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Herring SA, Putukian M, Kibler WB, LeClere L, Boyajian-O'Neill L, Day MA, Franks RR, Indelicato P, Matuszak J, Miller TL, O'Connor F, Poddar S, Svoboda SJ, Zaremski JL. Team Physician Consensus Statement: Return to Sport/Return to Play and the Team Physician: A Team Physician Consensus Statement-2023 Update. Curr Sports Med Rep 2024; 23:183-191. [PMID: 38709944 DOI: 10.1249/jsr.0000000000001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Affiliation(s)
- Stanley A Herring
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | | | - W Ben Kibler
- Shoulder Center of Kentucky, Lexington Clinic, Lexington KY
| | - Lance LeClere
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | - Peter Indelicato
- Department of Orthopedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL
| | | | - Timothy L Miller
- Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Fran O'Connor
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Sourav Poddar
- Primary Sports Medicine, University of Colorado School of Medicine, Denver, CO
| | | | - Jason L Zaremski
- Department of Physical Medicine & Rehabilitation, University of Florida Health, Gainesville, FL
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2
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Herring SA, Putukian M, Kibler WB, Leclere L, Boyajian-O'Neill L, Day MA, Franks RR, Indelicato P, Matuszak J, Miller TL, O'Connor F, Poddar S, Svoboda SJ, Zaremski JL. Team Physician Consensus Statement: Return to Sport/Return to Play and the Team Physician: A Team Physician Consensus Statement-2023 Update. Med Sci Sports Exerc 2024; 56:767-775. [PMID: 38616326 DOI: 10.1249/mss.0000000000003371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Affiliation(s)
- Stanley A Herring
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | | | - W Ben Kibler
- Shoulder Center of Kentucky, Lexington Clinic, Lexington KY
| | - Lance Leclere
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | - Peter Indelicato
- Department of Orthopedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL
| | | | - Timothy L Miller
- Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Fran O'Connor
- Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Sourav Poddar
- Primary Sports Medicine, University of Colorado School of Medicine, Denver, CO
| | | | - Jason L Zaremski
- Department of Physical Medicine & Rehabilitation, University of Florida Health, Gainesville, FL
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Mayer MA, Deliso M, Hong IS, Saltzman BM, Longobardi RS, DeLuca PF, Rizio L. Rehabilitation and Return to Play Protocols After Anterior Cruciate Ligament Reconstruction in Soccer Players: A Systematic Review. Am J Sports Med 2024:3635465241233161. [PMID: 38622858 DOI: 10.1177/03635465241233161] [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: 04/17/2024]
Abstract
BACKGROUND Rehabilitation after anterior cruciate ligament ACL reconstruction (ACLR) is crucial for safe return to play (RTP) and reducing the chances of a reinjury. Yet, there is no consensus on the ideal functional tests to assess rehabilitation progress in soccer players after ACLR. PURPOSE The primary objective was to highlight the existing gap in the literature concerning the most effective standardized rehabilitation protocols and testing for facilitating successful RTP among soccer players. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS A systematic review using PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted. Inclusion criteria encompassed original studies (level of evidence 1-4) that examined rehabilitation protocols, metrics of knee rehabilitation, and clinical outcomes after ACLR in soccer players. RESULTS This review incorporated 23 studies, predominantly retrospective case series, with a total number of 874 soccer players who underwent ACLR and rehabiliation. 5 (21.7%) studies utilized an accelerated rehabilitation protocol, while 7 (30.4%) of studies utilized a criterion-based rehabilitation. A wide heterogeneity of data was extracted including functional tests of rehabilitation and RTP such as strength test batteries, hop test batteries, and movement quality assessments. Of the 23 selected studies, 2 (8.7%) used all 3 test batteries, 8 (34.8%) used 2 test batteries, 12 (52.2%) used 1 test battery, and 1 (4.3%) used 0 of the test batteries. The mean time between surgery and RTP ranged from 3 to 8 months with only 2 (8.7%) studies reporting complications after ACLR. Lastly, out of the total studies examined, 9 (39.1%) assessed patient-reported outcome measures (PROMs), all of which demonstrated significant improvement from the initial assessment to the final follow up. CONCLUSION Soccer-specific rehabilitation after ACLR lacks standardization. Even though many studies have assessed protocols for optimal RTP and reduced secondary ACL injuries, there is a gap in the literature regarding the most effective protocols and RTP testing. The methodology reported by Kyritsis et al could serve as a foundation for future prospective randomized multicenter studies to establish a standard rehabilitation protocol and enable a successful return to soccer.
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Affiliation(s)
- McKenzie A Mayer
- Department of Orthopedic Surgery, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA
- Department of Orthopedic Surgery, Jersey City Medical Center, Jersey City, New Jersey, USA
| | - Marisa Deliso
- Department of Orthopedic Surgery, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA
- Department of Orthopedic Surgery, Jersey City Medical Center, Jersey City, New Jersey, USA
| | - Ian S Hong
- Department of Orthopedic Surgery, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA
- Department of Orthopedic Surgery, Jersey City Medical Center, Jersey City, New Jersey, USA
| | - Bryan M Saltzman
- OrthoCarolina Sports Medicine Center, Charlotte, North Carolina, USA
- Musculoskeletal Institute, Atrium Health, Charlotte, North Carolina, USA
| | - Raphael S Longobardi
- Department of Sports Medicine, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA
| | - Peter F DeLuca
- Department of Sports Medicine, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA
| | - Louis Rizio
- Department of Sports Medicine, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA
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Guevara SA, Crunkhorn ML, Drew M, Waddington G, Périard JD, Etxebarria N, Toohey LA, Charlton P. Injury and illness in short-course triathletes: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:172-185. [PMID: 36898525 PMCID: PMC10980869 DOI: 10.1016/j.jshs.2023.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/04/2022] [Accepted: 01/11/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies. This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting health problems (injury and illness) in triathletes (all sexes, ages, and experience levels) training and/or competing in short-course distances were included. Six electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, APA PsychINFO, Web of Science Core Collection, and SPORTDiscus) were searched. Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale. Two authors independently completed data extraction. RESULTS The search yielded 7998 studies, with 42 studies eligible for inclusion. Twenty-three studies investigated injuries, 24 studies investigated illnesses, and 5 studies investigated both injuries and illnesses. The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures, and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days. Injury and illness prevalence ranged between 2%-15% and 6%-84%, respectively. Most injuries reported occurred during running (45%-92%), and the most frequently reported illnesses affected the gastrointestinal (7%-70%), cardiovascular (14%-59%), and respiratory systems (5%-60%). CONCLUSION The most frequently reported health problems in short-course triathletes were: overuse and lower limb injuries associated with running; gastrointestinal illnesses and altered cardiac function, primarily attributable to environmental factors; and respiratory illness mostly caused by infection.
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Affiliation(s)
- Sara A Guevara
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; New South Wales Institute of Sport, Sydney, NSW 2127, Australia
| | - Melissa L Crunkhorn
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; Queensland Academy of Sport, Brisbane, QLD 4111, Australia; Triathlon Australia, Gold Coast, QLD 4227, Australia.
| | - Michael Drew
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia
| | - Gordon Waddington
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; Australian Institute of Sport, Bruce, ACT 2617, Australia
| | - Julien D Périard
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia
| | - Naroa Etxebarria
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia
| | - Liam A Toohey
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; Australian Institute of Sport, Bruce, ACT 2617, Australia
| | - Paula Charlton
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Bruce, ACT 2617, Australia; Triathlon Australia, Gold Coast, QLD 4227, Australia
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Read D, Rosenbloom C. What contextual factors influence pain management decision making concerning player availability in professional men's football? A qualitative analysis of practitioner perceptions. SCI MED FOOTBALL 2024:1-12. [PMID: 38341871 DOI: 10.1080/24733938.2024.2316093] [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] [Accepted: 01/31/2024] [Indexed: 02/13/2024]
Abstract
PURPOSE Football practitioners must regularly assess the risk of participation when determining player availability. At present, there is a lack of information detailing the factors that influence risk assessments. Accordingly, the following research question was explored: what contextual factors influence pain management decision-making when determining player availability in professional men's football? METHODS 20 semi-structured interviews were conducted with club doctors (8), physiotherapists (6), and heads of medicine and performance (8) working in professional men's football in the United Kingdom. The methodology is reported using COREQ criteria and data were analysed using thematic analysis. RESULTS Three themes were created that explain how decision-making concerning analgesia was influenced by: (1) access to medical resources, (2) trust between staff and players, and (3) prioritising short-term success. First, the time, resources, and medical information available to staff impacted the ability to assess players and their risk tolerance in relation to analgesia. Second, decision-making was perceived as a multi-stakeholder process and the nature of relationships with players and performance staff could increase or decrease risk tolerance. Third, player decisions are made against a performance and working environment that privileges short term success over long term wellbeing. CONCLUSION The data support that pain management decision-making in professional men's football is influenced by the player and staff's working context. Further, practitioners viewed potential harm to a player from a socio-economic and physical perspective. These findings support the adoption of a patient-centred care approach and can inform clear recommendations from international and national governing bodies.
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Affiliation(s)
- Daniel Read
- Institute for Sport Business, Loughborough University, Loughborough, UK
| | - Craig Rosenbloom
- Sport and Exercise Medicine Department, Queen Mary University of London, London, UK
- Medical Department, Tottenham Hotspur Football Club, London, UK
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Shrier I, Stokes T, Wang C, Trejovargas J, Impellizzeri FM, Steele RJ. Investigating the Effect of Return-to-Play Timing After Injury on Performance: Does the Analysis Answer the Research Objective? Sports Med 2022; 53:949-958. [PMID: 36378413 DOI: 10.1007/s40279-022-01792-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 11/16/2022]
Abstract
Return-to-play decision making should be based on all the advantages and disadvantages of return to play for athletes, not just the risk of injury. For competitive athletes, this includes the effect of early versus delayed return to sport on performance. In this paper, we address the questions "How can I estimate the effect of injury on the individual's performance at return to play?" and "What is the effect of delaying return to sport on the individual's performance?". To address these questions, we describe (1) some foundational concepts, design and analytical challenges related to estimating the causal effect of return to play timing on performance in the athlete, (2) additional challenges if one is interested in the effects of delaying return to play and (3) differences when the questions relate to the team's performance. Although the analytical strategies described appear complicated, coaches and athletes make these judgements informally every day without explicitly stating their assumptions. Using a formal approach should help analysts provide the most valid answers to the questions asked by athletes and coaches. In brief, the choice of a comparison group depends on the research question and requires that one consider the hypothetical performance trajectory of the athlete had they never been injured. Thus, the optimal comparison group depends on the shape of the expected trajectory and the specific research question being asked.
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Affiliation(s)
- Ian Shrier
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, McGill University, 3755 Cote Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada.
| | - Tyrel Stokes
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
| | - Chinchin Wang
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Jorge Trejovargas
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
| | | | - Russell J Steele
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
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Anderson D, Cathcart J, Kerr D, Moore I, Hislop M, Wilson I. An investigation of coaches' awareness of injury in elite adolescent rugby union in Northern Irish schools - A qualitative study. Phys Ther Sport 2022; 57:17-25. [PMID: 35849980 DOI: 10.1016/j.ptsp.2022.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the decision-making processes employed by schools' Rugby coaches in the management of injured players and to explore the factors that influenced those decisions. A secondary objective was to gauge interest in an education focused toolkit for schools' Rugby coaches. DESIGN A qualitative study using one-to-one online interviews. SETTING Schools who compete in the Ulster Schools' Cup Rugby competition. PARTICIPANTS Eleven Rugby union coaches from four post primary schools. OUTCOME MEASURES A thematic analysis approach was used to examine the factors that influence schools' Rugby coaches' decision-making processes in the management of injured players. RESULTS Findings suggest coaches are influenced in their decision making by four primary factors: their experience and learning, their relationships with other stakeholders, their knowledge and understanding of the roles and responsibilities of medical staff, healthcare and health fitness professionals, and resources available to them. CONCLUSIONS Schools' Rugby coaches play a significant role in the supervision of injured adolescent Rugby players, often drawing from their playing and coaching experiences. Schools retain, or recommend the services, of healthcare professionals (HCPs) and health and fitness professionals (HFPs). The role of these healthcare and health and fitness professionals, along with their qualifications and experience is not fully understood by coaches. Coaches acknowledge that there is a need for further training and would welcome education initiatives aimed at increasing awareness of musculoskeletal injury in schoolboy Rugby players.
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Affiliation(s)
- David Anderson
- Life and Health Sciences, Ulster University, Jordanstown Campus, Newtownabbey, United Kingdom.
| | - John Cathcart
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown Campus, Newtownabbey, United Kingdom
| | - Daniel Kerr
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Jordanstown Campus, Newtownabbey, United Kingdom
| | - Isabel Moore
- School of Sport and Health, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Mike Hislop
- Player Welfare and Rugby Services Department, World Rugby, Dublin, Ireland
| | - Iseult Wilson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
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Yung KK, Ardern CL, Serpiello FR, Robertson S. A Framework for Clinicians to Improve the Decision-Making Process in Return to Sport. SPORTS MEDICINE - OPEN 2022; 8:52. [PMID: 35416633 PMCID: PMC9008084 DOI: 10.1186/s40798-022-00440-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/23/2022] [Indexed: 12/14/2022]
Abstract
Return-to-sport (RTS) decisions are critical to clinical sports medicine and are often characterised by uncertainties, such as re-injury risk, time pressure induced by competition schedule and social stress from coaches, families and supporters. RTS decisions have implications not only for the health and performance of an athlete, but also the sports organisation. RTS decision-making is a complex process, which relies on evaluating multiple biopsychosocial factors, and is influenced by contextual factors. In this narrative review, we outline how RTS decision-making of clinicians could be evaluated from a decision analysis perspective. To begin with, the RTS decision could be explained as a sequence of steps, with a decision basis as the core component. We first elucidate the methodological considerations in gathering information from RTS tests. Second, we identify how decision-making frameworks have evolved and adapt decision-making theories to the RTS context. Third, we discuss the preferences and perspectives of the athlete, performance coach and manager. We conclude by proposing a framework for clinicians to improve the quality of RTS decisions and make recommendations for daily practice and research.
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Affiliation(s)
- Kate K Yung
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Clare L Ardern
- Musculoskeletal and Sports Injury Epidemiology Centre, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden.,Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Fabio R Serpiello
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Sam Robertson
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Volker K, Julia O, Werner K, Oliver L, Johannes W, Maximilian K, Siegmund L, Matthias K, Volker A, Michael W. Decision-making to stop or continue playing after football injuries - a systematic video analysis of 711 injury situations in amateur football. Eur J Sport Sci 2021; 22:1459-1465. [PMID: 34157959 DOI: 10.1080/17461391.2021.1943717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Scientific injury registration via video analysis is lacking in amateur football. The purpose of this study was to analyse match injury situations with a focus on the decisions made by players and referees after sustaining a football trauma. In a retrospective cohort study, traumatic injuries sustained in any of the 305 matches of the highest amateur level (4th league) in Germany in the 2015-16 season were assessed by means of video analysis and a standardised video protocol. In total, 711 traumatic incidents at 919 different body regions had been recorded. The three most frequently injured body regions were the ankles (34.1%), the head (17.5%) and the knees (17.0%). 90% (n = 156) of head injuries were direct contact injuries, this percentage was significantly higher than that of contact injuries on ankle (68.4%; p < 0.001) or knee (52.6%; p = 0.001). Referees decided on foul play significantly more often in case of knee injuries (57.1%; p = 0.002) or ankle injuries (64.5%; p < 0.001) than in head injuries (39.8%). Only 26.1% of players with a head injury opted for substitution, which was lower than after ankle (27.8%; p = 0.78) and knee injuries (34.0%; p = 0.13). In conclusion, amateur football is associated with a considerable number of injury situations that are followed by match interruptions and the substitution of players. Players and referees decided to continue playing more often after a head injury than after an injury to other body regions. An advanced education programme on the risks and management of head injuries in football is required to prevent long-term health consequences.
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Affiliation(s)
- Krutsch Volker
- Department of Otorhinolaryngology, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Oberhauser Julia
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Krutsch Werner
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany.,SportDocsFranken, Nuremberg, Germany
| | - Loose Oliver
- Clinic of Paediatric Surgery, Olgahospital, Clinic Stuttgart, Stuttgart, Germany
| | - Weber Johannes
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Kerschbaum Maximilian
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Lang Siegmund
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Koch Matthias
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Alt Volker
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Worlicek Michael
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
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Gómez-Carmona CD, Mancha-Triguero D, Pino-Ortega J, Ibáñez SJ. Multi-Location External Workload Profile in Women's Basketball Players. A Case Study at the Semiprofessional-Level. SENSORS 2021; 21:s21134277. [PMID: 34206600 PMCID: PMC8296836 DOI: 10.3390/s21134277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 12/19/2022]
Abstract
The external workload measured in one anatomical location does not determine the total load supported by the human body. Therefore, the purpose of the present study was to characterize the multi-location external workload through PlayerLoadRT of 13 semi-professional women’s basketball players, as well as to analyze differences among anatomical locations (inter-scapulae line, lumbar region, 2× knee, 2× ankle) and laterality (left vs. right) during five tests that represent the most common movements in basketball—(a) linear locomotion, 30-15 IFT; (b) acceleration and deceleration, 16.25-m RSA (c) curvilinear locomotion, 6.75-m arc (d) jump, Abalakov test (e) small-sided game, 10’ 3 vs. 3 10 × 15-m. Statistical analysis was composed of a repeated-measures t-test and eta partial squared effect size. Regarding laterality, differences were found only in curvilinear locomotion, with a higher workload in the outer leg (p < 0.01; ηp2 = 0.33–0.63). In the vertical profile, differences among anatomical locations were found in all tests (p < 0.01; ηp2 = 0.56–0.98). The nearer location to ground contact showed higher values except between the scapulae and lumbar region during jumps (p = 0.83; ηp2 = 0.00). In conclusion, the multi-location assessment of external workload through a previously validated test battery will make it possible to understand the individual effect of external workload in each anatomical location that depends on the type of locomotion. These results should be considered when designing specific strategies for training and injury prevention.
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Affiliation(s)
- Carlos D. Gómez-Carmona
- Research Group in Optimization of Training and Sports Performance (GOERD), Sport Science Faculty, University of Extremadura, Av. de la Universidad s/n, 10005 Caceres, Spain; (D.M.-T.); (S.J.I.)
- Correspondence: (C.D.G.-C.); (J.P.-O.)
| | - David Mancha-Triguero
- Research Group in Optimization of Training and Sports Performance (GOERD), Sport Science Faculty, University of Extremadura, Av. de la Universidad s/n, 10005 Caceres, Spain; (D.M.-T.); (S.J.I.)
| | - José Pino-Ortega
- BioVetMed & Sport Sci Research Group, Physical Activity and Sports Department, Sport Science Faculty, University of Murcia, Argentina Street s/n, San Javier, 30720 Murcia, Spain
- Correspondence: (C.D.G.-C.); (J.P.-O.)
| | - Sergio J. Ibáñez
- Research Group in Optimization of Training and Sports Performance (GOERD), Sport Science Faculty, University of Extremadura, Av. de la Universidad s/n, 10005 Caceres, Spain; (D.M.-T.); (S.J.I.)
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11
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Assessment of the Multi-Location External Workload Profile in the Most Common Movements in Basketball. SENSORS 2021; 21:s21103441. [PMID: 34063340 PMCID: PMC8156149 DOI: 10.3390/s21103441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 01/30/2023]
Abstract
The present study analyzed the multi-location external workload profile in basketball players using a previously validated test battery and compared the demands among anatomical locations. A basketball team comprising 13 semi-professional male players was evaluated in five tests (abilities/skills/tests): (a) aerobic, linear movement, 30-15 IFT; (b) lactic anaerobic, acceleration and deceleration, 16.25 m RSA (c) alactic anaerobic, curvilinear movement, 6.75 m arc (d) elastic, jump, Abalakov test (e) physical-conditioning, small-sided game, 10' 3 vs.3 10 × 15 m. PlayerLoadRT was evaluated at six anatomical locations simultaneously (interscapular line, lumbar region, knees and ankles) by six WIMU PROTM inertial devices attached to the player using an ad hoc integral suit. Statistical analysis was composed of an ANOVA of repeated measures and partial eta squared effect sizes. Significant differences among anatomical locations were found in all tests with higher values in the location nearer to ground contact (p < 0.01). However, differences between lower limb locations were only found in curvilinear movements, with a higher workload in the outside leg (p < 0.01). Additionally, high between-subject variability was found in team players, especially at lower limb locations. In conclusion, multi-location evaluation in sports movements will make it possible to establish an individual external workload profile and design specific strategies for training and injury prevention programs.
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Jukic I, Calleja-González J, Cuzzolin F, Sampaio J, Cos F, Milanovic L, Krakan I, Ostojic S, Olmo J, Requena B, Njaradi N, Sassi R, Rovira M, Kocaoglu B. The 360° Performance System in Team Sports: Is It Time to Design a "Personalized Jacket" for Team Sports Players? Sports (Basel) 2021; 9:sports9030040. [PMID: 33802654 PMCID: PMC8002432 DOI: 10.3390/sports9030040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/21/2022] Open
Abstract
Elite performance in team sports attracts the attention of the general public. In particular, the best players became incredibly skilled and physically powerful, which is a fact that potentiates the delivery of a product that is considered attractive, exciting, and competitive. Not surprisingly, this is a very valuable product from an economic and social standpoint; thus, all sports professionals are extremely interested in developing new procedures to improve their sports performance. Furthermore, the great interests of the various stakeholders (owners, chief executive officers (CEOs), agents, fans, media, coaches, players, families, and friends) are one of the main reasons for this development under the sports science umbrella and the accompanying sports industry. All their personal performances should be coordinated and put into practice by the sports team. In this scientific and applied study, we primarily dealt with the individual treatment of players in order to improve their personal performance and, consequently, the team’s sporting performance.
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Affiliation(s)
- Igor Jukic
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Biotrening Ltd., 10000 Zagreb, Croatia
| | - Julio Calleja-González
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Faculty of Education and Sport, University of Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain
- Correspondence:
| | | | - Jaime Sampaio
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, 5001-801 Vila Real, Portugal;
| | - Francesc Cos
- National Institute of Physical Education (INEFC), University of Barcelona, 08038 Barcelona, Spain;
- Manchester City Football Club, Manchester M11 4TS, UK
| | - Luka Milanovic
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Biotrening Ltd., 10000 Zagreb, Croatia
| | - Ivan Krakan
- Faculty of Kinesiology, University of Zagreb, 10110 Zagreb, Croatia; (I.J.); (L.M.); (I.K.)
- Biotrening Ltd., 10000 Zagreb, Croatia
| | - Sergej Ostojic
- Faculty of Physical Education and Sport, University of Novi Sad, 21000 Novi Sad, Serbia;
- Center for Health, Exercise and Sport Sciences, 11000 Belgrade, Serbia
| | - Jesús Olmo
- Football Science Institute, 18016 Granada, Spain; (J.O.); (B.R.)
| | - Bernardo Requena
- Football Science Institute, 18016 Granada, Spain; (J.O.); (B.R.)
| | - Nenad Njaradi
- Football Club Deportivo Alavés, 01007 Vitoria-Gasteiz, Spain;
| | | | - Mar Rovira
- Tecnocampus, Universitat Pompeu Fabra, Grup de recerca en Activitat Física, Rendiment i Salut (AFIRS), Av. d’Ernest Lluch, 32, 08302 Mataró, Spain;
| | - Baris Kocaoglu
- Faculty of Medicine, Acibadem University, Küçükbakkalköy, Kayışdağı Cd., 34755 Ataşehir/İstanbul, Turkey;
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Meredith SJ, Rauer T, Chmielewski TL, Fink C, Diermeier T, Rothrauff BB, Svantesson E, Hamrin Senorski E, Hewett TE, Sherman SL, Lesniak BP, Symposium P. Return to sport after anterior cruciate ligament injury: Panther Symposium ACL Injury Return to Sport Consensus Group. J ISAKOS 2021; 6:138-146. [PMID: 34006577 DOI: 10.1136/jisakos-2020-000495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES A precise and consistent definition of return to sport (RTS) after anterior cruciate ligament (ACL) injury is lacking, and there is controversy surrounding the process of returning patients to sports and their previous activity level. The aim of the Panther Symposium ACL Injury RTS Consensus Group was to provide a clear definition of RTS after ACL injury and description of the RTS continuum, as well as provide clinical guidance on RTS testing and decision-making. METHODS An international, multidisciplinary group of ACL experts convened as part of a consensus meeting. Consensus statements were developed using a modified Delphi method. Literature review was performed to report the supporting evidence. RESULTS Key points include that RTS is characterised by achievement of the preinjury level of sport and involves a criteria-based progression from return to participation to RTS, and ultimately return to performance. Purely time-based RTS decision-making should be abandoned. Progression occurs along an RTS continuum with decision-making by a multidisciplinary group that incorporates objective physical examination data and validated and peer-reviewed RTS tests, which should involve functional assessment as well as psychological readiness. Consideration should be given to biological healing, contextual factors and concomitant injuries. CONCLUSION The resultant consensus statements and scientific rationale aim to inform the reader of the complex process of RTS after ACL injury that occurs along a dynamic continuum. Research is needed to determine the ideal RTS test battery, the best implementation of psychological readiness testing and methods for the biological assessment of healing and recovery.
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Affiliation(s)
- Sean J Meredith
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA .,Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Thomas Rauer
- Klinik für Traumatologie, UniversitätsSpital Zürich, Zurich, Switzerland
| | | | - Christian Fink
- Gelenkpunkt-Sports and Joint Surgery Innsbruck, Innsbruck, Austria
| | - Theresa Diermeier
- Department of Sportorthopedic, Technical University of Munich, Munchen, Germany
| | - Benjamin B Rothrauff
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Eleonor Svantesson
- Department of Orthopedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.,Gothenburg Sport Trauma Research Center, Gothenburg, Sweden
| | - Eric Hamrin Senorski
- Gothenburg Sport Trauma Research Center, Gothenburg, Sweden.,Department of Health and Rehabilitation, University of Gothenburg, Gothenburg, Sweden
| | | | - Seth L Sherman
- Department of Orthopaedic Surgery, Stanford Medicine, Stanford, California, USA
| | - Bryson P Lesniak
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Panther Symposium
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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14
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Rojas-Valverde D, Gutiérrez-Vargas JC, Sánchez-Ureña B. Sport Readaptation: Where Do We Draw the Lines Between Professionals? Front Sports Act Living 2020; 1:62. [PMID: 33344985 PMCID: PMC7739741 DOI: 10.3389/fspor.2019.00062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/04/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica.,Grupo de Avances en Entrenamiento Deportivo y Acondicionamiento Físico, Facultad Ciencias del Deporte, Universidad de Extremadura, Cáceres, Spain
| | - Juan Carlos Gutiérrez-Vargas
- Centro de Estudios para el Desarrollo y Rehabilitación en Salud, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica
| | - Braulio Sánchez-Ureña
- Programa de Ciencias del Ejercicio y la Salud, Escuela Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional, Heredia, Costa Rica
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15
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Meredith SJ, Rauer T, Chmielewski TL, Fink C, Diermeier T, Rothrauff BB, Svantesson E, Hamrin Senorski E, Hewett TE, Sherman SL, Lesniak BP. Return to sport after anterior cruciate ligament injury: Panther Symposium ACL Injury Return to Sport Consensus Group. Knee Surg Sports Traumatol Arthrosc 2020; 28:2403-2414. [PMID: 32347344 DOI: 10.1007/s00167-020-06009-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/16/2020] [Indexed: 01/07/2023]
Abstract
PURPOSE A precise and consistent definition of return to sport (RTS) after anterior cruciate ligament (ACL) injury is lacking, and there is controversy surrounding the process of returning patients to sports and their previous activity level. The aim of the Panther Symposium ACL Injury RTS Consensus Group was to provide a clear definition of RTS and description of the RTS continuum, as well as to provide clinical guidance on RTS testing and decision-making. METHODS An international, multidisciplinary group of ACL experts convened as part of a consensus meeting. Consensus statements were developed using a modified Delphi method. Literature review was performed to report the supporting evidence. RESULTS Key points include that RTS is characterized by achievement of the pre-injury level of sport and involves a criteria-based progression from return to participation to return to sport, and ultimately return to performance. Purely time-based RTS decision-making should be abandoned. Progression occurs along a RTS continuum with decision-making by a multidisciplinary group that incorporates objective physical examination data and validated and peer-reviewed RTS tests, which should involve functional assessment as well as psychological readiness. Consideration should be given to biological healing, contextual factors and concomitant injuries. CONCLUSION The resultant consensus statements and scientific rationale aim to inform the reader of the complex process of RTS after ACL injury that occurs along a dynamic continuum. Research is needed to determine the ideal RTS test battery, the best implementation of psychological readiness testing and methods for the biologic assessment of healing and recovery. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Sean J Meredith
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA.
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, 3200 S Water St, Pittsburgh, 15203, PA, USA.
| | - Thomas Rauer
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, 3200 S Water St, Pittsburgh, 15203, PA, USA
- Department of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland
| | | | - Christian Fink
- Gelenkpunkt-Sports and Joint Surgery Innsbruck, Innsbruck, Austria
- Research Unit for Orthopaedic Sports Medicine and Injury Prevention (OSMI), UMIT, Hall in Tirol, Austria
| | - Theresa Diermeier
- Department of Sportorthopedics, Klinikum rechts der Isar Technische Universitat Munchen, Munchen, Germany
| | - Benjamin B Rothrauff
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, 3200 S Water St, Pittsburgh, 15203, PA, USA
| | - Eleonor Svantesson
- Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Gothenburg Sport Trauma Research Center, Gothenburg, Sweden
| | - Eric Hamrin Senorski
- Gothenburg Sport Trauma Research Center, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Seth L Sherman
- Department of Orthopaedic Surgery, Stanford Medicine, Stanford, CA, USA
| | - Bryson P Lesniak
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, 3200 S Water St, Pittsburgh, 15203, PA, USA
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16
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Meredith SJ, Rauer T, Chmielewski TL, Fink C, Diermeier T, Rothrauff BB, Svantesson E, Hamrin Senorski E, Hewett TE, Sherman SL, Lesniak BP, Bizzini M, Chen S, Cohen M, Villa SD, Engebretsen L, Feng H, Ferretti M, Fu FH, Imhoff AB, Kaeding CC, Karlsson J, Kuroda R, Lynch AD, Menetrey J, Musahl V, Navarro RA, Rabuck SJ, Siebold R, Snyder-Mackler L, Spalding T, van Eck C, Vyas D, Webster K, Wilk K. Return to Sport After Anterior Cruciate Ligament Injury: Panther Symposium ACL Injury Return to Sport Consensus Group. Orthop J Sports Med 2020; 8:2325967120930829. [PMID: 32647735 PMCID: PMC7328222 DOI: 10.1177/2325967120930829] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/20/2020] [Indexed: 12/28/2022] Open
Abstract
Background A precise and consistent definition of return to sport (RTS) after anterior cruciate ligament (ACL) injury is lacking, and there is controversy surrounding the process of returning patients to sport and their previous activity level. Purpose The aim of the Panther Symposium ACL Injury Return to Sport Consensus Group was to provide a clear definition of RTS after ACL injury and a description of the RTS continuum as well as provide clinical guidance on RTS testing and decision-making. Study Design Consensus statement. Methods An international, multidisciplinary group of ACL experts convened as part of a consensus meeting. Consensus statements were developed using a modified Delphi method. Literature review was performed to report the supporting evidence. Results Key points include that RTS is characterized by achievement of the preinjury level of sport and involves a criteria-based progression from return to participation to RTS and, ultimately, return to performance. Purely time-based RTS decision-making should be abandoned. Progression occurs along an RTS continuum, with decision-making by a multidisciplinary group that incorporates objective physical examination data and validated and peer-reviewed RTS tests, which should involve functional assessment as well as psychological readiness. Consideration should be given to biological healing, contextual factors, and concomitant injuries. Conclusion The resultant consensus statements and scientific rationale aim to inform the reader of the complex process of RTS after ACL injury that occurs along a dynamic continuum. Research is needed to determine the ideal RTS test battery, the best implementation of psychological readiness testing, and methods for the biological assessment of healing and recovery.
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Affiliation(s)
- Sean J Meredith
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Thomas Rauer
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Terese L Chmielewski
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Christian Fink
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Theresa Diermeier
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Benjamin B Rothrauff
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Eleonor Svantesson
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Eric Hamrin Senorski
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Timothy E Hewett
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Seth L Sherman
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Bryson P Lesniak
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | | | - Mario Bizzini
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Shiyi Chen
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Moises Cohen
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Stefano Della Villa
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Lars Engebretsen
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Hua Feng
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mario Ferretti
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Freddie H Fu
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Andreas B Imhoff
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Christopher C Kaeding
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jon Karlsson
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Ryosuke Kuroda
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Andrew D Lynch
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jacques Menetrey
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Volker Musahl
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Ronald A Navarro
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Stephen J Rabuck
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Rainer Siebold
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Lynn Snyder-Mackler
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Tim Spalding
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Carola van Eck
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Dharmesh Vyas
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Kate Webster
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Kevin Wilk
- Investigation performed at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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17
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Mayer J, Burgess S, Thiel A. Return-To-Play Decision Making in Team Sports Athletes. A Quasi-Naturalistic Scenario Study. Front Psychol 2020; 11:1020. [PMID: 32581922 PMCID: PMC7283921 DOI: 10.3389/fpsyg.2020.01020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/23/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jochen Mayer
- Institute of Sports Sciences, Faculty of Social Sciences, University of Göttingen, Göttingen, Germany
- *Correspondence: Jochen Mayer,
| | - Stephanie Burgess
- Institute of Occupational and Social Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Faculty of Economics and Social Sciences, University of Tübingen, Tübingen, Germany
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Criteria-Based Return to Sport Decision-Making Following Lateral Ankle Sprain Injury: a Systematic Review and Narrative Synthesis. Sports Med 2020; 49:601-619. [PMID: 30747379 DOI: 10.1007/s40279-019-01071-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this systematic review was to identify prospective studies that used a criteria-based return to sport (RTS) decision-making process for patients with lateral ankle sprain (LAS) injury. DESIGN Systematic review and narrative synthesis. DATA SOURCES The PubMed (MEDLINE), Web of Science, PEDro, Cochrane Library, SPORTDiscus (EBSCO), ScienceDirect, and Scopus databases were searched to 23 November 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies were included if they prospectively applied a criteria-based RTS decision-making process for patients with LAS injury, but were excluded if they merely gathered outcome measures at the RTS time point. Studies were also excluded if patients were recovering from ankle fracture, high ankle sprain, medial ankle sprain, chronic ankle instability or complex ankle injury. RESULTS No studies were identified that used a criteria-based RTS decision-making process for patients with LAS injury. We were unable to conduct a quantitative synthesis or meta-analysis, therefore we provide a narrative synthesis of relevant questionnaires, as well as clinical and functional assessments commonly used in studies retrieved in the search. CONCLUSION There are currently no published evidence-based criteria to inform RTS decisions for patients with an LAS injury. Based on our narrative synthesis, we propose a number of variables that could be used to develop a criteria-based RTS decision paradigm. Future research should aim to reach consensus on these variables and apply them to actual RTS decisions within prospective study designs. Furthermore, we suggest that complex systems theory and the RTS continuum could be used to inform the development of an RTS decision-making paradigm for athletes with LAS injury.
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Abstract
During the protective phase of treatment, therapy for hand and wrist injuries in athletes is similar to the plan of care provided to all patients. The nuances in the care provided to athletes become apparent during the transition to the postprotective phase of rehabilitation when the focus has shifted to return to play. Therapy following a sports injury should address the individual needs of the athletes in their everyday lives as well as the specificity of their training and sports-specific activities. The factors that influence return to play are discussed.
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Affiliation(s)
- Jane M Fedorczyk
- Center for Hand and Upper Limb Health and Performance, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, 901 Walnut Street, Suite 600, Philadelphia, PA 19107, USA.
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Niederer D, Wilke J, Krause F, Banzer W, Engeroff T. Integrating the Evidence and Clinical Expertise in the Shared Decision and Graduated Return to Sport Process: A Time Series Case Study after Anterior Cruciate Ligament Rupture and Reconstruction. J Orthop Case Rep 2019; 10:35-44. [PMID: 32547976 PMCID: PMC7276579 DOI: 10.13107/jocr.2019.v10.i01.1628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Rehabilitation following anterior cruciate ligament (ACL) rupture is often characterized by a large discrepancy between the available scientific evidence and its implementation into practice. PURPOSE We aimed to research, selectively rate, and transfer the available evidence to the returntosport (RTS) process after ACL rupture adopting an athlete time series case study design. CASE REPORT AND METHODS The participant is a male athlete aged 33 who was diagnosed with an isolated right-sided total ACL rupture. Knee arthroscopy using semitendinosus tendon plastic (×4) was performed. For rehabilitation, a graded and shared decision RTS algorithm was derived from the existing evidence and all relevant decision-makers expertise. Starting with basic functional abilities and range of motion, the functional ability at each stage had to be achieved before the next stage was aimed. The corresponding therapeutic focus (in addition to standard therapy) was adopted to reach this goal. Functions to be tested were as follows: Knee function confidence, dynamic balance, isometric and isokinetic strength/torque testing, as well as jumping ability (single-leg hop and triple crossover hop for distance). RESULTS RTS was reached (Level 3) 5 months and (Level 2) 10 months post-surgery. CONCLUSION Integrating the available evidence and the clinical expertise of all relevant stakeholders into a shared decision and graduated RTS process after ACL rupture and reconstruction was feasible and successful. Particularly, multiple functional measurements in a time series approach to determine the actual rehabilitation focus seem promising.
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Frieder Krause
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Winfried Banzer
- Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Hospital of the Goethe-University Frankfurt am Main, Germany
| | - Tobias Engeroff
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
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21
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Can grip strength be used as a surrogate marker to monitor recovery from shoulder fatigue? J Electromyogr Kinesiol 2018; 41:139-146. [DOI: 10.1016/j.jelekin.2018.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/04/2018] [Accepted: 06/05/2018] [Indexed: 02/05/2023] Open
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22
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Personal subjectivity in clinician discussion about retirement from sport post-concussion. Soc Sci Med 2018; 218:37-44. [PMID: 30336393 DOI: 10.1016/j.socscimed.2018.07.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 07/19/2018] [Accepted: 07/29/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is increasing focus on the number of concussions after which an athlete should discontinue participating in contact or collision sports. This is a clinically subjective and, in some cases, a preference-sensitive decision. PURPOSE Our goal was to assess whether there is personal subjectivity in when athletic trainers (ATs) discuss the possibility of sport retirement post-concussion with athletes. METHODS A national sample of ATs who provide clinical care to college athletes completed a questionnaire (n = 677, 34% response rate). Structural equation modeling was used to assess the association between risk perceptions, risk tolerance, social influences (beliefs about athlete, coach and parent preferences), expectancies about athlete success (on and off field), and the number of concussions after which retirement would be discussed. RESULTS There was a significant direct effect of AT risk tolerance on the number of concussions after which sport retirement would be discussed, among both male and female ATs (male B = 0.54, p < 0.001; female B = 0.31, p < 0.001). ATs who more strongly prioritized athletes' on-field achievements indicated that they would discuss sport retirement after a larger number of concussions compared to their peers who less strongly valued athletic achievement. CONCLUSIONS The results suggest the potential utility of standardized approaches to communicating concussion risk consistently to athletes. This can help ensure that all athletes are uniformly able to make informed decisions about continued exposure to concussion risk that are based on their values and preferences.
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23
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Loose O, Achenbach L, Fellner B, Lehmann J, Jansen P, Nerlich M, Angele P, Krutsch W. Injury prevention and return to play strategies in elite football: no consent between players and team coaches. Arch Orthop Trauma Surg 2018; 138:985-992. [PMID: 29679206 DOI: 10.1007/s00402-018-2937-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Injuries are a common problem in football. To improve prevention strategies, the players' (p) and coaches' (c) views need to be disclosed as they have a strong impact on return to play decisions. The aim of this study is to reveal current opinions with regard to injury prevention and return to play strategies to introduce new strategies in elite football. MATERIALS AND METHODS In a retrospective data analysis of elite salaried football players (n = 486) and team coaches (n = 88), a detailed investigation by means of a standardized questionnaire was carried out. In a preseason period of the 2015/16 season and as part of a large interventional research project in elite salaried German football, a request about players' and team coaches' knowledge and opinions was performed. Topics such as injury prevention, return to play after injuries, the importance of screening tests, general problems of injuries in football, or the decision-making in terms of prevention and return to play in elite football were investigated. RESULTS The study revealed a high interest in injury prevention and screening tests among players and coaches (p 82.5%; c 99.1%). The participants of the study reported warm-up exercises (p 76.4%; c 74.7%), regeneration training (p 54.1%; c 56.3%), and core stability (p 53.8; c 70.1%) as the most important prevention methods, but the additional investigation of the teams' current daily training routine showed that the transfer is incomplete. Coaches are more familiar with scientific published warm-up programs like FIFA 11 + than players (42.5 vs. 12.6; p < 0.001). Knee injuries (p 90.7%; c 93.1%) and ACL injuries in particular were reported as the most severe and common problem in elite football. Players and coaches expressed different attitudes concerning return to play decisions. While players want to decide themselves (81.4%), team coaches consult medical advice ahead of the decision of return to play after injuries (83.5%; p < 0.001). Decisions against the doctor's recommendation are often made by both groups (p 64.4% vs. c 87.1%; p < 0.001). CONCLUSION The basic knowledge of prevention and injuries is sufficient in elite football, but the transfer from theoretical knowledge to practical routine is suboptimal. The study also shows possibilities to improve the prevention process and communication between players, coaches, doctors, and physiotherapists, while there is no consent between players and coaches regarding return to play decision.
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Affiliation(s)
- Oliver Loose
- Clinic of Pediatric Surgery, Clinic St. Hedwig Regensburg, Steinmetzstraße 1-3, 93049, Regensburg, Germany.
| | - Leonard Achenbach
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Birgit Fellner
- Institute of Sport Science, University of Regensburg, Regensburg, Germany
| | - Jennifer Lehmann
- Institute of Sport Science, University of Regensburg, Regensburg, Germany
| | - Petra Jansen
- Institute of Sport Science, University of Regensburg, Regensburg, Germany
| | - Michael Nerlich
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Peter Angele
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Werner Krutsch
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
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24
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Fortington LV, van der Worp H, van den Akker-Scheek I, Finch CF. Reporting Multiple Individual Injuries in Studies of Team Ball Sports: A Systematic Review of Current Practice. Sports Med 2018; 47:1103-1122. [PMID: 27785773 PMCID: PMC5432578 DOI: 10.1007/s40279-016-0637-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. Objective The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and reported in prospective, long-term, injury studies in team ball sports. Data Sources A systematic search of three online databases for articles published before 2016. Study Selection Publications were included if (1) they collected prospective data on musculoskeletal injuries in individual participants; (2) the study duration was >1 consecutive calendar year/season; and (3) individuals were the unit of analysis. Data Extraction Key study features were summarised, including definitions of injury, how multiple individual injuries were reported and results relating to multiple injuries. Results Of the 71 publications included, half did not specifically indicate multiple individual injuries; those that did were largely limited to reporting recurrent injuries. Eight studies reported the number/proportion of athletes with more than one injury, and 11 studies presented the mean/number of injuries per athlete. Conclusions Despite it being relatively common to collect data on individuals across more than one season, the reporting of multiple injuries within individuals is much more limited. Ultimately, better addressing of multiple injuries will improve the accuracy of injury incidence studies and enable more precise targeting and monitoring of the effectiveness of preventive interventions. Electronic supplementary material The online version of this article (doi:10.1007/s40279-016-0637-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lauren V Fortington
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, VIC, 3353, Australia.
| | - Henk van der Worp
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Inge van den Akker-Scheek
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Caroline F Finch
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, VIC, 3353, Australia
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Niederer D, Engeroff T, Lange K, Vogt L, Banzer W. Return-to-play after concussion: state of knowledge, frequency of use and application barriers of guidelines among decision-makers in rugby. Brain Inj 2018; 32:1096-1102. [PMID: 29870281 DOI: 10.1080/02699052.2018.1483032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Validated strategies and guidelines for a safe and individualized diagnosis and return-to-play (RTP) after concussion in rugby are needed. Little is known about the state of knowledge, frequency of use and application barriers of state-of-the-art guidelines among decision-makers in professional or semi-professional rugby teams. Participants (n = 195) from the coaching team (head coach, assistance coach, athletic coach), the medical team (physiotherapist, physician, rehabilitation therapist, neuropsychologist), or from the officials of a professional or semi-professional rugby team (top three major leagues in Germany), filled in a questionnaire on their knowledge, frequency of use and application barriers of evidence-based guidelines (Graduated RTP protocol and The 5R). Depending on their function in the team and on the league of play, the state of knowledge and application of the diagnostic tools and the RTP guidelines differ. A considerable number are aware of one or both guidelines, but do not apply these guidelines (up to 27% of respondants). The main reasons for the non-usage were not my decision (59%), use of concurrent guidelines (54%), each player must decide by his own (36%), never experienced a concussion in my players (30%), other (19%), the guideline is useless (18%) and a player may play despite a concussion (14%). Raising awareness of the state-of-the-art guidelines is important to educate further the coaching, medical and official team members in identifying symptoms and executing the RTP-process in accordance with evidence-based strategies.
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Affiliation(s)
- Daniel Niederer
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Tobias Engeroff
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Kevin Lange
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Lutz Vogt
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
| | - Winfried Banzer
- a Department of Sports Medicine , Goethe University Frankfurt , Frankfurt am Main , Germany
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González-Ponce I, Leo FM, Jiménez R, Sánchez-Oliva D, Sarmento H, Figueiredo A, García-Calvo T. Athletes' perceptions of coaching competency and team conflict in sport teams: A multilevel analysis. Eur J Sport Sci 2018; 18:851-860. [PMID: 29683770 DOI: 10.1080/17461391.2018.1461245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The purpose of this study was to examine the relationship between coaching competency and team conflict, at individual and team levels, over the season. The participants were professional female and male soccer players, who participated in the First and Second Division. A longitudinal study was performed. At Time 1, the sample of participants consisted of 581 soccer players aged between 15 and 39 years. At Time 2, 549 players were recruited from the original sample aged between 15 and 37 years. Finally, at Time 3, the sample comprised 576 players aged between 15 and 37 years. All participants completed a multi-section questionnaire assessing coaching competency (motivation, game strategy, technique competency, and character-building competency) and team conflict (task conflict and relationship conflict). Results showed that both task and relationship conflict increased significantly over time. Multilevel modelling analysis showed that game strategy and character-building competencies negatively predicted both task and relationship conflicts at the individual level, whereas motivation competency was also added as a significant predictor of task conflict at the team level. Moreover, technique competency positively predicted task conflict at the team level. The current study suggests the importance of coaching competency in group dynamics in sport.
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Affiliation(s)
- I González-Ponce
- a Faculty of Sport Sciences , University of Extremadura , Cáceres , Spain
| | - F M Leo
- b Faculty of Teacher Training , University of Extremadura , Cáceres , Spain
| | - R Jiménez
- a Faculty of Sport Sciences , University of Extremadura , Cáceres , Spain
| | - D Sánchez-Oliva
- a Faculty of Sport Sciences , University of Extremadura , Cáceres , Spain.,c Faculty of Education , University of Cádiz , Cádiz , Spain
| | - H Sarmento
- d Faculty of Sport Sciences and Physical Education , University of Coimbra , Coimbra , Portugal
| | - A Figueiredo
- c Faculty of Education , University of Cádiz , Cádiz , Spain
| | - T García-Calvo
- a Faculty of Sport Sciences , University of Extremadura , Cáceres , Spain
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Niederer D, Wilke J, Vogt L, Banzer W. Return to Play After Injuries: A Survey on the Helpfulness of Various Forms of Assistance in the Shared Decision-Making Process in Semiprofessional Athletes in Germany. Arch Phys Med Rehabil 2018; 99:690-698. [DOI: 10.1016/j.apmr.2017.10.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/29/2017] [Accepted: 10/20/2017] [Indexed: 11/17/2022]
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Hamilton B, Wangensteen A, Whiteley R, Almusa E, Geertsema L, Targett S, Tol JL. Cohen's MRI scoring system has limited value in predicting return to play. Knee Surg Sports Traumatol Arthrosc 2018; 26:1288-1294. [PMID: 28161749 PMCID: PMC5876264 DOI: 10.1007/s00167-016-4403-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 12/07/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Numerous authors have hypothesised that MRI scoring systems provide a valid means of predicting return to play duration following an acute hamstring muscle strain. The purpose is to prospectively investigate the predictive value of the MRI scoring system of Cohen for return to sport (RTS), following an acute hamstring injury. METHODS Male football (soccer) players (n = 139) with acute onset posterior thigh pain underwent standardised clinical and MRI examinations within 5 days after injury. All players underwent a standardised physiotherapy regimen with RTS documented. The MRI scoring was statistically evaluated against RTS. RESULTS One hundred and ten MRI-positive hamstring injuries were evaluated with RTS duration ranging from 1 to 66 days. Total Cohen's MRI score accounted for approximately 4% of the variance in RTS duration. When comparing those with an MRI score of 10 or more took on average 9.8 days longer to RTS than those with an MRI score less than 10 (effect size: 0.85, p < 0.01). CONCLUSIONS Utilising the Cohen's MRI scoring system previously described, we were unable to provide a clinically useful prognosis for RTS in male soccer players. This may reflect the broader challenges of attempting to accurately determine RTS duration from imaging performed at a single point in time. LEVEL OF EVIDENCE Prospective case series, IV.
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Affiliation(s)
- Bruce Hamilton
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar ,High Performance Sport NZ, Sport Research Institute of New Zealand, Millenium Institute of Sport and Health, Mairangi Bay, Auckland, New Zealand
| | - Arnlaug Wangensteen
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar ,Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Science, Oslo, Norway
| | - Rod Whiteley
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Emad Almusa
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | | | - Stephen Targett
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Johannes L. Tol
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar ,Acedemic Center for Evidence Based Medicine (ACES), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Abstract
PURPOSE OF REVIEW The purpose of this paper is to identify strategies for a successful transition to sports in patients following rehabilitation for ACL reconstruction surgery (ACLR). RECENT FINDINGS Recent research continues to demonstrate a relatively low rate of return to previous level of play among athletes following ACLR combined with a significant risk of injury to either the ipsi or the contralateral ACL. Recent research also demonstrates a growing use of a varied battery of assessments to determine readiness to return to sport as well as a lack of consensus on the ideal rehabilitation program, the criteria for clearance for return to play (both in time from surgery and functional milestones), and the nature of a conditioning program designed specifically for transitioning the cleared athlete back to competition. Due to the lack of consensus and consistency regarding rehabilitation protocols and criteria for clearance to play after ACLR, deficits in strength, neuromuscular control, and psychological readiness may exist in "cleared" athletes. These deficits may not only negatively impact sports performance but also raise the risk of re-injury. Programs designed to successfully return an athlete to previous level of play should include not only strength and conditioning aimed at restoring fitness that was compromised as a result of the injury but also include attention to psychological readiness and address deficits in neuromuscular control. Problems that exist following ACLR cannot be solved by one professional; successful rehabilitation and return to play require a coordinated effort among the surgeon, physical therapist, athletic trainer, and fitness professional. Future research is needed to determine the optimal strategy to restore the neuromuscular control, functional strength, and psychological readiness necessary for a successful return to competition following ACLR.
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Affiliation(s)
- Polly de Mille
- Sports Rehabilitation and Performance Center, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
| | - Jamie Osmak
- Sports Rehabilitation and Performance Center, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA
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van der Horst N, Backx FJG, Goedhart EA, Huisstede BMA. Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making. Br J Sports Med 2017; 51:1583-1591. [DOI: 10.1136/bjsports-2016-097206] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2017] [Indexed: 01/08/2023]
Abstract
There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify RTP consultation and responsibilities after hamstring injury. The study used the Delphi procedure. The results of a systematic review were used as a starting point for the Delphi procedure. Fifty-eight experts in the field of hamstring injury management selected by 28 FIFA Medical Centres of Excellence worldwide participated. Each Delphi round consisted of a questionnaire, an analysis and an anonymised feedback report. After four Delphi rounds, with more than 83% response for each round, consensus was achieved that RTP should be defined as ‘the moment a player has received criteria-based medical clearance and is mentally ready for full availability for match selection and/or full training’. The experts reached consensus on the following criteria to support the RTP decision: medical staff clearance, absence of pain on palpation, absence of pain during strength and flexibility testing, absence of pain during/after functional testing, similar hamstring flexibility, performance on field testing, and psychological readiness. It was also agreed that RTP decisions should be based on shared decision-making, primarily via consultation with the athlete, sports physician, physiotherapist, fitness trainer and team coach. The consensus regarding aspects of RTP should provide clarity and facilitate the assessment of when RTP is appropriate after hamstring injury, so as to avoid or reduce the risk of injury recurrence because of a premature RTP.
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Optimization of the Return-to-Sport Paradigm After Anterior Cruciate Ligament Reconstruction: A Critical Step Back to Move Forward. Sports Med 2017; 47:1487-1500. [DOI: 10.1007/s40279-017-0674-6] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Liem BC, Olafsen NP, Harrast MA, Herring SA. Final Comment: Return‐to‐Play Decision Making: Does Level of Competition Make a Difference? PM R 2016; 8:S139-43. [DOI: 10.1016/j.pmrj.2015.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/17/2015] [Accepted: 09/20/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Brian C. Liem
- Department of Rehabilitation Medicine, Sports Medicine Center at Husky Stadium, University of Washington, 3800 Montlake Blvd NE, Seattle, WA 98195
| | - Nathan P. Olafsen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Mark A. Harrast
- Department of Rehabilitation Medicine, Sports Medicine Center at Husky Stadium, University of Washington, Seattle, WA
| | - Stanley A. Herring
- Sports, Spine and Orthopedic Health for UW Medicine, Sports Concussion Program, and Department of Rehabilitation Medicine, University of Washington, Seattle, WA
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Lombardi N, Freedman K, Tucker B, Austin L, Eck B, Pepe M, Tjoumakaris F. Economic analysis of athletic team coverage by an orthopedic practice. PHYSICIAN SPORTSMED 2015; 43:355-9. [PMID: 26414156 DOI: 10.1080/00913847.2015.1092858] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Coverage of high school football by orthopedic sports medicine specialists is considered standard of care in many localities. Determining the economic viability of this endeavor has never been investigated. The primary purpose of the present investigation was to perform an economic analysis of local high school sports coverage by an orthopedic sports medicine practice. METHODS From January 2010 to June 2012, a prospective injury report database was used to collect sports injuries from five high school athletic programs covered by a single, private orthopedic sports medicine practice. Patients referred for orthopedic care were then tracked to determine expected cost of care (potential revenue). Evaluation and management codes and current procedure terminology codes were obtained to determine the value of physician visits and surgical care rendered. Overhead costs were calculated based on historical rates within our practice and incorporated to determine estimated profit. RESULTS 19,165 athletic trainer contacts with athletes playing all sports, including both those 'on-field' and in the training room, resulted in 473 (2.5%) physician referrals. The covering orthopedic practice handled 89 (27.9%) of the orthopedic referrals. Of orthopedic physician referrals, 26 (5.4%) required orthopedic surgical treatment. The covering team practice handled 17/26 (65%) surgical cases. The total revenue collected by the covering team practice was $26,226.14. The overhead cost of treatment was $9441.41. Overall estimated profit of orthopedic visits and treatment during this period for the covering practice was $16,784.73. CONCLUSIONS The covering team practice handled 28% of the orthopedic referrals, 65% of the surgical cases and captured 59% of the potential profit. An increase in physician referrals could increase the benefit for orthopedic surgeons.
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Affiliation(s)
- Nicholas Lombardi
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Kevin Freedman
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Brad Tucker
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Luke Austin
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Brandon Eck
- b 2 Mercy Suburban Hospital , Norristown, PA, USA
| | - Matt Pepe
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
| | - Fotios Tjoumakaris
- a 1 Rothman Institute of Orthopaedics at Thomas Jefferson University , Egg Harbor Township, NJ, USA
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Boutin RD, Fritz RC. MRI of Musculotendinous Injuries—What’s New? Part II: Strain Injuries. CURRENT RADIOLOGY REPORTS 2015. [DOI: 10.1007/s40134-015-0109-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Shrier I. Strategic Assessment of Risk and Risk Tolerance (StARRT) framework for return-to-play decision-making. Br J Sports Med 2015; 49:1311-5. [DOI: 10.1136/bjsports-2014-094569] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/04/2022]
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Niederer D, Wilke J, Füzéki E, Banzer W. [Sporting loads to Spondylodesis of lumbar spine: The return-to-play process]. DER ORTHOPADE 2014; 43:1100-5. [PMID: 25403690 DOI: 10.1007/s00132-014-3038-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Return to play (RTP) and competition following spinal fusion is of particular importance for athletes. There is a lack of guidelines for decision making in RTP processes. OBJECTIVE The purpose of this work was to provide a systematic review of the criteria and time of return in the RTP decision process for adults undergoing lumbar spinal fusion. METHODS Two independent investigators searched MEDLINE using MeSH terms. Targeted outcomes were criteria for return to play decisions and total duration of the RTP process. RESULTS So far, no prospective randomized controlled trials on RTP after spinal fusion considering inclusion and exclusion criteria are available. Five of the included studies are based on original data. Most of the identified studies are narrative reviews and, thus, exhibit low evidence levels. In addition to the narrative reviews, one observational study, two expert opinion surveys and two model development studies were found. CONCLUSION Based on the literature research, a positive RTP decision can be made if the following criteria are fulfilled: (1) anatomical and functional healing is complete, (2) safety of the athlete and secondary subjects during training and competition is guaranteed, (3) sport-specific skills are regained, and (4) patient is psychosocially ready. The RTP process can often be successfully initiated 6 months after surgery; some patients however, will never manage the return to full-contact sports and/or sports with risk of collision.
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Affiliation(s)
- D Niederer
- Abteilung Sportmedizin, Goethe-Universität Frankfurt, Ginnheimer Landstraße 39, 60487, Frankfurt am Main, Deutschland,
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Rodenberg RM. Cardiac disorders, participation decisions and decision-making under legal uncertainty: a reply to Panhuyzen-Goedkoop and Smeets. Br J Sports Med 2014; 48:1136-7. [DOI: 10.1136/bjsports-2014-093612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Orchard J. What role for MRI in hamstring strains? An argument for a difference between recreational and professional athletes. Br J Sports Med 2014; 48:1337-8. [DOI: 10.1136/bjsports-2014-093900] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
This prospective cohort study described return-to-play (RTP) data for different types of muscle injuries in male elite-level football players in Europe. Eighty-nine European professional teams were followed between 2001 and 2013. Team medical staff recorded individual player exposure and time-loss injuries. A total of 17,371 injuries occurred, including 5603 (32%) muscle injuries. From 2007, we received results from 386 magnetic resonance imaging (MRI) examinations, and radiological grading was performed. A negative MRI was associated with shorter recovery time (6 ± 7 days). Lay-off days were correlated with MRI grading of thigh muscle injuries (P < 0.001). Among hamstring injuries, 83% occurred to the biceps femoris, 12% affected the semimembranosus and 5% the semitendinosus. Recurrence rate was higher among biceps femoris injuries (18%) compared with semitendinosus and semimembranosus injuries (2% together). Groin muscle injuries caused shorter median absence (9 days) than hamstring (13 days; P < 0.001), quadriceps (12 days; P < 0.001) and calf muscle (13 days; P < 0.001) injuries. Overall, we found that MRI was valuable for prognosticating RTP, with radiological grading associated with lay-off times after injury. Re-injuries were common in biceps femoris injuries but rare in semitendinosus and semimembranosus injuries.
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Affiliation(s)
- Anna Hallén
- a Football Research Group, Medical and Health Sciences , Linköping University , Linköping , Sweden
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Lowrey KM, Morain SR. State experiences implementing youth sports concussion laws: challenges, successes, and lessons for evaluating impact. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2014; 42:290-296. [PMID: 25264087 DOI: 10.1111/jlme.12146] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
While provisions of youth sports concussion laws are very similar, little is known as to how they are being implemented, factors that promote or impede implementation, or the level of compliance in each jurisdiction. We aimed to describe state experiences with implementation in order to inform ongoing efforts to reduce the harm of sports-related traumatic brain injury and to guide future evaluations of the laws' impacts and the development of future public health laws. We conducted key-informant interviews in 35 states with recently enacted concussion legislation. States varied considerably in their readiness and capacity for implementation. Factors facilitating implementation included existing partnerships, procedures, and resources; centralized implementation authority; prior related efforts; and involvement in the policymaking process by those now charged with implementation. Inhibitors included ambiguous statutory language, unclear delegation of authority, and compliance difficulties. Ongoing challenges persist, including primary prevention; determining which providers are qualified to make return-to-play assessments and contents of those assessments; compliance difficulties in rural and under-served areas; and unclear responsibility for enforcement. Despite the similarity of youth sports concussion laws, early evidence suggests there is considerable variation in their implementation. These findings are critical for ongoing empirical investigations to accurately evaluate the laws' provisions and to identify successful legal approaches to protecting young athletes.
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Affiliation(s)
- Kerri McGowan Lowrey
- Deputy Director, Eastern Region, Network for Public Health Law. She received her J.D. from the University of Maryland Francis King Carey School of Law in Baltimore, MD, M.P.H. from the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, and A.B. from Brown University in Providence, RI
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