitation study aimed to explore the salient beliefs of young Saudi women aged 18-35 regarding physical activity (PA). METHODS A descriptive qualitative methodology was utilized using a semi-structured interview. A total of 25 transcribed interviews were coded. Content analysis was used to identify the salient beliefs and to rank-order the beliefs using an adaptation of Burnard's model. FINDINGS Thirty-five salient beliefs were identified as dominant factors in the decision to engage in PA. The salient beliefs about PA are classified as positive (related to advantages, social approval, and enabling) and negative (related to disadvantages, social disapproval, and barriers). These included behavioural beliefs (concerning physical/psychological well-being and social opportunities), normative beliefs (concerning family, community, international and local media influencers' expectations), and control beliefs (concerning personal, social, natural, and built environment enablers as well as constraints). CONCLUSIONS Due to the elicited beliefs, young women may be able to adopt more active lifestyles and change their inactive behaviour. Addressing negative beliefs can help change their inactive behaviour. Strengthening positive beliefs and facilitators is also beneficial.
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Affiliation(s)
- Basmah Fehaid H Alharbi
- Basic Health Science Department, Qassim University, Applied Medical Science College, Al-Qassim Province, Kingdom of Saudi Arabia
| | - Philip Baker
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove
| | - Toby Pavey
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology
| | - Manal F. Alharbi
- Maternal & Child Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
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Zhang G, Brink M, Aus der Fünten K, Tröß T, Willeit P, Meyer T, Lemmink K, Hecksteden A. The Time Course of Injury Risk After Return-to-Play in Professional Football (Soccer). Sports Med 2024:10.1007/s40279-024-02103-3. [PMID: 39276305 DOI: 10.1007/s40279-024-02103-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2024] [Indexed: 09/16/2024]
Abstract
BACKGROUND Injury risk in professional football (soccer) is increased in the weeks following return-to-play (RTP). However, the time course of injury risk after RTP (the hazard curve) as well as its influencing factors are largely unknown. This knowledge gap, which is arguably due to the volatility of instantaneous risk when calculated for short time intervals, impedes on informed RTP decision making and post-RTP player management. OBJECTIVES This study aimed to characterize the hazard curve for non-contact time-loss injuries after RTP in male professional football and to investigate the influence of the severity of the index injury and playing position. METHODS Media-based injury records from the first German football league were collected over four seasons as previously published. Time-to-event analysis was employed for non-contact time-loss injury after RTP. The Kaplan-Meier survival function was used to calculate the cumulative hazard function, from which the continuous hazard function was retrieved by derivation. RESULTS There were 1623 observed and 1520 censored events from 646 players analyzed. The overall shape of the hazard curve was compatible with an exponential decline of injury risk, from an approximately two-fold level shortly after RTP towards baseline, with a half-time of about 4 weeks. Interestingly, the peak of the hazard curve was slightly delayed for moderate and more clearly for severe index injuries. CONCLUSIONS The time course of injury risk after RTP (the hazard curve) can be characterized based on the Kaplan-Meier model. The shape of the hazard curve and its influencing factors are of practical as well as methodological relevance and warrant further investigation.
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Affiliation(s)
- Guangze Zhang
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Michel Brink
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tobias Tröß
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
- University Sports, Stuttgart University, Stuttgart, Germany
| | - Peter Willeit
- Institute of Health Economics, Medical University of Innsbruck, Innsbruck, Austria
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Koen Lemmink
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Anne Hecksteden
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany.
- Department of Sport Science, Institute of Sport Science, University of Innsbruck, Fürstenweg 176, 6020, Innsbruck, Austria.
- Institute of Physiology, Medical University of Innsbruck, Innsbruck, Austria.
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Tanaka M, Inoue Y, Gonno M, Nomura T, Oku K, Matsui T, Hiramoto M, Miyazaki T, Koda H, Watanabe Y, Kai Y, Morihara T, Kida N. Relationship between Tilt Sensation Ability and Lower Limb Injuries in Junior Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:947. [PMID: 39063523 PMCID: PMC11276802 DOI: 10.3390/ijerph21070947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
The purpose of this study was to devise a tilt sensation measurement method to evaluate ankle proprioception and to examine its reliability. It was also used to determine the relationship among tilt sensation abilities, physical development, and lower limb injuries in junior athletes. In this study, a step platform created tilt angles. Participants with eye masks answered "yes" or "no" to sensing a tilt, evaluated over nine or seven trials. Experiment 1 involved 22 university students (20.6 ± 0.9 years). The minimum angle at which a tilt could be sensed while standing on both feet was determined, and measurements were taken again to examine reliability. Experiment 2 involved 40 junior athletes (12.3 ± 2.0 years), where the minimum angle for tilt sensation was obtained, and medical checks were conducted to assess injuries in the knee, lower leg, and foot. Reliability studies showed a moderately significant correlation between the first and second sessions (r = 0.504, p = 0.017), suggesting the reliability of the experimental method. The proportion capable of sensing a tilt of 1.1° and 1.6° was significantly higher in junior high school students than in elementary school students (1.1°; χ2 = 8.839, p = 0.003. 1.6°; χ2 = 4.038, p = 0.044). The group unable to sense a tilt of 1.6° and 2.1° had a significantly higher positive rate of knee injuries compared to the sensed group among junior high school students (1.6°; χ2 = 4.622, p = 0.032. 2.1°; χ2 = 4.622, p = 0.032). Our findings suggested that a reduced tilt sensation ability was associated with knee injuries in junior high school students. Utilizing our devised tilt sensation assessment could play a crucial role in preventing and detecting early injuries in junior high school students.
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Affiliation(s)
- Maki Tanaka
- Department of Childhood Education, Faculty of Human Development and Education, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto 607-8175, Japan
| | - Yuka Inoue
- Underprograms of Applied Biology, Kyoto Institute of Technology, Hashikami-cho, Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan;
| | - Megumi Gonno
- Department of Childhood Education, Faculty of Childhood Education, Nagoya Women’s University, 3-40 Shioji-cho, Mizuho-ku, Nagoya-shi 467-8610, Japan;
| | - Teruo Nomura
- Faculty of Arts and Sciences, Kyoto Institute of Technology, Hashikami-cho, Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan; (T.N.); (K.O.); (N.K.)
| | - Kyosuke Oku
- Faculty of Arts and Sciences, Kyoto Institute of Technology, Hashikami-cho, Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan; (T.N.); (K.O.); (N.K.)
| | - Tomoyuki Matsui
- Marutamachi Rehabilitation Clinic, 12 Nishinokyo Kurumazakacho Nakagyo-ku, Kyoto 604-8405, Japan; (T.M.); (M.H.); (T.M.); (T.M.)
| | - Machiko Hiramoto
- Marutamachi Rehabilitation Clinic, 12 Nishinokyo Kurumazakacho Nakagyo-ku, Kyoto 604-8405, Japan; (T.M.); (M.H.); (T.M.); (T.M.)
| | - Tetsuya Miyazaki
- Marutamachi Rehabilitation Clinic, 12 Nishinokyo Kurumazakacho Nakagyo-ku, Kyoto 604-8405, Japan; (T.M.); (M.H.); (T.M.); (T.M.)
| | - Hitoshi Koda
- Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, Kansai University of Welfare Sciences, Asahigaoka 3-11-1, Kashiwara-shi 582-0026, Japan;
| | - Yuya Watanabe
- Department of Sports Study, Faculty of Sport Study, Biwako Seikei Sport College, 1204 Kitahira, Otsu-shi 520-0503, Japan;
| | - Yoshihiro Kai
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto 607-8175, Japan;
| | - Toru Morihara
- Marutamachi Rehabilitation Clinic, 12 Nishinokyo Kurumazakacho Nakagyo-ku, Kyoto 604-8405, Japan; (T.M.); (M.H.); (T.M.); (T.M.)
| | - Noriyuki Kida
- Faculty of Arts and Sciences, Kyoto Institute of Technology, Hashikami-cho, Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan; (T.N.); (K.O.); (N.K.)
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Gill VS, Tummala SV, Sullivan G, Han W, Haglin JM, Marks L, Tokish JM. Functional Return-to-Sport Testing Demonstrates Inconsistency in Predicting Short-Term Outcomes Following Anterior Cruciate Ligament Reconstruction: A Systematic Review. Arthroscopy 2024; 40:2135-2151.e2. [PMID: 38216071 DOI: 10.1016/j.arthro.2023.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/26/2023] [Accepted: 12/17/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE To systematically review the relationship between functional testing at the time of return to sport (RTS) and short-term outcomes, such as second anterior cruciate ligament (ACL) tear and return to a preinjury level of sport, among athletes who underwent anterior cruciate ligament reconstruction (ACLR). METHODS A systematic literature search was performed in MEDLINE, EMBASE, Scopus, and Web of Science to identify studies examining athletes who underwent functional RTS testing and were followed for at least 12 months following ACLR. Studies were screened by 2 reviewers. A standardized template was used to extract information regarding study characteristics, ACLR information, functional test results, and risk factors associated with retear or reduced RTS. RESULTS Of the 937 studies identified, 22 met the inclusion criteria. The average time between ACLR and RTS testing was 8.5 months. Single leg hop for distance performance had no association with retear risk in any study and no association with RTS rates in most studies. Quadriceps strength had conflicting results in relation to retear risk, whereas it had no relationship with RTS rates. Rates of reinjury and RTS were similar between patients who passed and did not pass combined hop and strength batteries. Asymmetric knee extension and hip moments, along with increased knee valgus and knee flexion angles, demonstrated increased risk of retear. CONCLUSIONS Individual hop and strength tests that are often used in RTS protocols following ACLR may have limited and inconsistent value in predicting ACL reinjury and reduced RTS when used in isolation. Combined hop and strength test batteries also demonstrate low sensitivity and negative predictive value, highlighting conflicting evidence to suggest RTS testing algorithm superiority. LEVEL OF EVIDENCE Level IV, systematic review of Level I-IV studies.
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Affiliation(s)
- Vikram S Gill
- Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A..
| | | | | | - Will Han
- Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A
| | - Jack M Haglin
- Department of Orthopedic Surgery, Mayo Clinic, Arizona, U.S.A
| | - Lisa Marks
- Division of Education, Department of Library Services, Mayo Clinic, Arizona, U.S.A
| | - John M Tokish
- Department of Orthopedic Surgery, Mayo Clinic, Arizona, U.S.A
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Gómez-Carrión Á, Sánchez-Gómez R, Reguera-Medina JM, Martínez-Sebastián C, Márquez-Reina S, Coheña-Jiménez M, Moisan G. Effect of using a kinetic wedge during the hallux dorsiflexion resistance test in asymptomatic individuals. BMC Musculoskelet Disord 2024; 25:409. [PMID: 38783248 PMCID: PMC11118613 DOI: 10.1186/s12891-024-07520-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The hallux dorsiflexion resistance test is a frequently employed clinical maneuver for assessing the initiation of the windlass mechanism This maneuver involves dorsiflexion of the phalanx of the hallux, thereby evaluating plantarflexion of the first metatarsal, elevation of the medial longitudinal arch, and supination of the rearfoot. The windlass mechanism plays a crucial role in gait, and orthopedic devices, such as a kinetic wedge, which aims to facilitate its activation by increasing the hallux dorsiflexion. Although it is believed that facilitating the windlass mechanism with the kinetic wedge should be directly correlated with a decrease in hallux dorsiflexion resistance, its effects have yet to be characterized. Thus, this study aimed to determine the influence of a kinetic wedge on hallux dorsiflexion resistance in asymptomatic individuals. METHODS The sample comprised thirty participants (14 women and 16 men). A digital force gauge measured the force required to perform the hallux dorsiflexion resistance test during two conditions: barefoot and with a kinetic wedge. The Wilcoxon signed-rank test was used to compare the hallux dorsiflexion resistance between conditions. RESULTS A statistically significant reduction in force (10.54 ± 3.16N vs. 19.62 ± 5.18N, p < 0.001) was observed when using the kinetic wedge compared to the barefoot condition during the hallux dorsiflexion resistance test. CONCLUSION The use of a kinetic wedge reduces the required force for performing the passive hallux dorsiflexion resistance test in asymptomatic individuals. Future studies should determine to what extent the kinetic wedge can attenuate the required force to dorsiflex the hallux in individuals with musculoskeletal disorders such as plantar fasciopathy and functional hallux limitus.
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Affiliation(s)
- Álvaro Gómez-Carrión
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain.
| | - Rubén Sánchez-Gómez
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain
- IdISSC, Institute for Health Research. Hospital Clínico San Carlos, 28040, Madrid, Spain
| | | | - Carlos Martínez-Sebastián
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain
| | - Salvador Márquez-Reina
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, 41009, Seville, Spain
| | - Manuel Coheña-Jiménez
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, 41009, Seville, Spain
| | - Gabriel Moisan
- Department of Human Kinetics, Université du Québec À Trois-Rivières, Trois Rivières, Québec, Canada
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Dyer OL, Seeley MA, Wheatley BB. Effects of static exercises on hip muscle fatigue and knee wobble assessed by surface electromyography and inertial measurement unit data. Sci Rep 2024; 14:10448. [PMID: 38714802 PMCID: PMC11076610 DOI: 10.1038/s41598-024-61325-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 05/03/2024] [Indexed: 05/10/2024] Open
Abstract
Hip muscle weakness can be a precursor to or a result of lower limb injuries. Assessment of hip muscle strength and muscle motor fatigue in the clinic is important for diagnosing and treating hip-related impairments. Muscle motor fatigue can be assessed with surface electromyography (sEMG), however sEMG requires specialized equipment and training. Inertial measurement units (IMUs) are wearable devices used to measure human motion, yet it remains unclear if they can be used as a low-cost alternative method to measure hip muscle fatigue. The goals of this work were to (1) identify which of five pre-selected exercises most consistently and effectively elicited muscle fatigue in the gluteus maximus, gluteus medius, and rectus femoris muscles and (2) determine the relationship between muscle fatigue using sEMG sensors and knee wobble using an IMU device. This work suggests that a wall sit and single leg knee raise activity fatigue the gluteus medius, gluteus maximus, and rectus femoris muscles most reliably (p < 0.05) and that the gluteus medius and gluteus maximus muscles were fatigued to a greater extent than the rectus femoris (p = 0.031 and p = 0.0023, respectively). Additionally, while acceleration data from a single IMU placed on the knee suggested that more knee wobble may be an indicator of muscle fatigue, this single IMU is not capable of reliably assessing fatigue level. These results suggest the wall sit activity could be used as simple, static exercise to elicit hip muscle fatigue in the clinic, and that assessment of knee wobble in addition to other IMU measures could potentially be used to infer muscle fatigue under controlled conditions. Future work examining the relationship between IMU data, muscle fatigue, and multi-limb dynamics should be explored to develop an accessible, low-cost, fast and standardized method to measure fatiguability of the hip muscles in the clinic.
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Affiliation(s)
- Olivia L Dyer
- Musculoskeletal Institute, Geisinger, Danville, PA, USA
| | - Mark A Seeley
- Musculoskeletal Institute, Geisinger, Danville, PA, USA
| | - Benjamin B Wheatley
- Musculoskeletal Institute, Geisinger, Danville, PA, USA.
- Department of Mechanical Engineering, Bucknell University, 1 Dent Drive, Lewisburg, PA, 17837, USA.
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Knapic H, Shanley E, Thigpen CA, Prats-Uribe A, Fair CD, Bullock GS. Impact of Prolonged Sport Stoppage on Knee Injuries in High School Athletes: An Ecological Study. J Sport Rehabil 2024; 33:225-230. [PMID: 38412853 DOI: 10.1123/jsr.2023-0018] [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: 01/17/2023] [Revised: 01/03/2024] [Accepted: 01/16/2024] [Indexed: 02/29/2024]
Abstract
CONTEXT In March 2020, public health concerns resulted in school closure throughout the United States. The prolonged sport cessation may affect knee injury risk in high school athletes. The purpose of this study was to describe and compare risk of knee injuries in high school athletes during 2019-2020 and 2020-2021 academic years, and stratify by gender, severity, mechanism of injury, injury type, and knee anatomic region. DESIGN Historical-prospective cohort study. METHODS This historical-prospective cohort study included 176 schools in 6 states matched by sport participation in control and COVID years from July 1, 2019 to June 30, 2021. Injury rates per 1000 athletes per year were calculated with 95% confidence intervals. A negative binomial regression was performed to assess potential differences in knee injuries between academic years. RESULTS 94,847 and 72,521 high school athletes participated in the 2019-2020 (19-20) and 2020-2021 (20-21) seasons. Knee injury risk was higher in the 20-21 season (19-20: 28.89% [27.82-29.96]; 20-21: 33.82% [32.50-35.14]). Risk increased for male athletes from 2019-2020 to 2020-2021 (19-20: 29.42% [28.01-30.83]; 20-21: 40.32% [38.89-41.75]). Female knee injury risk was similar between years (19-20: 25.78% [24.29-27.27]; 20-21: 26.03% [24.31-27.75]). Knee injuries increased by a ratio of 1.2 ([95% CI, 1.1-1.3], P < .001) during 2020-2021. CONCLUSIONS Knee injury risk and relative risk increased among males in 2020-2021. Results indicate changes in knee injury risk following return from COVID shelter in place among high school athletes and implicate potential negative downstream effects of interrupted sports training and participation on high school injury risk.
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Affiliation(s)
- Hannah Knapic
- Department of Public Health Studies, Elon University, Elon, NC, USA
| | - Ellen Shanley
- ATI Physical Therapy, Greenville, SC, USA
- Center for Rehabilitation and Reconstruction Sciences, University of South Carolina, Columbia, SC, USA
| | - Charles A Thigpen
- ATI Physical Therapy, Greenville, SC, USA
- Center for Rehabilitation and Reconstruction Sciences, University of South Carolina, Columbia, SC, USA
| | - Albert Prats-Uribe
- Pharmaco- and Device Epidemiology, Center for Statistics in Medicine, Nuffield Department of Orthopedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Cynthia D Fair
- Department of Public Health Studies, Elon University, Elon, NC, USA
| | - Garrett S Bullock
- Department of Orthopedic Surgery and Rehabilitation, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Center for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, United Kingdom
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Keogh JAJ, Ruder MC, White K, Gavrilov MG, Phillips SM, Heisz JJ, Jordan MJ, Kobsar D. Longitudinal Monitoring of Biomechanical and Psychological State in Collegiate Female Basketball Athletes Using Principal Component Analysis. TRANSLATIONAL SPORTS MEDICINE 2024; 2024:7858835. [PMID: 38654723 PMCID: PMC11023736 DOI: 10.1155/2024/7858835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/07/2024] [Accepted: 03/23/2024] [Indexed: 04/26/2024]
Abstract
Background The growth in participation in collegiate athletics has been accompanied by increased sport-related injuries. The complex and multifactorial nature of sports injuries highlights the importance of monitoring athletes prospectively using a novel and integrated biopsychosocial approach, as opposed to contemporary practices that silo these facets of health. Methods Data collected over two competitive basketball seasons were used in a principal component analysis (PCA) model with the following objectives: (i) investigate whether biomechanical PCs (i.e., on-court and countermovement jump (CMJ) metrics) were correlated with psychological state across a season and (ii) explore whether subject-specific significant fluctuations could be detected using minimum detectable change statistics. Weekly CMJ (force plates) and on-court data (inertial measurement units), as well as psychological state (questionnaire) data, were collected on the female collegiate basketball team for two seasons. Results While some relationships (n = 2) were identified between biomechanical PCs and psychological state metrics, the magnitude of these associations was weak (r = |0.18-0.19|, p < 0.05), and no other overarching associations were identified at the group level. However, post-hoc case study analysis showed subject-specific relationships that highlight the potential utility of red-flagging meaningful fluctuations from normative biomechanical and psychological patterns. Conclusion Overall, this work demonstrates the potential of advanced analytical modeling to characterize components of and detect statistically and clinically relevant fluctuations in student-athlete performance, health, and well-being and the need for more tailored and athlete-centered monitoring practices.
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Affiliation(s)
- Joshua A. J. Keogh
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Matthew C. Ruder
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Kaylee White
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Momchil G. Gavrilov
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Stuart M. Phillips
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Jennifer J. Heisz
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Matthew J. Jordan
- Faculty of Kinesiology, Sport Medicine Centre, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Dylan Kobsar
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
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Quintana-Cepedal M, Rodríguez MÁ, Nuño-Iglesias N, Del Valle M, Crespo I, Olmedillas H. Injury characteristics of young elite inline speed skaters: A one season retrospective study. PHYSICIAN SPORTSMED 2024; 52:181-186. [PMID: 37078191 DOI: 10.1080/00913847.2023.2205454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/18/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES Determining the rate of injuries related to a certain sport is accepted as the primary step toward designing, implementing and evaluating injury prevention programs. This observational and retrospective study was to examine the injuries sustained by elite young Spanish inline speed skaters during a season. METHODS Athletes participating in the national championship (n = 80) were surveyed via an anonymous online questionnaire to screen for injury characteristics: incidence, location, and tissue affected; plus training information and demographics. RESULTS A total of 52 injuries were recorded across 33,351 hours of exposure, which gives a rate of 1.65/1,000 h. The lower body comprised 79% of the total amount of injuries (1.3/1000 h), and the main areas affected were the thigh and foot, accounting for 25% and 19.2% of the recorded injuries, respectively. Musculotendinous injuries were the most frequent, with an incidence of 0.92/1000 h. No significant gender differences were observed for any of the variables studied. CONCLUSION Speed skating can be considered a low injury rate sport based on our findings. The risk of sustaining an injury was independent of gender, age, and BMI.
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Affiliation(s)
| | | | | | - Miguel Del Valle
- Department of Cellular Morphology and Biology, Universidad de Oviedo, Oviedo, Spain
| | - Irene Crespo
- Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - Hugo Olmedillas
- Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain
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Suhood AY, Summers SJ, Opar DA, Astill T, An WW, Rio E, Cavaleri R. Bilateral Corticomotor Reorganization and Symptom Development in Response to Acute Unilateral Hamstring Pain: A Randomized, Controlled Study. THE JOURNAL OF PAIN 2024; 25:1000-1011. [PMID: 37907112 DOI: 10.1016/j.jpain.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/08/2023] [Accepted: 10/21/2023] [Indexed: 11/02/2023]
Abstract
Accumulating evidence demonstrates that pain induces adaptations in the corticomotor representations of affected muscles. However, previous work has primarily investigated the upper limb, with few studies examining corticomotor reorganization in response to lower limb pain. This is important to consider, given the significant functional, anatomical, and neurophysiological differences between upper and lower limb musculature. Previous work has also focused on unilateral corticomotor changes in response to muscle pain, despite an abundance of literature demonstrating that unilateral pain conditions are commonly associated with bilateral motor dysfunction. For the first time, this study investigated the effect of unilateral acute hamstring pain on bilateral corticomotor organization using transcranial magnetic stimulation (TMS) mapping. Corticomotor outcomes (TMS maps), pain, mechanical sensitivity (pressure pain thresholds), and function (maximal voluntary contractions) were recorded from 28 healthy participants at baseline. An injection of pain-inducing hypertonic (n = 14) or pain-free isotonic (n = 14) saline was then administered to the right hamstring muscle, and pain ratings were collected every 30 seconds until pain resolution. Follow-up measures were taken immediately following pain resolution and at 25, 50, and 75 minutes post-pain resolution. Unilateral acute hamstring pain induced bilateral symptom development and changes in corticomotor reorganization. Two patterns of reorganization were observed-corticomotor facilitation and corticomotor depression. Corticomotor facilitation was associated with increased mechanical sensitivity and decreased function bilaterally (all P < .05). These effects persisted for at least 75 minutes after pain resolution. PERSPECTIVE: These findings suggest that individual patterns of corticomotor reorganization may contribute to ongoing functional deficits of either limb following acute unilateral lower limb pain. Further research is required to assess these adaptations and the possible long-term implications for rehabilitation and reinjury risk in cohorts with acute hamstring injury.
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Affiliation(s)
- Ariane Y Suhood
- Brain Stimulation and Rehabilitation Lab, School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Simon J Summers
- Brain Stimulation and Rehabilitation Lab, School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia; School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David A Opar
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia; School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Tom Astill
- Brain Stimulation and Rehabilitation Lab, School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Winko W An
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Ebonie Rio
- School of Allied Health, La Trobe University Melbourne, Melbourne, Victoria, Australia; The Victorian Institute of Sport, Albert Park, Victoria, Australia
| | - Rocco Cavaleri
- Brain Stimulation and Rehabilitation Lab, School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia; School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
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11
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Vetter S, Witt M, Hepp P, Schleichardt A, Schleifenbaum S, Roth C, Denecke T, Henkelmann J, Köhler HP. A 6-week randomized-controlled field study: effect of isokinetic eccentric resistance training on strength, flexibility and muscle structure of the shoulder external rotators in male junior handball players. Front Physiol 2024; 15:1368033. [PMID: 38516212 PMCID: PMC10955123 DOI: 10.3389/fphys.2024.1368033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Background: Team handball involves a tremendous amount of shoulder motion with high forces during repeated extended external range of motion. This causes shoulder complaints and overuse injuries. While eccentric training for the lower extremity shows preventive effects by improving strength, range of motion and fascicle length, there is a research gap for the shoulder joint and for advanced tissue characterization using diffusion tensor imaging. Objectives: To investigate the effects of 6-week eccentric isokinetic resistance training on strength, flexibility, and fiber architecture characteristics of the external rotators compared to an active control group in junior male handball players. Methods: 15 subjects were randomly assigned to the eccentric training group and 14 subjects to the active control group (conventional preventive training). Primary outcome measures were eccentric and concentric isokinetic strength of the external rotators, range of motion, and muscle fascicle length and fascicle volume. Results: The intervention group, showed significant changes in eccentric strength (+15%). The supraspinatus and infraspinatus muscles showed significant increases in fascicle length (+13% and +8%), and in fractional anisotropy (+9% and +6%), which were significantly different from the control group. Conclusion: Eccentric isokinetic training has a significant effect on the function and macroscopic structure of the shoulder external rotators in male junior handball players. While strength parameters and muscle structure improved, range of motion did not change. This research helps understanding the physiology of muscle and the role of eccentric training on shoulder function and muscle structure. Furthermore, DTI was found to be a promising tool for advanced tissue characterization, and the in vivo derived data can also serve as model input variables and as a possibility to extend existing ex-vivo muscle models. Future research is needed for functional and structural changes following convenient eccentric field exercises.
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Affiliation(s)
- Sebastian Vetter
- Department of Biomechanics in Sports, Leipzig University, Leipzig, Germany
| | - Maren Witt
- Department of Biomechanics in Sports, Leipzig University, Leipzig, Germany
| | - Pierre Hepp
- Department of Orthopaedics, Trauma and Plastic Surgery, Leipzig University, Leipzig, Germany
| | - Axel Schleichardt
- Department of Biomechanics, Institute for Applied Training Science, Leipzig, Germany
| | - Stefan Schleifenbaum
- Department of Orthopaedics, Trauma and Plastic Surgery, Leipzig University, Leipzig, Germany
| | - Christian Roth
- Department of Pediatric Radiology, Leipzig University, Leipzig, Germany
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, Leipzig University, Leipzig, Germany
| | - Jeanette Henkelmann
- Department of Diagnostic and Interventional Radiology, Leipzig University, Leipzig, Germany
| | - Hans-Peter Köhler
- Department of Biomechanics in Sports, Leipzig University, Leipzig, Germany
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12
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Oldham JR, Bowman TG, Walton SR, Beidler E, Campbell TR, Smetana RM, Munce TA, Larson MJ, Cullum CM, Bushaw MA, Rosenblum DJ, Cifu DX, Resch JE. Sport Type and Risk of Subsequent Injury in Collegiate Athletes Following Concussion: a LIMBIC MATARS Consortium Investigation. Brain Inj 2024:1-9. [PMID: 38317302 DOI: 10.1080/02699052.2024.2310782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To investigate the association between sport type (collision, contact, non-contact) and subsequent injury risk following concussion in collegiate athletes. MATERIALS AND METHODS This retrospective chart review of 248 collegiate athletes with diagnosed concussions (age: 20.0 ± 1.4 years; height: 179.6 ± 10.9 cm; mass: 79.0 ± 13.6 kg, 63% male) from NCAA athletic programs (n = 11) occurred between the 2015-2020 athletic seasons. Acute injuries that occurred within six months following concussion were evaluated. Subsequent injuries were grouped by lower extremity, upper extremity, trunk, or concussion. The independent variable was sport type: collision, contact, non-contact. A Cox proportional hazard model was used to assess the risk of subsequent injury between sport types. RESULTS Approximately 28% (70/248) of athletes sustained a subsequent acute injury within six months post-concussion. Collision sport athletes had a significantly higher risk of sustaining any injury (HR: 0.41, p < 0.001, 95% CI: 0.28, 0.62), lower extremity (HR: 0.55, p = 0.04, 95% CI: 0.32, 0.97), and upper extremity (HR: 0.41, p = 0.01, 95% CI: 0.20, 0.81) injuries following concussion. No differences between sport types were observed for other injuries. CONCLUSION Collision sport athletes had a higher rate of any subsequent injury, lower, and upper extremity injuries following concussion. Future research should focus on sport-specific secondary injury prevention efforts.
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Affiliation(s)
- Jessie R Oldham
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Thomas G Bowman
- Department of Athletic Training, College of Health Sciences, University of Lynchburg, Lynchburg, Virginia, USA
| | - Samuel R Walton
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Thomas R Campbell
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Racheal M Smetana
- Neuropsychology Assessment Clinic, University of Virginia Health, Charlottesville, Virginia, USA
| | - Thayne A Munce
- Environmental Influences on Health & Disease Group, Sanford Research, Sioux Falls, South Dakota, USA
| | - Michael J Larson
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - C Munro Cullum
- Departments of Psychiatry, Neurology, and Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Daniel J Rosenblum
- United States Navy, Virginia Beach, Virginia, USA
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
| | - David X Cifu
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jacob E Resch
- United States Navy, Virginia Beach, Virginia, USA
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia, USA
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13
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Gómez-Carrión Á, Reguera-Medina JM, Ayerra-Andueza I, Cortés-Morán JF, Martínez-Nova A, Sánchez-Gómez R. The effect of varus rearfoot wedges on hallux dorsiflexion resistance. BMC Musculoskelet Disord 2024; 25:84. [PMID: 38254082 PMCID: PMC10801971 DOI: 10.1186/s12891-024-07182-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The first metatarsophalangeal joint (MTPJ), which includes the first metatarsal and proximal phalanx, plays a crucial role in gait and impacts the windlass mechanism. Disruptions to this mechanism are implicated in various foot pathologies. Jack's Test serves as a valuable tool for clinicians to assess the functionality of the MTPJ. Varus rearfoot wedges (VRFWs) are a common treatment employed in the management of lower limb pathologies. The impact of VRFWs on the resistance of the first MTPJ during Jack´s Test is currently unknown. This study aimed to measure the influence of VRFWs on the resistance of the first MTPJ during Jack´s Test. The secondary objective was to validate a new measurement method using a digital force gauge. METHODS Thirty participants (17 women and 13 men) were enrolled. A digital force gauge measured the weight-bearing force needed for Jack's Test, thereby evaluating the effects of VRFWs of different angulations. The Kolmogorov-Smirnov test confirmed that the data followed a normal distribution (p > 0.05). The nonparametric Friedman test (p < 0.001) showed that there were significant differences among all VRFWs, while the Wilcoxon test (p < 0.001) showed that there were differences between barefoot conditions and 3°, 5°, and 8° VRFWs. RESULTS The use of 8° VRFWs yielded a statistically significant reduction in the passive dorsiflexion force of hallux during Jack's Test (12.51 N ± 4.12, p < 0.001). CONCLUSIONS The use of VRFWs has been observed to reduce dorsiflexion resistance in the proximal phalanx of the first MTPJ during Jack's Test. Additionally, the digital force gauge was proven to be a valid tool for conducting Jack's Test, thus offering a reliable measurement method.
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Affiliation(s)
- Álvaro Gómez-Carrión
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain.
| | | | | | | | | | - Rubén Sánchez-Gómez
- Nursing Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain
- IdISSC, Institute for Health Research, Hospital Clínico San Carlos, Madrid, 28040, Spain
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14
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Park TS, Shin MJ, Kang JH. Differences in muscle activity during squat exercises according to the knee angle and standing angle of a sliding tilt table: A comparative study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2050. [PMID: 37787665 DOI: 10.1002/pri.2050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/31/2023] [Accepted: 09/17/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND AND PURPOSE Weight-bearing exercises can help improve physical function; however, they may be difficult to perform in patients with neurological issues or lower limb fractures. The purpose of this study was to evaluate the activity of the leg muscles during squatting when using a new exercise aid designed to help patients with difficulty in performing squats, termed the sliding tilt table, at different knee angles and to estimate the squat level for each angle. METHODS This study was a cross-sectional, observational study performed in the general community. Participants comprised 30 healthy adult men. Squats were performed by setting the knee joints at 30, 60, and 90° and the tilt table angles to 15, 30, and 45°. The muscle activity of the vastus medialis, tibialis anterior, and gastrocnemius was measured using surface electromyography. RESULTS As the tilt table and knee joint angle increased, the %maximal voluntary isometric contraction increased. Similar patterns were found in both legs. CONCLUSIONS Weight-bearing exercises, such as squats, are important exercise elements in patients who require lower limb rehabilitation. Therefore, it is necessary to provide efficient lower limb rehabilitation exercises by adjusting the squat level according to the patient's ability, which can be achieved using a sliding tilt table.
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Affiliation(s)
- Tae Sung Park
- Department of Convergence Medical Institute of Technology, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Myung-Jun Shin
- Department of Rehabilitation Medicine, Convergence Medical Institute of Technology, Biomedical Research Institute of Pusan National University Hospital, Busan, Republic of Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Jong Ho Kang
- Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan, Busan, Republic of Korea
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15
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Meghani O, Albright JA, Testa EJ, Arcand MA, Daniels AH, Owens BD. Testosterone Therapy Is Associated With Increased Odds of Quadriceps Tendon Injury. Clin Orthop Relat Res 2024; 482:175-181. [PMID: 37404114 PMCID: PMC10723858 DOI: 10.1097/corr.0000000000002744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/24/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Anabolic steroid use at supraphysiologic doses has been associated with an increased risk of tendon injury. However, the musculoskeletal effects of testosterone therapy in the clinical setting are not well understood. QUESTIONS/PURPOSES (1) Is prescription testosterone associated with a higher odds of subsequent quadriceps muscle or tendon injury? (2) Is prescription testosterone associated with a higher odds of surgical repair of the quadriceps tendon? METHODS The PearlDiver Database, which contains data on Medicaid, Medicare, and commercially insured patients, allows for a large representative sample of the US population including both publicly and privately insured patients. The database was queried for all patients between 2011 and 2018 who filled a testosterone prescription. Additionally, all quadriceps injuries using ICD-9 and ICD-10 codes between 2011 and 2018 were queried. Propensity score matching based on age, sex, Charlson comorbidity index, and specific comorbidities allowed us to create matched control groups. We used the t-test and chi-square analysis to compare the unmatched and matched cohorts. A total of 151,797 patients (123,627 male patients and 28,170 female patients) with a history of filled testosterone prescriptions were included in the study after matching with the control group, which was of equal size and representation of age, male-female proportions, and comorbidities. Chi-square and logistic regression analyses were performed to compare odds of quadriceps injury and quadriceps tendon repair among the testosterone groups to that of their respective control groups by age and sex. RESULTS Within 1 year of filling prescriptions for testosterone, 0.06% (97 of 151,797) of patients experienced a quadriceps injury compared with less than 0.01% (18 of 151,797) of patients in the control group (OR 5.4 [95% CI 3.4 to 9.2]; p < 0.001). Within the sex-specific matched groups, filling a testosterone prescription was associated with an increase in the odds of quadriceps injury in male patients within 1 year of the prescription (OR 5.8 [95% CI 3.5 to 10.3]; p < 0.001). Additionally, patients who filled a testosterone prescription were at increased risk of having quadriceps tendon repair within a year of the injury than were patients in the matched control group (OR 4.7 [95% CI 2.0 to 13.8]; p = 0.001). CONCLUSION Considering these findings, it is important for physicians to counsel patients receiving testosterone replacement therapy of the substantially increased odds of quadriceps tendon injury. Future investigations into the mechanisms of influence of exogenous anabolic steroids on tendon injury remains of interest. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Ozair Meghani
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - J. Alex Albright
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Edward J. Testa
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Michel A. Arcand
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Alan H. Daniels
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Brett D. Owens
- Department of Orthopaedics at the Warren Alpert Medical School of Brown University, Providence, RI, USA
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16
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Yousufy U, Chimera NJ. Is There an Association Between Injury History and Lower Extremity Joint Injury During Canada Games Competition? Int J Sports Phys Ther 2023; 18:1308-1319. [PMID: 38050547 PMCID: PMC10693481 DOI: 10.26603/001c.89273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/12/2023] [Indexed: 12/06/2023] Open
Abstract
Background Injuries during elite level competition like the Canada Games, occur frequently and injury history is one of the strongest predictors of future injury; however, this association is unknown in the Canada Games. Purpose To determine the association between injury history and incidence of lower extremity joint injury during Canada Games competition. Methods Data from the 2009 - 2019 Canada Games (8710 male and 8391 female athletes) competitions were de-identified by the Canada Games Council for analysis. Injury data were cleaned and categorized for previous injury and injury type and location. Injury history was self-reported and included concussion, major surgical procedure, neck and back, trauma to joint or bone, and trauma to ligament or tendon. Injury from the Canada Games competitions were categorized to include ankle, knee, hip, and patellofemoral joint injuries. Chi-Square (χ2 ) test of independence determined association between injury history and incidence of lower extremity joint injury during Canada Games competition. IBM SPSS (Version 26) was used for statistical analysis (p-value < 0.05). Results Four hundred and seventy-five ankle, 503 knee, 253 hip, and 106 patellofemoral joint injuries were reported during 10 years of Canada Games competitions. There were significant associations between history of neck and back injuries with ankle injuries and knee injuries, history of trauma and overuse of ligament or tendon with hip injuries and history of trauma or overuse of joint or bone with patellofemoral joint injuries. Conclusion These findings support previous literature suggesting that injury history is associated with future injury. Level of Evidence 3.
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Affiliation(s)
- Umar Yousufy
- Faculty of Applied Health Science Brock University
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17
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Ekenros L, Fridén C, von Rosen P. Does injury risk increase when youth athletes start to study at a sports high school? BMJ Open Sport Exerc Med 2023; 9:e001686. [PMID: 37937308 PMCID: PMC10626774 DOI: 10.1136/bmjsem-2023-001686] [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: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
Background/aim The injury risk is high in adolescent elite athletes. However, little is known about how the injury risk changes when young talented athletes start studying at a sports high school. The primary aim was therefore to explore the risk of injury when the athlete starts to study at a sports high school. A secondary aim was to identify risk factors for injury. Methods A total of 489 athletes (age 15-16 years) were followed for 20 weeks, including 10 weeks before and 10 weeks after the athlete had started to study at a sports high school. Substantial injury was monitored in adolescent elite athletes using the Oslo Sports Trauma Research Centre Questionnaire. Results The results showed that the mean difference (md) in injury prevalence was significantly (p=0.001) higher across the 10 weeks after school had started (md 3.6; 95% CI 1.5 to 5.8), compared with the 10 weeks before. Female athletes had significantly (p<0.001) higher injury prevalence (md 6.4%; 95% CI 3.0 to 9.8) across the 10 weeks after school had started, whereas male athletes (md 0.9%; 95% CI -1.8 to 3.6) had not (p=0.530). Three significant (p<0.05) risk factors were identified; previous injury within the past 12 months (OR 3.23), higher training volume (OR 0.97) and lower well-being (OR 0.71). Conclusions Our results provide supporting evidence for increased injury risk in female adolescent elite athletes after the athletes had started to study at a sports high school.
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Affiliation(s)
- Linda Ekenros
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, Sweden
| | - Cecilia Fridén
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- School of Health, Care and Social Welfare, Physiotherapy, Mälardalen University, Mälardalen, Västerås, Sweden
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, Sweden
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18
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Støvland VR, Amundsen R, Paulsen G, Dalen-Lorentsen T. Prepare to fail or failing to prepare? Acute performance after the 11+ with and without strength exercises. BMJ Open Sport Exerc Med 2023; 9:e001634. [PMID: 37937306 PMCID: PMC10626785 DOI: 10.1136/bmjsem-2023-001634] [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] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
Objectives The 11+ is an effective injury prevention warm-up programme but is often poorly adopted in practice. One reason for low compliance is the claim that the strength training part of the programme acutely impairs muscle performance before the football activity. This study aims to compare the acute effects of the 11+ with (WU+S) or without (WU-S) the strength training part on performance. Methods Fifteen female junior football players completed WU+S and WU-S on two separate days in randomised order. Maximal voluntary torque in knee extension and flexion (60°/s and 180°/s) and countermovement jump (CMJ) were tested before and after performing the warm-up protocol. Sprint performance and rating of perceived exertion (RPE) were assessed post-warm-up. Results Warm-up with strength training reduced peak torque in knee flexion at 180°/s more than WU-S, while no differences were found at 60°/s. Knee extension work was reduced more with WU+S than WU-S at 180°/s, but no differences at 60°/s. Peak torque angle and CMJ were unaffected. Players were slower on 20 and 30 m sprints after WU+S than WU-S. The RPE was higher after WU+S than WU-S, but there were no differences in readiness to train between the two protocols. Conclusion Performing the 11+ programme as a warm-up routine with the strength training part can impair subsequent knee flexion torque at high velocity and sprint performance in female junior football players compared with performing the 11+ warm-up without the strength part.
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Affiliation(s)
| | - Roar Amundsen
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Gøran Paulsen
- Department of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway
| | - Torstein Dalen-Lorentsen
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Smart Sensors and Microsystems, SINTEF Digital, Trondheim, Norway
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19
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Kakavas G, Malliaropoulos NG, Forelli F, Mazeas J, Skarpas G, Maffuli N. How Subtalar Kinematics Affects Knee Laxity in Soccer Players After Anterior Cruciate Ligament Injury? Cureus 2023; 15:e47850. [PMID: 38021974 PMCID: PMC10679957 DOI: 10.7759/cureus.47850] [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] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose The goal of the current study was to ascertain whether there is an association between foot pronation and anterior cruciate ligament (ACL) injury in a group of elite professional soccer players. Methods Two groups of soccer players were studied, all of whom played in the Greek Super League. The ACL group included players who had suffered an ACL injury in the last 2 years. The non-ACL group was composed of players who had never suffered an ACL injury. We used a 3D baropodometric laser scanner to measure pronation or overpronation (navicular drop phenomenon) of the subtalar joint and how this affects the subtalar joint while standing. We assessed ACL laxity using the Genourob Rotab. Results ACL-injured patients, regardless of the mechanism of injury, exhibited greater navicular drop values than a randomly selected group of subjects with no history of ACL injury. Conclusion Greater knee joint laxity and subtalar pronation may be associated with an increased risk of ACL injury. Pronation of the foot appears to be a risk factor for ACL injury. These findings should be integrated into future studies to better define how neuromuscular control related to lower extremity biomechanics is associated with ACL injury.
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Affiliation(s)
- Georgios Kakavas
- Sports Science and Physical Education, University of Thessaly, Trikala, GRC
- Sport Medicine, Fysiotek Spine and Sport, Athens, GRC
| | | | - Florian Forelli
- Research and Development, Société Française des Masseurs Kinésithérapeutes du Sport (SFMKS) Lab, Pierrefitte sur Seine, FRA
- Orthopaedic Surgery, Clinic of Domont, Domont, FRA
- Sports Medicine, Orthosport Rehab Center, Domont, FRA
| | - Jean Mazeas
- Orthopaedic Surgery, Clinic of Domont, Domont, FRA
- Sports Medicine, Orthosport Rehab Center, Domont, FRA
| | - George Skarpas
- Sports Injuries and Regenerative Medicine, "MITERA" General Hospital-HHG, Athens, GRC
| | - Nicola Maffuli
- Centre of Sports and Exercise Medicine, Queen Mary University of London Medical School, London, GBR
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20
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Yawar A, Lieberman DE. Biomechanical Tradeoffs in Foot Function From Variations in Shoe Design. Exerc Sport Sci Rev 2023; 51:128-139. [PMID: 37220782 DOI: 10.1249/jes.0000000000000322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
There is debate and confusion over how to evaluate the biomechanical effects of running shoe design. Here, we use an evolutionary perspective to analyze how key design features of running shoes alter the evolved biomechanics of the foot, creating a range of tradeoffs in force production and transmission that may affect performance and vulnerability to injury.
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Affiliation(s)
- Ali Yawar
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA
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Huang C, Ye J, Song Y, Kovács B, Baker JS, Mao Z, Gu Y. The Effects of Fatigue on the Lower Limb Biomechanics of Amateur Athletes during a Y-Balance Test. Healthcare (Basel) 2023; 11:2565. [PMID: 37761762 PMCID: PMC10530907 DOI: 10.3390/healthcare11182565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/27/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The Y-Balance Test (YBT) is a reliable tool for assessing the dynamic balance of athletes' lower limbs. This study aimed to compare the effects of the YBT on lower limb biomechanics before and after fatigue. Sixteen adult male recreational athletes were recruited for the study, and motion capture in combination with a force plate was used to collect kinematic, dynamics, and center of pressure (COP) data of the dominant leg during YBT testing before and after fatigue. Based on the research findings, there were significant statistical differences in the distances reached during the YBT in three directions before and after fatigue. After fatigue, there is a significant decrease in the ROM of the hip and knee joints in all three directions. Also, there is a significant increase in hip joint torque in the anterior- and posterior-lateral directions, while a significant decrease in hip and ankle joint torque is observed in the posterior-medial direction. Moreover, there is an increasing trend in positive and negative joint work for the hip, knee, and ankle joints in all three directions after fatigue. The range of COP displacement also increases following fatigue. The decline in YBT scores demonstrates the detrimental impact of fatigue on the dynamic balance of the lower limbs of adult male amateur athletes. We hope that these results can provide information for athletes and coaches to better understand the effects of fatigue on the dynamic balance of lower limbs, so as to carry out targeted lower limb balance training and prevent sports injuries.
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Affiliation(s)
- Congyu Huang
- Faculty of Sport Science, Ningbo University, Ningbo 315832, China
| | - Jingyi Ye
- Faculty of Sport Science, Ningbo University, Ningbo 315832, China
| | - Yang Song
- Faculty of Sport Science, Ningbo University, Ningbo 315832, China
- Doctoral School of Safety and Security Sciences, Obuda University, 1034 Budapest, Hungary
- Faculty of Engineering, University of Szeged, 6724 Szeged, Hungary
| | - Balint Kovács
- Faculty of Sport Science, Ningbo University, Ningbo 315832, China
- Department of Kinesiology, University of Physical Education, Alkotás u. 44, 1123 Budapest, Hungary
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong 999077, China;
| | - Zhuqing Mao
- Faculty of Sport Science, Ningbo University, Ningbo 315832, China
| | - Yaodong Gu
- Faculty of Sport Science, Ningbo University, Ningbo 315832, China
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo 315010, China
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22
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Feigel ED, Bird MB, Koltun KJ, Lovalekar M, Mi Q, Martin BJ, Forse JN, Steele EJ, Bannister A, Cruz AV, Burns I, Fain A, Doyle TLA, Nindl BC. Association of clinically-measured and dynamic ankle dorsiflexion assessed by markerless motion capture during the drop-jump task on landing biomechanics and risk of ankle injury in military personnel undergoing 10 weeks of physical training. J Sci Med Sport 2023; 26:476-481. [PMID: 37574406 DOI: 10.1016/j.jsams.2023.07.012] [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: 12/06/2022] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES Determine the influence of clinically-measured maximum dorsiflexion, dynamic peak dorsiflexion and percent of clinically-measured maximum dorsiflexion used during a drop-jump task on landing biomechanics and risk of ankle injury in military personnel. DESIGN Prospective cohort study. METHODS 672 participants (122 women) enrolled. The weightbearing lunge test assessed clinically-measured maximum dorsiflexion averaged across limbs (degrees). Markerless motion capture and force plates collected lower extremity kinematic and kinetic data during a drop-jump task. Percent of clinically-measured maximum dorsiflexion used during landing was calculated as dynamic peak dorsiflexion divided by clinically-measured value, multiplied by 100 (%). De-identified injury data was derived from military physical therapists. Simple linear regression analysis determined the association between dorsiflexion measures and landing biomechanics. Simple binary logistic regression analyses identified predictors of ankle injuries. Statistical significance was set at α = 0.05. RESULTS Eighteen participants sustained a traumatic ankle injury from a landing. All measures of dorsiflexion were associated with movement patterns that countered the stiff-legged landing strategy with dynamic measures showing a higher predictive value. Protective factors against ankle injury included height (odds ratio: 0.818, p = 0.006) and weight (odds ratio: 0.824, p = 0.023) for women. Relative braking impulse was a risk factor for men (odds ratio: 1.890, p = 0.001). CONCLUSIONS Greater clinically-measured and dynamic measures of dorsiflexion were associated with movement patterns that countered the stiff-legged landing strategy but neither measure of dorsiflexion predicted ankle injury risk. Resultant biomechanics and anthropometrics influenced ankle injury risk to warrant recognition for injury prevention initiatives.
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Affiliation(s)
- Evan D Feigel
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States.
| | - Matthew B Bird
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Kristen J Koltun
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Mita Lovalekar
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Qi Mi
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Brian J Martin
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Jennifer N Forse
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | - Elizabeth J Steele
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
| | | | | | - Ian Burns
- Marine Corps Base Quantico, United States
| | - AuraLea Fain
- Biomechanics, Physical Performance, and Exercise (BioPPEx) Research Group, Macquarie University, Australia; Faculty of Medicine, Health, and Human Sciences, Macquarie University, Australia
| | - Tim L A Doyle
- Biomechanics, Physical Performance, and Exercise (BioPPEx) Research Group, Macquarie University, Australia; Faculty of Medicine, Health, and Human Sciences, Macquarie University, Australia
| | - Bradley C Nindl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, United States
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23
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Spolaor F, Guiotto A, Ciniglio A, Cibin F, Sawacha Z. Effects of a proprioceptive focal stimulation (Equistasi®) on reducing the biomechanical risk factors associated with ACL injury in female footballers. Front Sports Act Living 2023; 5:1134702. [PMID: 37521101 PMCID: PMC10382620 DOI: 10.3389/fspor.2023.1134702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 06/20/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Football presents a high rate of lower limb injuries and high incidence of Anterior Cruciate Ligament (ACL) rupture, especially in women. Due to this there is the need to optimize current prevention programs. This study aims to verify the possibility to reduce the biomechanical risk factors associated with ACL injury, through the application of proprioceptive stimulation by means of the Equistasi® device. Methods Ten elite female footballers were enrolled and received the device for 4 weeks (5 days/week, 1h/day). Athletes were assessed directly on-field at four time points: T0 and T1 (evaluation without and with the device), T2 (after 2 weeks), T4 (after 4 weeks) while performing two different tasks: Romberg Test, and four sidestep cutting maneuvers bilaterally. Seven video cameras synchronized with a plantar pressure system were used, thirty double colored tapes were applied on anatomical landmarks, and three dimensional coordinates reconstructed. Vertical ground reaction forces and center of pressure data were extracted from the plantar pressure insoles. Hip, knee, and ankle flexion-extension angles and moments were computed as well as abd-adduction joint torques. From the Romberg Test both center of pressure descriptive variables and frequency analysis parameters were extracted. Each variable was compared among the different time frames, T1, T2 and T4, through Friedman Test for non-parametric repeated measures (p<0.05); Wilcoxon Signed Rank Test was used for comparing variables between T0 and T1 (p<0.05) and across the different time frames as follows: T1-T2, T2-T4 and T1-T4. Results Statistically significant differences in both posturographic and biomechanical variables between the assessment at T0 and T1 were detected. Reduced hip and knee abduction torques were revealed in association with reduced both ground reaction forces and ankle dorsiflexion torque from T1 up to T4. Discussion The proprioceptive stimuli showed to have the potential to improve cutting biomechanics mainly with respect to the ligament and quadriceps dominance theories. Results of the present study, even if preliminary and on a small sample size, could be considered promising towards the inclusion of proprioceptive training in injury prevention programs.
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Affiliation(s)
- Fabiola Spolaor
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Annamaria Guiotto
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Alfredo Ciniglio
- Department of Information Engineering, University of Padova, Padova, Italy
| | | | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Padova, Italy
- Department of Medicine, University of Padova, Padova, Italy
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24
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Baek SY, Beaulieu ML, Wojtys EM, Ashton-Miller JA. Relationship Between Lateral Tibial Posterior Slope and Tibiofemoral Kinematics During Simulated Jump Landings in Male Cadaveric Knees. Orthop J Sports Med 2023; 11:23259671231160213. [PMID: 37347020 PMCID: PMC10280540 DOI: 10.1177/23259671231160213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/01/2023] [Indexed: 06/23/2023] Open
Abstract
Background It is not known mechanistically whether a steeper lateral posterior tibial slope (LTS) leads to an increase in anterior tibial translation (ATT) as well as internal tibial rotation (ITR) during a given jump landing. Hypothesis A steeper LTS will result in increased ATT and ITR during simulated jump landings when applying knee compression, flexion, and internal tibial torque of increasing severity. Study Design Descriptive laboratory study. Methods Seven pairs of cadaveric knees were harvested from young male adult donors (mean ± SD; age, 25.71 ± 5.53 years; weight, 71.51 ± 4.81 kg). The LTS of each knee was measured by a blinded observer from 3-T magnetic resonance images. Two sets of 25 impact trials of ∼700 N (1× body weight [BW] ±10%) followed by 2 sets of 25 trials of 1400 N (2× BW ±10%) were applied to a randomly selected knee of each pair. Similarly, on the contralateral knee, 2 sets of 25 impact trials of ∼1800 N (2.5× BW ±10%) followed by 2 sets of 25 trials of ∼2100 N (3× BW ±10%) were applied. Three-dimensional knee kinematics, including ATT and ITR, were measured at 400 Hz using optoelectronic motion capture. Two-factor linear mixed effect models were used to determine the relationship of LTS to ATT and ITR as impact loading increased. Results As LTS increased, so did ATT and ITR during increasingly severe landings. LTS had an increasing effect on ATT (coefficient, 0.50; 95% CI, 0.29-0.71) relative to impact force (coefficient, 0.52; 95% CI, 0.50-0.53). ITR was proportional to LTS (coefficient, 1.36; 95% CI, 0.80-1.93) under increasing impact force (coefficient, 0.49; 95% CI, 0.47-0.52). For steeper LTS, the increase in ITR was proportionally greater than the increase in ATT. Conclusion In male knee specimens, a steeper LTS significantly increased ATT and ITR during jump landings. Clinical Relevance Increases in ITR and ATT during jump landings lead to increased strain on the anterior cruciate ligament and are therefore associated with greater risk of ligament failure.
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Affiliation(s)
- So Young Baek
- Department of Mechanical Engineering,
University of Michigan, Ann Arbor, Michigan, USA
| | - Mélanie L. Beaulieu
- Department of Orthopedic Surgery,
University of Michigan, Ann Arbor, Michigan, USA
| | - Edward M. Wojtys
- Department of Orthopedic Surgery,
University of Michigan, Ann Arbor, Michigan, USA
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25
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Froehle AW, Edwards B, Peterson MJ, Meyerson B, Duren DL. Effects of pubertal growth variation on knee mechanics during walking in female and male adolescents. Am J Hum Biol 2023; 35:e23853. [PMID: 36571458 PMCID: PMC10175122 DOI: 10.1002/ajhb.23853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/11/2022] [Accepted: 12/11/2022] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Puberty substantially alters the body's mechanical properties, neuromuscular control, and sex differences therein, likely contributing to increased, sex-biased knee injury risk during adolescence. Female adolescents have higher risk for knee injuries than male adolescents of similar age engaging in similar physical activities, and much research has investigated sex differences in mechanical risk factors. However, few studies address the considerable variation in pubertal growth (timing, pace), knee mechanics, and injury susceptibility within sexes, or the impact of such growth variation on mechanical injury risk. OBJECTIVES The present study tested for effects of variation in pubertal growth on established mechanical knee injury risk factors, examining relationships between and within sexes. METHODS Pubertal growth indices describing variation in the timing and rate of pubertal growth were developed using principal component analysis and auxological data from serial stature measurements. Linear mixed models were applied to evaluate relationships between these indices and knee mechanics during walking in a sample of adolescents. RESULTS Later developing female adolescents with slower pubertal growth had higher extension moments throughout stance, whereas earlier developers had higher valgus knee angles and moments. In male adolescents, faster and later growth were related to higher extension moments throughout gait. In both sexes, faster growers had higher internal rotation moments at foot-strike. CONCLUSIONS Pubertal growth variation has important effects on mechanical knee injury risk in adolescence, affecting females and males differently. Earlier developing females exhibit greater injury risk via frontal plane factors, whereas later/faster developing males have elevated risk via sagittal plane mechanisms.
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Affiliation(s)
- Andrew W Froehle
- Department of Kinesiology and Health, Wright State University, Dayton, Ohio, USA
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA
| | - Brian Edwards
- Department of Kinesiology and Health, Wright State University, Dayton, Ohio, USA
| | - Matthew J Peterson
- School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Brian Meyerson
- Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA
| | - Dana L Duren
- Department of Orthopaedic Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA
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26
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Kelley EA, Hogg JA, Gao L, Waxman JP, Shultz SJ. Demographic Factors and Instantaneous Lower Extremity Injury Occurrence in a National Collegiate Athletic Association Division I Population. J Athl Train 2023; 58:393-400. [PMID: 35789230 PMCID: PMC11220903 DOI: 10.4085/1062-6050-0673.21] [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] [Indexed: 11/09/2022]
Abstract
CONTEXT Temporal prediction of the lower extremity (LE) injury risk will benefit clinicians by allowing them to better leverage limited resources and target those athletes most at risk. OBJECTIVE To characterize the instantaneous risk of LE injury by demographic factors of sex, sport, body mass index (BMI), and injury history. DESIGN Descriptive epidemiologic study. SETTING National Collegiate Athletic Association Division I athletic program. PATIENTS OR OTHER PARTICIPANTS A total of 278 National Collegiate Athletic Association Division I varsity student-athletes (119 males, 159 females; age = 19.07 ± 1.21 years, height = 175.48 ± 11.06 cm, mass = 72.24 ± 12.87 kg). MAIN OUTCOME MEASURE(S) Injuries to the LE were tracked for 237 ± 235 consecutive days. Sex-stratified univariate Cox regression models were used to investigate the association between time to first LE injury and sport, BMI, and LE injury history. The instantaneous LE injury risk was defined as the injury risk at any given point in time after the baseline measurement. Relative risk ratios and Kaplan-Meier curves were generated. Variables identified in the univariate analysis were included in a multivariate Cox regression model. RESULTS Female athletes displayed similar instantaneous LE injury risk to male athletes (hazard ratio [HR] = 1.29; 95% CI= 0.91, 1.83; P = .16). Overweight athletes (BMI >25 kg/m2) had similar instantaneous LE injury risk compared with athletes with a BMI of <25 kg/m2 (HR = 1.23; 95% CI = 0.84, 1.82; P = .29). Athletes with previous LE injuries were not more likely to sustain subsequent LE injury than athletes with no previous injury (HR = 1.09; 95% CI = 0.76, 1.54; P = .64). Basketball (HR = 3.12; 95% CI = 1.51, 6.44; P = .002) and soccer (HR = 2.78; 95% CI = 1.46, 5.31; P = .002) athletes had a higher risk of LE injury than cross-country athletes. In the multivariate model, instantaneous LE injury risk was greater in female than in male athletes (HR = 1.55; 95% CI = 1.00, 2.39; P = .05), and it was greater in male athletes with a BMI of >25 kg/m2 than that in all other athletes (HR = 0.44; 95% CI = 0.19, 1.00; P = .05), but these findings were not significantly different. CONCLUSIONS In a collegiate athlete population, previous LE injury was not a contributor to the risk of future LE injury, whereas being female or being male with a BMI of >25 kg/m2 resulted in an increased risk of LE injury. Clinicians can use these data to extrapolate the LE injury risk occurrence to specific populations.
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Affiliation(s)
| | - Jennifer A. Hogg
- Department of Health and Human Performance, University of Tennessee at Chattanooga
| | - Lani Gao
- Department of Mathematics, University of Tennessee at Chattanooga
| | | | - Sandra J. Shultz
- Department of Kinesiology, University of North Carolina at Greensboro
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27
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Ross BJ, Lupica GM, Dymock ZR, Miskimin C, Mulcahey MK. Sex-related differences in hip and groin injuries in adult runners: a systematic review. PHYSICIAN SPORTSMED 2023; 51:107-120. [PMID: 34905425 DOI: 10.1080/00913847.2021.2016355] [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] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Hip/groin running-related injuries (RRIs) are relatively uncommon. It is unclear if runners of either sex are disproportionately affected. Our objective was to systematically review differences in hip/groin RRIs between males and females. DATA SOURCES A structured and comprehensive search of four medical literature databases was performed (PubMed, Embase, Ovid Medline, and CINAHL). Terms searched were as follows: risk, epidemiology, hip injury, groin injury, overuse injury, running, sprinting, and track and field. STUDY SELECTION Studies reporting sex-specific data on hip/groin RRIs in adult runners were included. Data was extracted and reviewed independently by two authors. STUDY APPRAISAL AND DATA SYNTHESIS Sex-specific injury rates, risk factors, and return to sport (RTS) following hip/groin RRI were extracted. Risk of bias was assessed using the Joanna-Briggs Institute Critical Appraisal Tool. RESULTS Ten studies with 7,353 total runners were included: 2,315 (47%) males and 2,559 (53%) females. The mean age of the included runners was 37.3 ± 8.9 years and the mean weekly running distance was 10.4 ± 8.4 km. Hip/groin injuries comprised 10.1% (491/4,874) of total RRIs, including 6.3% of RRIs sustained by males and 11.0% by females. Three studies reported significantly higher rates of hip/groin RRIs in female runners. One study reported significantly higher rates of gluteus medius and adductor RRIs for females and males, respectively. One study identified female sex as an independent risk factor for hip/groin RRIs. Three studies reported on RTS after hip/groin RRIs: the pooled RTS rate was 81.4% (57/70) at 1 to 368 days after injury. LIMITATIONS Data was pooled when possible; however, there was considerable clinical, methodological, and statistical heterogeneity across studies. CONCLUSIONS Hip/groin RRIs comprise a greater percentage of total injuries among injured female runners relative to males. Females may be at a higher risk for sustaining hip/groin RRIs though more research on risk factors and RTS is needed.
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Affiliation(s)
| | | | - Zakari R Dymock
- Department of Physical Medicine & Rehabilitation, University of Kentucky College of Medicine, Lexington
| | - Cadence Miskimin
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans
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Promsri A, Bangkomdet K, Jindatham I, Jenchang T. Leg Dominance—Surface Stability Interaction: Effects on Postural Control Assessed by Smartphone-Based Accelerometry. Sports (Basel) 2023; 11:sports11040075. [PMID: 37104149 PMCID: PMC10145104 DOI: 10.3390/sports11040075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/19/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
The preferential use of one leg over another in performing lower-limb motor tasks (i.e., leg dominance) is considered to be one of the internal risk factors for sports-related lower-limb injuries. The current study aimed to investigate the effects of leg dominance on postural control during unipedal balancing on three different support surfaces with increasing levels of instability: a firm surface, a foam pad, and a multiaxial balance board. In addition, the interaction effect between leg dominance and surface stability was also tested. To this end, a tri-axial accelerometer-based smartphone sensor was placed over the lumbar spine (L5) of 22 young adults (21.5 ± 0.6 years) to record postural accelerations. Sample entropy (SampEn) was applied to acceleration data as a measure of postural sway regularity (i.e., postural control complexity). The results show that leg dominance (p < 0.001) and interaction (p < 0.001) effects emerge in all acceleration directions. Specifically, balancing on the dominant (kicking) leg shows more irregular postural acceleration fluctuations (high SampEn), reflecting a higher postural control efficiency or automaticity than balancing on the non-dominant leg. However, the interaction effects suggest that unipedal balancing training on unstable surfaces is recommended to reduce interlimb differences in neuromuscular control for injury prevention and rehabilitation.
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Affiliation(s)
- Arunee Promsri
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence in Neuromechanics, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Correspondence: ; Tel.: +66-54-466-666 (ext. 3817)
| | - Kotchakorn Bangkomdet
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
| | - Issariya Jindatham
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
| | - Thananya Jenchang
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
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29
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Monteleone G, Tramontana A, Sorge R, Tiloca A, Roselli M. Ankle sprain and podoscopic footprint pattern in female volleyball players. Acta Orthop Belg 2023; 89:141-145. [PMID: 37294998 DOI: 10.52628/89.1.10704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Ankle sprain (AS) is the most common sports injury that can be complicated by chronic joint instability. The aim of this study was to examine the relationship between foot types and the ankle sprain events suffered during the sport career in female volleyball players. In this retrospective study, we randomly selected 98 female volleyball players competing in several divisions. Data were obtained from self-administered questionnaires in which the athlete noted data about volleyball practice, whether they had had ankle sprains and the number of these events. Plantar footprint was photographed by a plantoscope classifying each foot as normal, flat or cavus (196 feet). Of the 196 feet, 145 (74.0%) were normal, 8 (4.1%) were flat 43 and (21.9%) were cavus. Thirthy-five athletes reported at least one AS during volleyball practice. In total 65 sprain injuries were reported (35 to the right side and 30 to the left side). In 22 ankles (14 right, 8 left) sprain reinjure (AS >1) have been reported. A higher AS reinjury rate is correlated to the cavus footprint pattern (p = 0,005). Cavus foot associates to a higher risk of reinjury for ankle sprains in female volleyball players. Knowing the athletes which are more likely to sustain a reinjure may be helpful for the orthopedic surgeon to plan preventive strategies.
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30
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Zhang C, Han T, Tan X, Yu C, Li S, Zheng H, Zhu D, Zhang Y, Shen T. Effect of Exergame Intervention on Balance Ability of Adolescents: A Randomized Controlled Trial. Games Health J 2023; 12:249-258. [PMID: 36856487 DOI: 10.1089/g4h.2022.0182] [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: 03/02/2023] Open
Abstract
Objective: Balance is a strong indicator of physical development of adolescents, and there is a trend of employing exergame for balance training. However, the effectiveness of exergame specifically designed for balance training on adolescents' balance abilities in various postures remains unclear. Materials and Methods: In this study, an exergame for balance training was developed with Kinect and a randomized controlled trial was conducted to assess its effect on balance ability development. Thirty-two healthy adolescents (age: 11.44 ± 0.51) were recruited to participate in an 8-week trial and randomly allocated to an exergame group (N = 16) or control group (N = 16). Results: The static balance test in the eagle stance posture and the dynamic balance test using the Y-Balance Test were both conducted before and after the intervention. From the results of Mann-Whitney U test, the intervention group presented greater improvement during the eagle stance test with eyes closed than the control group with P = 0.009 and P = 0.03 in left and right leg, respectively. The intervention group also showed a more significant improvement in dynamic balance (P = 0.002), which was reflected by the higher increase of composite scores. Furthermore, the balance ability when standing with nondominant leg or eyes closed, both presented higher improvements than standing with dominant leg or eyes opened, respectively. Moreover, 75% participants reported high interest and 87.5% participants expressed high engagement with exergame (score ≥4) using 5-score scale questionnaire. Conclusion: The proposed exergame for balance training could potentially promote balance training and serve as an educational tool for healthy adolescents to enhance their balance abilities.
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Affiliation(s)
- Chenqi Zhang
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Ting Han
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Xinyang Tan
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Cong Yu
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Shuo Li
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Hongtao Zheng
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Dian Zhu
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Yahui Zhang
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Tianjia Shen
- School of Design, Shanghai Jiao Tong University, Shanghai, China
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31
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Boey D, Lee M. The Association Between Functional Movement Screen Scores and Knee Valgus Moments During Unplanned Sidestep Cutting in Netball. Int J Sports Phys Ther 2023; 18:113-121. [PMID: 36793577 PMCID: PMC9897044 DOI: 10.26603/001c.57678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/10/2022] [Indexed: 02/04/2023] Open
Abstract
Background Regular employment of three-dimensional (3D) motion analyses to assess and monitor knee valgus moments; a contributor to non-contact anterior cruciate ligament (ACL) injury; during unplanned sidestep cutting (USC) is costly and time-consuming. An alternative quick-to-administer assessment tool to infer an athlete's risk for this injury could allow prompt and targeted interventions to mitigate this risk. Purpose This study investigated whether peak knee valgus moments (KVM) during weight-acceptance phase of an unplanned sidestep cut were correlated with composite and component scores of the Functional Movement Screen (FMS™). Study Design Cross-sectional, Correlation. Methods Thirteen female national-level netballers performed six movements of the FMS™ protocol and three trials of USC. A 3D motion analysis system captured lower limb kinetics and kinematics of each participant's non-dominant leg during USC. Averages of peak KVM across USC trials were calculated and examined for correlations with composite and component scores of the FMS™. Results No correlations were found between FMS™ composite or any of its component scores with peak KVM during USC. Conclusions The current FMS™ did not show any correlations with peak KVM during USC on the non-dominant leg. This suggests that the FMS™ has limited utility in screening for non-contact ACL injury risks during USC. Level of Evidence 3.
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Affiliation(s)
| | - Marcus Lee
- Sport Biomechanics Singapore Sport Institute
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32
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Fridén C, Ekenros L, von Rosen P. Previous injury, sex and well-being are associated with injury profiles in 422 adolescent elite athletes of age 15-16 years: a 20-week longitudinal study. BMJ Open Sport Exerc Med 2023; 9:e001485. [PMID: 36643407 PMCID: PMC9835953 DOI: 10.1136/bmjsem-2022-001485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/11/2023] Open
Abstract
Background Adolescent elite athletes have a high injury risk and many risk factors for injury have been suggested. However, there is a lack of prospective studies in adolescent elite athletes of age 15-16 years. Aim The aim of the study was to prospectively explore risk factors associated with different injury prevalence profiles in adolescent elite athletes. Methods Substantial injury was monitored in adolescent elite athletes (n=422) using the validated Oslo Sports Trauma Research Center Questionnaire over 20 weeks. Athletes were categorised in tertiles based on injury prevalence. Results The median substantial injury prevalence for all athletes was 10% (IQR 0%-20%). Compared with the 'no injury' group, previous injury (p<0.001, OR 3.91) and well-being (p<0.001, OR 0.93) were associated with the 'high injury' group, and previous injury (p=0.006, OR 1.96) and being a female athlete (p=0.002, OR 2.08) with the 'low injury' group. A female athlete with a previous injury and low perceived well-being (25th percentile) had a 48% risk (95% CI 36% to 59%) of belonging to the 'high injury' group, compared with 7% (95% CI 4% to 12%) for a male athlete with no previous injury and high well-being (75th percentile). Conclusion Medical personnel should be aware of the high injury risk and risk factors for injury in adolescent elite athletes, and closely monitor the rehabilitation post-injury as a previous injury is such a strong risk factor for a new injury.
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Affiliation(s)
- Cecilia Fridén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden,Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Linda Ekenros
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
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33
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Hébert-Losier K, Boswell-Smith C, Hanzlíková I. Effect of an overhead goal on landing error scoring system and jump height measures. Phys Ther Sport 2023; 59:115-121. [PMID: 36528004 DOI: 10.1016/j.ptsp.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Compare overall Landing Error Scoring System (LESS) scores, risk categorisation, specific LESS errors, and double-leg jump-landing jump heights between overhead goal and no goal conditions. DESIGN Randomised cross-over. SETTING Laboratory. PARTICIPANTS 76 (51% male). MAIN OUTCOME MEASURES Participants landed from a 30-cm box to 50% of their body height and immediately jumped vertically for maximum height. Participants completed three trials under two random-ordered conditions: with and without overhead goal. Group-level mean LESS scores, risk categorisation (5-error threshold), specific landing errors, and jump heights were compared between conditions. RESULTS Mean LESS scores were greater (0.3 errors, p < 0.001) with the overhead goal, but this small difference was not clinically meaningful. Similarly, although the number of high-risk participants was greater with the overhead goal (p = 0.039), the 9.2% difference was trivial. Participants jumped 2.7 cm higher with the overhead goal (p < 0.001) without affecting the occurrence of any specific LESS errors. DISCUSSION Performing the LESS with an overhead goal enhances sport specificity and elicits greater vertical jump performances with minimal change in landing errors and injury-risk categorisation. Adding an overhead goal to LESS might enhance its suitability for injury risk screening, although the predictive value of LESS with an overhead goal needs confirmation.
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Affiliation(s)
- Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, 52 Miro Street, 3116, Tauranga, New Zealand. https://twitter.com/KimHebertLosier
| | - Caleb Boswell-Smith
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, 52 Miro Street, 3116, Tauranga, New Zealand
| | - Ivana Hanzlíková
- Department of Physiotherapy, Faculty of Physical Culture, Palacký University Olomouc, Třída Míru 177, Olomouc, 771 11, Czech Republic. https://twitter.com/HanzlikovaIvana
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34
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Moayedi M, Arshi AR, Salehi M, Akrami M, Javadi Asl N, Naemi R. An investigation into the hammer toe effects on the lower extremity mechanics and plantar fascia tension: A case for a vicious cycle and progressive damage. Comput Biol Med 2023; 152:106381. [PMID: 36563541 DOI: 10.1016/j.compbiomed.2022.106381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/14/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
Hammer toes are one of the common deformities of the forefoot that can lead to compensatory changes during walking in individuals with this condition. Predicting the adverse effects of tissue damage on the performance of other limbs is very important in the prevention of progressive damage. Finite element (FE) and musculoskeletal modeling can be helpful by allowing such effects to be studied in a way where the internal stresses in the tissue could be investigated. Hence, this study aims to investigate the effects of the hammer toe deformity on the lower extremity, especially on the plantar fascia functions. To compare the joint reactions of the hammer toe foot (HTF) and healthy foot (HF), two musculoskeletal models (MSM) of the feet of a healthy individual and that of a participant with hammer toe foot were developed based on gait analysis. A previously validated 3D finite element model which was constructed using Magnetic Resonance Imaging (MRI) of the diabetic participant with the hammer toe deformity was processed at five different events during the stance phase of gait. It was found that the hammer toe deformity makes dorsiflexion of the toes and the windlass mechanism less effective during walking. Specifically, the FE analysis results showed that plantar fascia (PF) in HTF compared to HF played a less dominant role in load bearing with both medial and lateral parts of PF loaded. Also, the results indicated that the stored elastic energy in PF was less in HTF than the HF, which can indicate a higher metabolic cost during walking. Internal stress distribution shows that the majority of ground reaction forces are transmitted through the lateral metatarsals in hammer toe foot, and the probability of fifth metatarsal fracture and also progressive deformity was subsequently increased. The MSM results showed that the joint reaction forces and moments in the hammer toe foot have deviated from normal, where the metatarsophalangeal joint reactions in the hammer toe were less than the values in the healthy foot. This can indicate a vicious cycle of foot deformity, leading to changes in body weight force transmission line, and deviation of joint reactions and plantar fascia function from normal. These in turn lead to increased internal stress concentration, which in turn lead to further foot deformities. This vicious cycle cause progressive damage and can lead to an increase in the risk of ulceration in the diabetic foot.
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Affiliation(s)
- M Moayedi
- Department of Mechanical Engineering, Amirkabir University of Technology, Iran.
| | - A R Arshi
- Biomechanics and Sports Engineering Groups, Biomedical Engineering Department, Amirkabir University of Technology, Iran.
| | - M Salehi
- Department of Mechanical Engineering, Amirkabir University of Technology, Iran.
| | - M Akrami
- Department of Engineering, College of Engineering, Mathematics, and Physical Sciences, University of Exeter, UK.
| | - N Javadi Asl
- Department of Mechanical Engineering, Amirkabir University of Technology, Iran.
| | - R Naemi
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, UK.
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35
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Moukhaiber N, Summers SJ, Opar D, Imam J, Thomson D, Chang WJ, Andary T, Cavaleri R. The effect of theta burst stimulation over the primary motor cortex on experimental hamstring pain: A randomised, controlled study. THE JOURNAL OF PAIN 2022; 24:593-604. [PMID: 36464137 DOI: 10.1016/j.jpain.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/02/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022]
Abstract
Theta burst stimulation (TBS) over the primary motor cortex (M1) is an emerging technique that may have utility in the treatment of musculoskeletal pain. However, previous work exploring the analgesic effects of noninvasive brain stimulation has been limited largely to the arm or hand, despite 80% of acute musculoskeletal injuries occurring in the lower limb. This is a pertinent point, given the functional and neurophysiological differences between upper and lower limb musculature, as well as evidence suggesting that reorganization of corticomotor pathways is region-specific. This study investigated the effect of excitatory TBS on pain, function, and corticomotor organization during experimentally induced lower limb pain. Twenty-eight healthy participants attended 2 experimental sessions. On Day 0, participants completed 10 sets of 10 maximal eccentric contractions of the right hamstring muscles to induce delayed onset muscle soreness. Four consecutive blocks of either active or sham TBS were delivered on Day 2. Measures of mechanical sensitivity, pain (muscle soreness, pain intensity, pain area) function (single-leg hop distance, maximum voluntary isometric contraction, lower extremity functional scale), and corticomotor organization were recorded before and after TBS on Day 2. Pain and function were also assessed daily from Days 2 to 10. Active TBS reduced mechanical sensitivity compared to sham stimulation (P = .01). Corticomotor organization did not differ between groups, suggesting that improvements in mechanical sensitivity were not mediated by changes in M1. Subjective reports of pain intensity and function did not change following active TBS, contrasting previous reports in studies of the upper limb. PERSPECTIVE: M1 TBS reduces mechanical sensitivity associated with experimentally induced hamstring pain. Though further work is needed, these findings may hold important implications for those seeking to expedite recovery or reduce muscle sensitivity following hamstring injury.
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Affiliation(s)
- Nadia Moukhaiber
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia
| | - Simon J Summers
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia; Queensland University of Technology, School of Biomedical Sciences, Queensland, Australia
| | - David Opar
- Australian Catholic University, Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, School of Behavioural and Health Sciences, Victoria, Australia
| | - Jawwad Imam
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia
| | - Daniel Thomson
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia
| | - Wei-Ju Chang
- University of Newcastle, College of Health Medicine and Wellbeing, School of Health Sciences, New South Wales, Australia; Neuroscience Research Australia (NeuRA), Centre for Pain IMPACT, New South Wales, Australia
| | - Toni Andary
- South Western Sydney Local Health District, New South Wales, Australia
| | - Rocco Cavaleri
- Western Sydney University, Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, New South Wales, Australia.
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Keogh JA, Ruder MC, Masood Z, Kobsar D. The Ecological Validity of Countermovement Jump to On-Court Asymmetry
in Basketball. Sports Med Int Open 2022; 6:E53-E59. [PMID: 36340854 PMCID: PMC9635953 DOI: 10.1055/a-1947-4848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022] Open
Abstract
Jump-based asymmetry is often used as an indicator of sport performance and may
be used to discern injury susceptibility. Due to task specificity, however,
countermovement jump asymmetry may not be representative of on-court asymmetry.
As such, we assessed the association between countermovement jump asymmetry and
on-court impact asymmetry metrics (n=3, and n=4, respectively)
using linear regressions (α=0.05). Fifteen female basketball
athletes completed countermovement jump and on-court sessions across a
competitive season. A significant negative association was found between peak
landing force asymmetry and both overall and medium acceleration on-court
asymmetry (b=–0.1, R
2
=0.08, p<0.001;
b=–0.1, R
2
=0.11, p<0.001,
respectively), as well as between peak propulsive force asymmetry and on-court
medium acceleration asymmetry (b=–0.24,
R
2
=0.04, p=0.01). Alternatively, both peak landing
and peak propulsive force asymmetry were significantly positively associated
with on-court high acceleration asymmetry (b=0.17,
R
2
=0.08, p<0.001; b=0.35,
R
2
=0.02, p=0.04, respectively). While some
overlap may exist, countermovement jump and on-court impact asymmetry appear to
be independent. Thus, sport-specific monitoring may be necessary to adequately
monitor injury susceptibility using asymmetry.
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Affiliation(s)
- Joshua A.J. Keogh
- Kinesiology, McMaster University Faculty of Science, Hamilton,
Canada,Correspondence Mr. Joshua A.J.
Keogh McMaster University Faculty of
ScienceKinesiology1280 Main
Street W.L8S 4K1HamiltonCanada(905)
923-8183
| | - Matthew C Ruder
- Kinesiology, McMaster University Faculty of Science, Hamilton,
Canada
| | - Zaryan Masood
- Kinesiology, McMaster University Faculty of Science, Hamilton,
Canada
| | - Dylan Kobsar
- Kinesiology, McMaster University Faculty of Science, Hamilton,
Canada
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Gómez Carrión Á, Atín Arratibe MDLÁ, Morales Lozano MR, Martínez Rincón C, Martínez Sebastián C, Saura Sempere Á, Nuñez-Fernandez A, Sánchez-Gómez R. Changes in the Kinematics of Midfoot and Rearfoot Joints with the Use of Lateral Wedge Insoles. J Clin Med 2022; 11:jcm11154536. [PMID: 35956151 PMCID: PMC9369829 DOI: 10.3390/jcm11154536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/02/2022] [Indexed: 01/27/2023] Open
Abstract
The lateral wedge insole (LWI) is a typical orthopedic treatment for medial knee osteoarthritis pain, chronic ankle instability, and peroneal tendon disorders. It is still unknown what the effects are in the most important joints of the foot when using LWIs as a treatment for knee and ankle pathologies. Objectives: The aim of this study was to determine the influence of LWIs on the position of the midfoot and rearfoot joints by measuring the changes using a tracking device. Methods: The study was carried out with a total of 69 subjects. Movement measurements for the midfoot were made on the navicular bone, and for the rearfoot on the calcaneus bone. The Polhemus system was used, with two motion sensors fixed to each bone. Subjects were compared by having them use LWIs versus being barefoot. Results: There were statistically significant differences in the varus movement when wearing a 4 mm LWI (1.23 ± 2.08°, p < 0.001) versus the barefoot condition (0.35 ± 0.95°), and in the plantarflexion movement when wearing a 4 mm LWI (3.02 ± 4.58°, p < 0.001) versus the barefoot condition (0.68 ± 1.34°), in the midfoot. There were also statistically significant differences in the valgus movement when wearing a 7 mm LWI (1.74 ± 2.61°, p < 0.001) versus the barefoot condition (0.40 ± 0.90°), and in the plantar flexion movement when wearing a 4 mm LWI (2.88 ± 4.31°, p < 0.001) versus the barefoot condition (0.35 ± 0.90°), in the rearfoot. Conclusions: In the navicular bone, a varus, an abduction, and plantar flexion movements were generated. In the calcaneus, a valgus, an adduction, and plantar flexion movements were generated with the use of LWIs.
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Moayedi M, Naemi R, Arshi AR, Akrami M, Salehi M. An investigation of the ankle contact forces in a foot with hammer toe deformity. A comparison of patient-specific approaches using finite element modeling and musculoskeletal simulation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:2552-2555. [PMID: 36086202 DOI: 10.1109/embc48229.2022.9871049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The internal forces and stresses in the tissue are important as they are linked to the risk of mechanical trauma and injuries. Despite their value, the internal stresses and forces cannot be directly measured in-vivo. A previously validated 3D finite element model (FEM) was constructed using Magnetic Resonance Imaging (MRI) of a person with diabetes and hammer toe deformity. The foot model simulated at five different instances during the stance phase of gait. The internal stress distribution on the talus that was obtained using the FEM simulation, was used to calculate the joint reaction force at the ankle joint. In addition, the musculoskeletal model (MSM) of the participant with hammer toe foot was developed based on the gait analysis and was used to determine the muscle forces and joint reactions. The result showed that the vertical reaction forces obtained from the FEM and MSM follow a similar trend through the stance phase of gait cycle and are significantly correlated ( R=0.99). The joint reaction forces obtained through the two methods do not differ for the first 25% of the gait cycle, while the maximum difference was ∼0.7 Body weight that was observed at 50% of the stance phase. Clinical Relevance: Finite element modeling and musculoskeletal simulation can shed light on the internal forces at the ankle in pathological conditions such as hammer toe. The similarities and differences observed in the joint reaction forces calculated from the two methods can have implications in assessing the effect of clinical interventions.
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Koşar ŞN, Güzel Y, Köse MG, Kin İşler A, Hazır T. Whole and segmental body composition changes during mid-follicular and mid-luteal phases of the menstrual cycle in recreationally active young women. Ann Hum Biol 2022; 49:124-132. [PMID: 35696275 DOI: 10.1080/03014460.2022.2088857] [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: 11/01/2022]
Abstract
BACKGROUND Changes in oestradiol and progesterone hormones and associated fluid retention during the menstrual cycle phases might affect body composition (BC) in women. AIM The main objectives of this study were to determine the changes in whole and segmental BC by dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance (BIA) during the mid-follicular (MFP) and mid-luteal (MLP) phases. SUBJECTS AND METHODS Thirty recreationally active young women participated in this study. BC was measured by DXA and BIA during MFP and MLP. A mixed linear model for repeated measures analysis was used to determine the differences between the two phases. RESULTS Body mass was higher during MLP than MFP, while total body water, total and segmental fat mass and fat percentages measured by both BIA and DXA were similar during the two phases. DXA-derived fat-free mass and soft lean mass in the android region were higher during MLP than MFP. Large variability in individual responses was evident. CONCLUSION On average, whole and segmental BC variables do not change significantly between MFP and MLP. However, given the large variability among the individual responses, it is suggested to perform repeated BC measurements during the same phase of the menstrual cycle.
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Affiliation(s)
- Şükran Nazan Koşar
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
| | - Yasemin Güzel
- Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
| | - Mehmet Gören Köse
- Division of Training and Movement Sciences, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
| | - Ayşe Kin İşler
- Division of Training and Movement Sciences, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
| | - Tahir Hazır
- Division of Training and Movement Sciences, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey
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40
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Szczęsny G, Kopec M, Szolc T, Kowalewski ZL, Małdyk P. Deformation of the Titanium Plate Stabilizing the Lateral Ankle Fracture Due to Its Overloading in Case of the Young, Obese Patient: Case Report Including the Biomechanical Analysis. Diagnostics (Basel) 2022; 12:diagnostics12061479. [PMID: 35741288 PMCID: PMC9221673 DOI: 10.3390/diagnostics12061479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
The number of overweight and obese patients in developed countries is gradually increasing. It was reported that 1287 (64%) out of 2007 adults operated on in 2017 had a body mass index (BMI) greater than 25 kg/m2, and 26.4% even greater than 30, while the BMI of the most obese patient was as high as 57.6 kg/m2. Such distressing statistics raised an issue related to the inadequate durability of implants used for the fixation of bone fractures. Implants for the lower-extremity fractures may not be durable enough to fit the requirements of overweight and obese patients. This case report presents the history of a 23-year-old obese male with a BMI of 38.7, who bent the angularly stabile titanium plate stabilizing his broken lateral ankle and torn distal tibiofibular syndesmosis. Biomechanical analysis showed that the maximal static bending moment registered during one-leg standing was equal to 1.55 Nm. This value was circa one-third of the maximally admissible bending moment for this particular plate (5.34 Nm) that could be transmitted without its plastic deformation. Since dynamic forces exceed static ones several (3–12) times during typical activities, such as walking, climbing the stairs, running, and jumping, unpredictable forces may occur and increase the risk of loosening, bending, and even breaking implants. None of these situations should have occurred for the typical patient’s body mass of 75 kg, or even for the analyzed mass of the young patient (120 kg) who tried to avoid excessive loading during his daily routine. Subsequent implant bending and destabilization of the fracture shows that for the significantly high and still growing number of obese patients, a very strict physical regime should be recommended to prevent overabundant dynamic loads. On the other hand, the geometry of implants dedicated to these patients should be reconsidered.
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Affiliation(s)
- Grzegorz Szczęsny
- Department of Orthopaedic Surgery and Traumatology, Medical University, 4 Lindleya Street, 02-005 Warsaw, Poland; (G.S.); (P.M.)
| | - Mateusz Kopec
- Institute of Fundamental Technological Research, Polish Academy of Sciences, 5B Pawińskiego Street, 02-106 Warsaw, Poland; (T.S.); (Z.L.K.)
- Correspondence:
| | - Tomasz Szolc
- Institute of Fundamental Technological Research, Polish Academy of Sciences, 5B Pawińskiego Street, 02-106 Warsaw, Poland; (T.S.); (Z.L.K.)
| | - Zbigniew L. Kowalewski
- Institute of Fundamental Technological Research, Polish Academy of Sciences, 5B Pawińskiego Street, 02-106 Warsaw, Poland; (T.S.); (Z.L.K.)
| | - Paweł Małdyk
- Department of Orthopaedic Surgery and Traumatology, Medical University, 4 Lindleya Street, 02-005 Warsaw, Poland; (G.S.); (P.M.)
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41
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Wichmann TK, Wolfson J, Roelofs EJ, Bosch TA, Bach CW, Oliver JM, Carbuhn A, Stanforth PR, Dengel DR. Longitudinal Assessment of NCAA Division I Football Body Composition by Season and Player Age. J Strength Cond Res 2022; 36:1682-1690. [PMID: 35333212 DOI: 10.1519/jsc.0000000000004256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Julian Wolfson
- School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Erica J Roelofs
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota
| | - Tyler A Bosch
- Performance and Data Analytics, Athlete Performance Center, Santa Monica, California
| | - Christopher W Bach
- Nebraska Athletic Performance Laboratory, University of Nebraska, Lincoln, Nebraska
| | - Jonathan M Oliver
- Department of Kinesiology, Texas Christian University, Fort Worth, Texas
| | - Aaron Carbuhn
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas; and
| | - Philip R Stanforth
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas
| | - Donald R Dengel
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota
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42
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Patel S, Lavoie-Gagne O, Mehta N, Farah G, Korrapati A, Forsythe B. Patellar fracture among elite-level European soccer players: 4-year case-control cohort analysis of return to play, re-injury, and player performance. PHYSICIAN SPORTSMED 2022; 51:275-284. [PMID: 35587816 DOI: 10.1080/00913847.2022.2077087] [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] [Indexed: 10/18/2022]
Abstract
OBJECTIVES There is a paucity of literature investigating the relationship between patellar fracture and player performance of professional soccer players following return to play (RTP). Our goal is to determine the rate of RTP, time to RTP, and effect on player performance following patellar fracture. METHODS Twenty-one elite-level European professional soccer players who sustained a patellar fracture between 1999 and 2018 were identified via a publicly accessible database. Athletes with patellar fracture were matched to controls by age, height, years played in the league, season of injury, and position. Change in performance metrics between one season prior to injury and the following four seasons after injury were compared. RESULTS Players with patellar fracture were absent for a mean 207.95 ± 135.55 days and 16.81 ± 31.79 games. Fifteen (71%) players returned to play after injury with 67% returning within 1 season after injury. Injured players did not demonstrate significant change in performance metrics at any of the follow-up timepoints compared to control. Subgroup analysis showed that attackers recorded approximately 1200 fewer minutes played per season than pre-injury levels 2 seasons following injury, significantly fewer (p < 0.05) than the control cohort recording similar minutes per season throughout the study period. Midfielders and defenders demonstrated similar fluctuations in performance to the control cohort for both field time and performance metrics (p > 0.05). CONCLUSION Seventy-one percent of players RTP after patellar fracture with an associated absence of 7 months and 17 missed games. Overall, injured players did not demonstrate a significant decline in performance as demonstrated by games played, total minutes played per season, minutes per game, assists, and goals 1 season after injury. Attackers played fewer minutes during the season of and 2 seasons after the initial injury.
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Affiliation(s)
- Sumit Patel
- Department of Orthopaedic Surgery, Western Michigan University, Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Ophelie Lavoie-Gagne
- Harvard Combined Orthopaedic Surgery Program, Harvard Medical School, Boston, MA, USA
| | - Nabil Mehta
- Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, IL, USA
| | - Ghassan Farah
- Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, IL, USA
| | - Avinaash Korrapati
- Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, IL, USA
| | - Brian Forsythe
- Department of Orthopaedic Surgery, Midwest Orthopaedics at Rush, Chicago, IL, USA
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Vetter S, Schleichardt A, Köhler HP, Witt M. The Effects of Eccentric Strength Training on Flexibility and Strength in Healthy Samples and Laboratory Settings: A Systematic Review. Front Physiol 2022; 13:873370. [PMID: 35574461 PMCID: PMC9100951 DOI: 10.3389/fphys.2022.873370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
Background: The risk of future injury appears to be influenced by agonist fascicle length (FL), joint range of motion (ROM) and eccentric strength. Biomechanical observations of the torque-angle-relationship further reveal a strong dependence on these factors. In practice, a longer FL improves sprinting performance and lowers injury risk. Classical stretching is a popular and evidenced-based training for enhancing ROM but does not have any effects on FL and injury risk. However, recent studies show that eccentric-only training (ECC) improves both flexibility and strength, and effectively lowers risk of injury. Objectives: To review the evidence on benefits of ECC for flexibility and strength. Methods: COCHRANE, PUBMED, SCOPUS, SPOLIT, and SPONET were searched for laboratory trials that compare ECC to at least one comparison group. Studies were eligible if they examined both strength and flexibility metrics in a healthy sample (<65 years) and met criteria for controlled or randomized clinical trials (CCT, RCT). 18 studies have been included and successfully rated using the PEDro scale. Results: 16 of 18 studies show strong evidence of strength and flexibility enhancements for the lower limb. While improvements between ECC and concentric training (CONC) were similar for eccentric (+19 ± 10% vs. +19 ± 11%) and isometric strength (+16 ± 10% vs. +13 ± 6%), CONC showed larger improvements for concentric strength (+9 ± 6% vs. +16 ± 7%). While for ROM ECC showed improvements (+9 ± 7%), no results could be found for CONC. The overall effectiveness of ECC seems to be higher than of CONC. Conclusion: There is clear evidence that ECC is an effective method for changes in muscle architecture, leading to both flexibility and strength improvements for the lower limb. Due to limited data no shoulder study could be included. Further research is needed for the upper body joints with a focus on functional and structural adaptions. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021283248, identifier CRD42021283248
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Affiliation(s)
- Sebastian Vetter
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
| | - Axel Schleichardt
- Department of Biomechanics, Institute for Applied Training Science, Leipzig, Germany
| | - Hans-Peter Köhler
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
| | - Maren Witt
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
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Wezenbeek E, Denolf S, Willems TM, Pieters D, Bourgois JG, Philippaerts RM, De Winne B, Wieme M, Van Hecke R, Markey L, Schuermans J, Witvrouw E, Verstockt S. Association between SARS-COV-2 infection and muscle strain injury occurrence in elite male football players: a prospective study of 29 weeks including three teams from the Belgian professional football league. Br J Sports Med 2022; 56:bjsports-2021-104595. [PMID: 35487684 PMCID: PMC9062454 DOI: 10.1136/bjsports-2021-104595] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the association between SARS-CoV-2 infection and muscle strain injury in elite athletes. METHODS A prospective cohort study in three Belgian professional male football teams was performed during the first half of the 2020-2021 season (June 2020-January 2021). Injury data were collected using established surveillance methods. Assessment of SARS-CoV-2 infection was performed by a PCR test before each official game. RESULTS Of the 84 included participants, 22 were infected with SARS-CoV-2 and 14 players developed a muscle strain during the follow-up period. Cox's proportional hazards regression analyses demonstrated a significant association between SARS-CoV-2 infection and the development of muscle strain (HR 5.1; 95% CI 1.1 to 23.1; p=0.037), indicating an increased risk of developing muscle strains following SARS-CoV-2 infection. All athletes who sustained a muscle strain after infection were injured within the first month (15.71±11.74 days) after sports resumption and completed a longer time in quarantine (14.57±6.50 days) compared with the infected players who did not develop a muscle strain (11.18±5.25 days). CONCLUSION This study reported a five times higher risk of developing a muscle strain after a SARS-CoV-2 infection in elite male football players. Although this association should be examined further, it is possible that short-term detraining effects due to quarantine, and potentially pathological effects of the SARS-CoV-2 infection are associated with a higher risk of muscle strain injury.
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Affiliation(s)
- Evi Wezenbeek
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Sander Denolf
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | | | - Dries Pieters
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Jan G Bourgois
- Department of Performance and Sports Sciences, KAA Ghent, Ghent, Belgium
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | | | - Matthias Wieme
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Robbe Van Hecke
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Laurence Markey
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Joke Schuermans
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Erik Witvrouw
- Department of Rehabilitation Sciences, Ghent University, Gent, Belgium
| | - Steven Verstockt
- Department of Electronics and Information Systems, Ghent University, Gent, Belgium
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Force, Power, and Morphology Asymmetries as Injury Risk Factors in Physically Active Men and Women. Symmetry (Basel) 2022. [DOI: 10.3390/sym14040787] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This study aimed to investigate whether asymmetry of force, power, and tissue morphology are lower limbs (LL) injury risk factors in physically active adults. Fifty-eight men aged 23.8 ± 1.2 years and forty-seven women aged 23.3 ± 1.0 years were examined. Physical activity level was measured by the International Physical Activity Questionnaire, and injury data were collected with the Injury History Questionnaire. The countermovement jump was performed to evaluate force and power. LL tissue composition was evaluated by a bioimpedance analyzer. The symmetry indices were calculated. A comparison between injured and non-injured subjects in both sexes was conducted to determine indices associated with injuries. The symmetry indices cut-off points were calculated to establish values indicating a significant injury risk increase, and logistic regression was performed. The relative peak force asymmetry above 4.049% was associated with increased injury risk in men. The LL skeletal muscle mass asymmetry above 3.584% was associated with a higher injury risk in women. Increased asymmetry in indicated indices by 1% was associated with 19.8% higher injury risk in men and 82.6% in women. Asymmetry proved to be an injury risk factor. However, a more suitable index for men is relative peak force asymmetry, whereas LL skeletal muscle mass asymmetry is more suitable for women.
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Risk factors for injuries in female soldiers: a systematic review. BMC Sports Sci Med Rehabil 2022; 14:54. [PMID: 35351209 PMCID: PMC8966186 DOI: 10.1186/s13102-022-00443-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022]
Abstract
Background Female soldiers form an integral part of any modern defence force. Previous reports have highlighted that female soldiers report injuries at higher rates than male personnel. One possible reason for this is an actual difference in underlying injury rates, purported to be due to several factors, including levels of fitness. The aim of this review was to determine risk factors for injuries in female soldiers. Methods A systematic search was conducted for studies which reported on risk factors for injuries in female soldiers. Databases searched included PUBMED, CINAHL and Medline through OVID. Eligible studies were rated for their methodological quality using the Critical Appraisal Skills Program (CASP) tools and data were extracted and synthesized using a critical narrative approach. Results A total of 18 articles were included in this review which reported on 18 risk factors for injury. Smoking, previous injury, no history of deployment, heavy occupational tasks, lower levels of aerobic fitness and lower number of push-up repetitions appear to be risk factors for injuries in female soldiers. Age, height, body fat, high or low BMI and body mass do not appear to be consistent risk factors for injury in female soldiers and there appears to be minimal evidence for current levels of activity, sit-up ability, and other assessments of strength, power, speed, or movement being associated with injury risk. Additionally, neither flexibility nor previous levels of activity appear to be associated with injury risk in female soldiers. Conclusion Strategies to improve aerobic fitness and upper limb endurance, reduce smoking, and optimise rehabilitation from injuries and risk management for heavy occupational tasks need to be developed for female soldiers. Such strategies are also likely to reduce risks for male soldiers.
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Adillón C, Gallegos M, Treviño S, Salvat I. Detection of Neuromuscular Deficits in Movement Pattern among Uninjured Federated Youth Basketball Players: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074077. [PMID: 35409759 PMCID: PMC8998294 DOI: 10.3390/ijerph19074077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 12/26/2022]
Abstract
(1) Background: The aim of the present study was to evaluate and to detect neuromuscular deficiencies in static and dynamic tests among federated youth basketball players. (2) Methods: Cross-sectional study with 778 basketball players. Specific tests and trials were conducted to evaluate members of teams from several clubs in male and female from under 12 (U12) to under 17 (U17) categories. The evaluations consisted of static physical measurements and dynamic measurements. (3) Results: 575 players were included in this study. A total of 95% of participants are unable to keep their ankle stable in monopodial loading; 86% present dynamic lower extremity valgus with statistically significant differences between categories (p = 0.004); 94% are unable to keep the pelvis stable when performing a single-leg squat; 93% are unable to keep their trunk stable when performing the same movement. During landing, 96% present dynamic lower extremity valgus. The thighs of 92% do not reach parallel (peak of jump). (4) Conclusions: The most frequent neuromuscular deficits in federated youth basketball players are related to instability, the most frequent being ankle instability, followed by lumbo-pelvic instability, dynamic postural instability and dynamic knee valgus. Deficits in jumping/landing technique are also very frequent in all the items analyzed (jumping, landing and plyometrics). The performed tests, which mostly showed a poor performance by the sample, can be indicative of injury probability.
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Affiliation(s)
- Cristina Adillón
- Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, 43204 Reus, Spain;
- Correspondence: ; Tel.: +34-977779940
| | - Montse Gallegos
- Health Department, Catalan Basketball Federation, 08018 Barcelona, Spain; (M.G.); (S.T.)
| | - Silvia Treviño
- Health Department, Catalan Basketball Federation, 08018 Barcelona, Spain; (M.G.); (S.T.)
| | - Isabel Salvat
- Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, 43204 Reus, Spain;
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Farley T, Barry E, Sylvester R, Medici AD, Wilson MG. Poor isometric neck extension strength as a risk factor for concussion in male professional Rugby Union players. Br J Sports Med 2022; 56:616-621. [PMID: 35197247 DOI: 10.1136/bjsports-2021-104414] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Concussion is one of the highest burden injuries within professional Rugby Union ('rugby') and comes with a high health and financial cost to players and teams. Limited evidence exists as to the existence of modifiable intrinsic risk factors for concussion, leaving athletes and clinicians with few options when developing prevention strategies. OBJECTIVE To investigate whether neck strength is significantly associated with concussion incidence in professional male rugby players. METHODS 225 rugby players were assessed for neck strength at three time points throughout the 2018/2019 season using a method of isometric contraction. Associations with clinically diagnosed concussion injuries are presented as incidence rate ratios (IRRs) with 95% CIs. RESULTS Thirty concussions occurred in 29 players during the study period; a rate of 13.7 concussions per 1000 hours played. Greater neck strength was observed at mid and end of season time points versus preseason across the study population. There was a significant association between extension strength and concussion; a 10% increase for extension strength was associated with a 13% reduction in concussion rate (adjusted IRR (95% CI) 0.87 (0.78 to 0.98). No other significant associations were observed between concussion incidence and any other unique neck strength range or composite score. CONCLUSION Higher neck extension strength is associated with lower concussion rates in male rugby players. Neck strength is a modifiable intrinsic risk factor for concussion and may be an important component of a strength and conditioning regime.
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Affiliation(s)
- Theo Farley
- Division of Surgery and Interventional Science, University College London, London, UK .,Institute of Sport, Exercise and Health (ISEH), University College London, London, London, UK
| | - Ed Barry
- Georgia Rugby Federation, Tbilisi, Georgia
| | - Richard Sylvester
- Institute of Sport, Exercise and Health (ISEH), University College London, London, London, UK.,National Hospital for Neurology and Neurosurgery, London, UK
| | - Akbar De Medici
- Institute of Sport, Exercise and Health (ISEH), University College London, London, London, UK
| | - Mathew G Wilson
- Division of Surgery and Interventional Science, University College London, London, UK.,Institute of Sport, Exercise and Health (ISEH), University College London, London, London, UK
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Domaradzki J, Koźlenia D. The performance of body mass component indices in detecting risk of musculoskeletal injuries in physically active young men and women. PeerJ 2022; 10:e12745. [PMID: 35127283 PMCID: PMC8800385 DOI: 10.7717/peerj.12745] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/14/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Body composition indices can be related to musculoskeletal injuries (MI), particularly in physically active groups. However, little is known about the accuracy of these diagnoses as potential predictors of musculoskeletal injuries. Therefore, this study aims to indicate the cut-off points of relative body mass (BMI), fat mass index (FMI), skeletal muscle mass (SMI), and muscle to fat ratio (MFR) and establish its reliability in injury prediction for physically active men and women. METHODS The sample included 119 physically active individuals aged 23.72 ± 1.12 (66 men body height 1.79 ± 0.07 (m); body weight 80.51 ± 9.85 (kg) and 53 women body height 1.67 ± 0.08 (m); body weight 62 ± 10.72 (kg)), students at university of physical education in Poland. The participants' physical activity was measured with the International Physical Activity Questionnaire (IPAQ). The relevance of body mass index (BMI), fat mass index (FMI), skeletal muscle mass index (SMI), and muscle to fat ratio (MFR) in detecting injury risk was examined. Musculoskeletal injuries during 1 year before examination were registered using a self-reporting questionnaire. The areas under the curve (AUC) and Youden Index in the receiver operating characteristic curve (ROC) were calculated. RESULTS The cut-off points used to classify the indices among men were BMI = 24.38; FMI = 3.74; SMI = 16.40; MFR = 3.70; and for women BMI = 20.90; FMI = 4.17; SMI = 8.96; MFR = 1.67. Results suggested the greatest reliability in the prediction of musculoskeletal injuries among men had BMI (AUC = 0.623; Youden = 0.30) and SMI (AUC = 0.608; Youden = 0.23) whereas among women, MFR (AUC = 0.628; Youden = 0.29) and FMI (AUC = 0.614; Youden = 0.32). CONCLUSION BMI and SMI are the most appropriate indices to predict the risk of musculoskeletal injury in physically active men, whereas in women, MFR and FMI are more reliable. These results indicate that the indices with more muscle mass meaning are better in predicting injury among men. In contrast, indices with a higher contribution of fat are better for women. It indicates sex differentiation of injury risk conditions. Men should focus on developing muscle mass, whereas women should reduce body fat to decrease injury risk. However, widespread use seemed to be limited to the specific examined group. Therefore, cut-off points should be used with caution, and calculated values should be verified and confirmed in subsequent studies.
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Kinematic Effect on the Navicular Bone with the Use of Rearfoot Varus Wedge. SENSORS 2022; 22:s22030815. [PMID: 35161560 PMCID: PMC8839556 DOI: 10.3390/s22030815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND The rearfoot varus wedge (RVW) is a common treatment for foot pain and valgus deformity. There is research on its effects in the calcaneus, but there is little research on the navicular. More research is needed with the use of RVW due to the relationship that exists between the position of the navicular and the risk of suffering an injury. OBJECTIVES this study sought to understand how RVW can influence the kinematics of the navicular bone, measuring their movement with the 6 SpaceFastrak system. METHODS a total of 60 subjects participated in the study. Two sensors were used to measure the movement of the calcaneus and navicular using RVWs as compared in the barefoot position in a static way. RESULTS there were statistically significant differences, the use of RVWs caused changes in the navicular bone, with subjects reaching the maximum varus movement with the use of RVW 7 mm of 1.35 ± 2.41° (p < 0.001), the maximum plantar movement flexion with the use of RVW 10 mm of 3.93 ± 4.44° (p < 0.001). CONCLUSIONS when RVWs were placed under the calcaneus bone, the navicular bone response was in varus movement too; thus, the use of rearfoot varus wedge can influence the movement of the navicular bone.
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