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Huber S, Alfuth M. Validity and Reliability of Sensor-based Measures of Lower Limb Range of Motion in Soccer Players: a Cross-sectional Study. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2024. [PMID: 38964364 DOI: 10.1055/a-2331-1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
A deficit in range of motion (ROM) is considered a risk factor for lower extremity injuries in soccer. Analog goniometers are used to measure the ROM of a joint. Sensor-based methods are increasingly being developed, but their quality of testing has not been sufficiently investigated. The purpose of this study was to determine the agreement and the intra- and inter-tester reliability of sensor-based lower extremity ROM measures in soccer players. 36 symptom-free male amateur soccer players (age: 26.3 ± 4.7 years) were included in the study. Three out of five physiotherapists were randomly selected to perform the measurements. Two testers performed the measurements (1. ROM knee from sitting; 2. extension deficit knee from sitting; 3. ROM knee from standing; 4. ROM ankle dorsiflexion [DF] during lunge; 5. ROM ankle plantar flexion [PF] while sitting on a chair) with the digital sensor (index test). The third examiner performed the measurements with the analog goniometer using the neutral-zero method with the subjects in the supine position (reference standard). Pearson's correlation coefficient r, Bland-Altman analysis (BAA), and intraclass correlation coefficient (ICC) were used for statistical analysis (p ≤ 0.05). Only measurements 4 and 5 showed acceptable mean differences of 8.4° (DF) and -10.2° (PF) in the BAA. Measurement 1 showed a moderate correlation (r = 0.582). The sensor-based measurements of knee and ankle ROM revealed excellent intra- and inter-tester reliability (ICC = 0.949-0.986; ICC = 0.895-0.968). However, they showed limited agreement with the established reference standard used here, which can be explained by the different starting positions between the index test and the reference standard.
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Affiliation(s)
- Sebastian Huber
- Department of Further Education, M.Sc. Sport Physiotherapy, German Sport University Cologne, Cologne, Germany
| | - Martin Alfuth
- Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany
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2
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Firmino T, Mendes B, Oliveira R, Vaz J, Radaelli R, Freitas S. Semitendinosus and biceps femoris long head activity during the single leg bridge test in healthy individuals. J Bodyw Mov Ther 2024; 39:435-440. [PMID: 38876665 DOI: 10.1016/j.jbmt.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 02/22/2024] [Accepted: 03/11/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION The single leg bridge test (SLBT) has been suggested as a clinical test to examine function, screen injury risk, and monitor the effectiveness of rehabilitation programes targeting the hamstring. This study aimed to determine the inter-day reliability and repeatability of both SLBT performance, semitendinosus (ST), and biceps femoris long head (BFlh) surface electromyography (sEMG) responses and characterise the BFlh and ST electrical activity during the SLBT performed until exhaustion in healthy individuals. METHODS Twelve physically active young men without previous hamstring injury were tested for the number of repetitions attained, and sEMG signal median frequency and amplitude in both ST and BFlh of each lower limb, randomly in two sessions, with a seven-day interval between sessions. RESULTS High reliability [ICC = 0.85] was found for the number of SLBT repetitions attained. Reliability of sEMG outcomes showed better results for ST (ICC = 0.62-0.91) than for BFlh (ICC = 0.39-0.81), and a high to very-high repeatability was found for both ST (ICC = 0.91-0.84) and BFlh (ICC = 0.91-0.85). sEMG median frequency decreased and amplitude increased for both BFlh (p ≤ 0.001) and ST (p ≤ 0.039) at the end of SLBT, suggesting localised fatigue. CONCLUSIONS The SLBT performed by healthy individuals until exhaustion proved to be reliable and to induce fatigue in both BFlh and ST, where the sEMG median frequency and amplitude can be measured on different days with acceptable reliability and high repeatability, suggesting its potential future use in both practical and clinical settings.
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Affiliation(s)
- Telmo Firmino
- Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisboa, Cruz Quebrada Dafundo, Portugal; Sport Lisboa e Benfica SAD, Human Performance Department - Health Performance, Av. Eusébio da Silva Ferreira, 1500-313, Lisboa, Portugal; Escola Superior de Saúde do Alcoitão, Rua Conde Barão, 2649-506, Alcabideche, Cascais, Portugal.
| | - Bruno Mendes
- Fulham Football Club, Training Ground, Motspur Park, Surrey, KT3 6PT, England, UK; Instituto Superior de Lisboa e Vale do Tejo, Rua Bento de Jesus Caraça 12, 2620-379, Ramada, Odivelas, Portugal
| | - Raul Oliveira
- Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisboa, Cruz Quebrada Dafundo, Portugal; CIPER, Faculty of Human Kinetics, University of Lisboa, Cruz Quebrada Dafundo, Portugal
| | - João Vaz
- Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisboa, Cruz Quebrada Dafundo, Portugal; CIPER, Faculty of Human Kinetics, University of Lisboa, Cruz Quebrada Dafundo, Portugal; Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, Monte da Caparica, Portugal
| | - Régis Radaelli
- Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisboa, Cruz Quebrada Dafundo, Portugal; CIPER, Faculty of Human Kinetics, University of Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Sandro Freitas
- Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisboa, Cruz Quebrada Dafundo, Portugal
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Bellosta-López P, Giner-Nicolás R, Molina-Molina A, Rubio-Peirotén A, Roche-Seruendo LE, Doménech-García V. Recovery of spatio-temporal gait and functional parameters following unilateral eccentric exercise-induced muscle damage in the hamstrings. J Sci Med Sport 2024; 27:387-393. [PMID: 38644066 DOI: 10.1016/j.jsams.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES This study aimed to analyze how spatiotemporal gait parameters, active knee extension range of motion, muscle activity, and self-perceived function change over a seven-day period in healthy individuals after exercise-induced muscle damage (EIMD) in the hamstrings. DESIGN Longitudinal cohort study. METHODS Twenty-four healthy males participated in four sessions before and after EIMD (pre-EIMD, 48 h, 96 h, and 168 h post-EIMD). A single-leg deadlift exercise was performed to provoke EIMD in the hamstrings of the dominant leg. Lower limb function perception, spatiotemporal gait parameters, active knee extension range of motion, and electromyographic (EMG) activity of the semitendinosus and biceps femoris muscles during gait and maximal isometric contraction were assessed bilaterally. RESULTS At 48 h, the EIMD-side showed reduced step length, active knee extension range of motion, maximal strength and EMG activity compared to baseline (P < 0.042), while increased relative EMG activity in the biceps femoris during gait (P = 0.001). At 96 h, step length and EMG activity on the EIMD-side reached similar values to those at baseline, whereas lower limb function perception and active knee extension range of motion returned to baseline state at 168 h post-EIMD. No changes over time were observed on the control-side. CONCLUSIONS Recovery from EIMD requires a multimodal assessment since the different parameters affected by EIMD recover at different paces. Active range of motion appears to be the last variable to fully recover. Self-perceived function should not be considered in isolation as it does not represent complete functional recovery.
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Affiliation(s)
- Pablo Bellosta-López
- Universidad San Jorge, Autov A23 km 299, 50830 Villanueva de Gállego, Zaragoza, Spain
| | - Rafael Giner-Nicolás
- Universidad San Jorge, Autov A23 km 299, 50830 Villanueva de Gállego, Zaragoza, Spain
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Bloch H, Klein C. [Injury prevention in football : A challenge for team doctors and coaching team]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:420-426. [PMID: 38662137 DOI: 10.1007/s00132-024-04503-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 04/26/2024]
Abstract
High injury rates and long injury-related downtimes demonstrate the need for effective and differentiated injury prevention strategies in football. Preventive measures should take place in various fields and should not be reduced to training programmes or medical approaches. The so-called "Big 6 of injury prevention" provide an overview of the key areas that should be addressed. In modern sports medicine, it should be a matter of course that the team doctor already participates in the primary prevention strategies and does not only get involved in the post-traumatic treatment. Similarly, a decision on a player's return to play after an injury should not be based solely on the medical assessment of the team doctor. Good communication and interdisciplinary cooperation, therefore, form the basis for successful prevention.
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Affiliation(s)
- Hendrik Bloch
- Bezirksverwaltung Bielefeld, Verwaltungs-Berufsgenossenschaft (VBG), Nikolaus-Dürkopp-Straße 8, 33602, Bielefeld, Deutschland.
| | - Christian Klein
- Bezirksverwaltung Bergisch Gladbach, Verwaltungs-Berufsgenossenschaft (VBG), Bergisch Gladbach, Deutschland
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Desai V. The Future of Artificial Intelligence in Sports Medicine and Return to Play. Semin Musculoskelet Radiol 2024; 28:203-212. [PMID: 38484772 DOI: 10.1055/s-0043-1778019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Artificial intelligence (AI) has shown tremendous growth over the last decade, with the more recent development of clinical applications in health care. The ability of AI to synthesize large amounts of complex data automatically allows health care providers to access previously unavailable metrics and thus enhance and personalize patient care. These innovations include AI-assisted diagnostic tools, prediction models for each treatment pathway, and various tools for workflow optimization. The extension of AI into sports medicine is still early, but numerous AI-driven algorithms, devices, and research initiatives have delved into predicting and preventing athlete injury, aiding in injury assessment, optimizing recovery plans, monitoring rehabilitation progress, and predicting return to play.
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Affiliation(s)
- Vishal Desai
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
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Veith S, Whalan M, Gibson N, Sampson JA. Exploring the true burden of a time-loss injury: full vs partial time-loss in elite academy football (soccer). SCI MED FOOTBALL 2024; 8:6-14. [PMID: 36473725 DOI: 10.1080/24733938.2022.2156587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
In football, the number of days without full participation in training/competition is often used as a surrogate measure for time-loss (TL) caused by injury. However, injury management and return-to-play processes frequently include modified participation, which to date has only been recorded through self-reports. This study aims to demonstrate the differentiation between 'full' (no participation in team football) and 'partial' (reduced/modified participation in team football) burden. Injury and exposure data were collected from 118 male elite footballers (U13-U18) over 3 consecutive seasons according to the Football Consensus Statement. TL injury burden was calculated separately as the number of total, 'full' and 'partial' days lost per 1000 h of exposure. Injury burden (137.2 days lost/1000 h, 95% CI 133.4-141.0) was comprised of 23% (31.9 days lost/1000 h, 95% CI 30.1-33.8) partial TL and 77% (105.3 days lost/1000 h, 95% CI 102.0-108.6) full TL burden. Injuries of moderate severity (8-28 days lost) showed 40% of partial TL. TL injury incidence rate (6.6 injuries/1000 h, 95% CI 5.8-7.5), the number of severe injuries (16%), and the distribution of TL and non-TL injuries (56% and 44%) were comparable to other reports in elite youth footballers. Almost one-quarter of the TL injury burden showed that injured players were still included in some team football activities, which, for injuries with TL >7 days, was likely related to the return to play process. Therefore, reporting on partial TL provides insight into the true impact of injury on participation levels.
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Affiliation(s)
- Stella Veith
- Centre of Medical and Exercise Science, University of Wollongong, Wollongong, NSW, Australia
- Medical Department, Sydney Football Club, Sydney, NSW, Australia
| | - Matthew Whalan
- Centre of Medical and Exercise Science, University of Wollongong, Wollongong, NSW, Australia
- Medical Department, Football Australia, Sydney, NSW, Australia
| | - Neil Gibson
- Centre of Medical and Exercise Science, University of Wollongong, Wollongong, NSW, Australia
| | - John A Sampson
- Centre of Medical and Exercise Science, University of Wollongong, Wollongong, NSW, Australia
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Scaturro D, de Sire A, Vitagliani F, Lo Nardo D, Tomasello S, Ammendolia A, Letizia Mauro G. Effectiveness of cryo plus ultrasound therapy versus diathermy in combination with high-intensity laser therapy for pain relief in footballers with muscle injuries: A prospective study. J Back Musculoskelet Rehabil 2024; 37:771-780. [PMID: 38160343 DOI: 10.3233/bmr-230265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Muscle injuries are common traumatic events in the clinical practice of the rehabilitation field. There is still a gap in the scientific literature on the effectiveness of physical agent modalities in the management of muscle injuries in athletes. OBJECTIVE The aim of this study was to assess the effectiveness of cryo plus ultrasound therapy com-pared to diathermy in combination with high-intensity laser therapy (HILT) for pain relief in professional footballers with muscle injuries. METHODS A case-control study was conducted on 31 professional footballers with a muscle injury of the lower limbs. Of these, 17 patients, assigned to a Group A (AG), were treated with HILT and cryoultrasound therapy; the remaining 14 patients, assigned to a Group B (BG), underwent HILT and diathermy. We assessed the extent of the pain, the size of the muscle injury, frequency of recurrence and number of days to recovery, at the time of recruitment, at the end of the rehabilitation and 3 months after the injury. RESULTS Group A athletes had a greater benefit on pain (4.65 ± 0.61 vs 3.24 ± 0.63; p< 0.05) and muscle injury recurrence. The return to play in the athletes of group A took place 4.73 days earlier. CONCLUSION HILT and cryo plus ultrasound therapy, in combination with therapeutic exercise, rep-resent a valid strategy in the treatment of muscle injuries in professional footballers.
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Affiliation(s)
- Dalila Scaturro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Fabio Vitagliani
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Davide Lo Nardo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Sofia Tomasello
- Faculty of Medicine and Surgery, University of Palermo, Palermo, Italy
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
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Westbrooks J, Low DA, Brownlee TE. Determining the definition and components of successful soccer referee performance. J Sports Sci 2023; 41:2187-2192. [PMID: 38389389 DOI: 10.1080/02640414.2024.2317641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/05/2024] [Indexed: 02/24/2024]
Abstract
There has been little work examining the intricacies of what makes a soccer referee successful. The aim of this study was to determine what the definition of a successful referee performance is and what are the characteristics of a successful referee from a broad range of stakeholders in Major League Soccer (MLS) and the Professional Referees Organisation (PRO). The study used Delphi methodology to ask 6 MLS General Managers, 2 MLS Coaches,1 MLS League Officer, 4 PRO Referees and 10 PRO Assistant Referees, 8 PRO Staff and 5 PRO Assessors, and 2 PRO2 Referees two questions: 1. Their definition of a successful referee performance. 2. Their opinion on the characteristics of a successful referee. The result was a 7-point definition of a successful referee performance and 26 characteristics of a successful referee. There were ten characteristics that overlapped with previous work examining successful referees. This study was able to develop a definition of a successful referee performance and determine the characteristics of a successful referee.
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Affiliation(s)
- John Westbrooks
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- Sports Performance, Professional Referee Organization, New York, USA
| | - David A Low
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Thomas E Brownlee
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Dunlop G, Ivarsson A, Andersen TE, Brown S, O'Driscoll G, Lewin C, Dupont G, Ardern CL, Delecroix B, Podlog L, McCall A. Examination of the validity of the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale in male professional football players: A worldwide study of 29 professional teams. J Sports Sci 2023; 41:1906-1914. [PMID: 38269550 DOI: 10.1080/02640414.2024.2307764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/12/2024] [Indexed: 01/26/2024]
Abstract
Perceived confidence is an important dimension of an athlete's psychological readiness to return-to-play. However, there is no established and validated tool to evaluate confidence in professional football. This study aimed to provide preliminary evaluation of the internal structure of the Injury-Psychological Readiness to Return-to-Sport scale (I-PRRS) in a cohort of injured male professional footballers. Over an 18-month period, 29 teams from 17 leagues participated. Players sustaining injuries eliciting ≥ 3 weeks' time-loss were recruited. Cross culturally adapted to 4 further languages, the I-PRRS was administered on two occasions: 1) day before returning-to-training and 2) day before returning-to-match-play. In total, 113 injuries were recorded with 96 completed I-PRRS data sets collected. Confirmatory factor analysis indicated the I-PRRS was a unidimensional scale, with all items measuring the same construct. The scale demonstrated good internal consistency (ω = .88). When examining longitudinal invariance of the I-PRRS across administration time-points, indices of model fit supported scalar invariance. There was preliminary evidence of good internal structure for the I-PRRS in professional male footballers. However, before further research involving the I-PRRS can be endorsed, efforts to confirm or refute empirical developments pertaining to psychological readiness are necessary.
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Affiliation(s)
- Gordon Dunlop
- Arsenal Performance and Research Team, Arsenal Football Club, London Colney, UK
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Centre, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Susan Brown
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Gary O'Driscoll
- Medical Department, Manchester United Football Club, Manchester, United Kingdom
| | | | - Gregory Dupont
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Clare L Ardern
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- Sport & Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | | | - Leslie Podlog
- School of Kinesiology and Physical Activity Sciences, University of Montreal, Montreal, Québec, Canada
- CHU Sainte-Justine Research Centre, Montreal, Quebec, Canada
| | - Alan McCall
- Arsenal Performance and Research Team, Arsenal Football Club, London Colney, UK
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
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Osborne JO, Tallent J, Girard O, Marshall PW, Kidgell D, Buhmann R. Neuromuscular electrical stimulation during maximal voluntary contraction: a Delphi survey with expert consensus. Eur J Appl Physiol 2023; 123:2203-2212. [PMID: 37247005 PMCID: PMC10492693 DOI: 10.1007/s00421-023-05232-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE The use of electrical stimulation to assess voluntary activation of muscle/s is a popular method employed in numerous exercise science and health research settings. This Delphi study aimed to collate expert opinion and provide recommendations for best practice when using electrical stimulation during maximal voluntary contractions. METHODS A two-round Delphi study was undertaken with 30 experts who completed a 62-item questionnaire (Round 1) comprising of open- and closed-ended questions. Consensus was assumed if ≥ 70% of experts selected the same response; such questions were removed from the subsequent Round 2 questionnaire. Responses were also removed if they failed to meet a 15% threshold. Open-ended questions were analysed and converted into closed-ended questions for Round 2. It was assumed there was no clear consensus if a question failed to achieve a ≥ 70% response in Round 2. RESULTS A total of 16 out of 62 (25.8%) items reached consensus. Experts agreed that electrical stimulation provides a valid assessment of voluntary activation in specific circumstances, such as during maximal contraction, and this stimulation can be applied at either the muscle or the nerve. Experts recommended using doublet stimuli, self-adhesive electrodes, a familiarisation session, real-time visual or verbal feedback during the contraction, a minimum current increase of + 20% to ensure supramaximal stimulation, and manually triggering stimuli. CONCLUSION The results of this Delphi consensus study can help researchers make informed decisions when considering technical parameters when designing studies involving electrical stimulation for the assessment of voluntary activation.
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Affiliation(s)
- J O Osborne
- School of Sport Sciences, UiT The Arctic University of Norway, Medisin- Og Helsebygget, UiT, 9037, Tromsø, Norway.
| | - J Tallent
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
- Monash Exercise Neuroplasticity Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VA, Australia
| | - O Girard
- School of Human Sciences (Exercise and Sport Sciences), The University of Western Australia, Perth, WA, Australia
| | - P W Marshall
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
- Department of Exercise Science, University of Auckland, Auckland, New Zealand
| | - D Kidgell
- Monash Exercise Neuroplasticity Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VA, Australia
| | - R Buhmann
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
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Aiello F, McCall A, Brown SJ, Serner A, Fortington LV, Huurman SAE, Lewin C, Nagao M, O'Brien J, Panossian A, Pruna R, Ramos GP, Whalan M, Impellizzeri FM. Development of a Standardised System to Classify Injury-Inciting Circumstances in Football: the Football Injury Inciting Circumstances Classification System (FIICCS). Sports Med 2023; 53:1805-1818. [PMID: 37233947 PMCID: PMC10432371 DOI: 10.1007/s40279-023-01857-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND A comprehensive examination of the sport-specific activities and circumstances being performed at the time of injury is important to hypothesise mechanisms, develop prevention strategies and inform future investigations. Results reported in the literature are inconsistent because inciting activities are reported using different classifications. Hence the aim was to develop a standardised system for the reporting of inciting circumstances. METHODS The system was developed using a modified Nominal Group Technique. The initial panel included 12 sports practitioners and researchers from four continents with respectively ≥ 5 years of experience working in professional football and/or conducting injury research. The process consisted of six phases: idea generation, two surveys, one online meeting and two confirmations. For answers to the closed questions, consensus was deemed achieved if ≥ 70% of respondents agreed. Open-ended answers were qualitatively analysed and then introduced in subsequent phases. RESULTS Ten panellists completed the study. The risk of attrition bias was low. The developed system includes a comprehensive range of inciting circumstances across five domains: contact type, ball situation, physical activity, session details, contextual information. The system also distinguishes between a core set (essential reporting) and an optional set. The panel deemed all the domains to be important and easy to use both in football and in research environments. CONCLUSION A system to classify inciting circumstances in football was developed. Given the extent of reporting inconsistency of inciting circumstances in the available literature, this can be used while further studies evaluate its reliability.
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Affiliation(s)
- Francesco Aiello
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Alan McCall
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK.
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK.
| | - Susan J Brown
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Andreas Serner
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
| | - Lauren V Fortington
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Suzanne Afra Elisabeth Huurman
- Medical Department Real Madrid CF, Madrid, Spain
- Sports Medicine Department, St Antonius Hospital, Utrecht, The Netherlands
| | - Colin Lewin
- The Lewin Sports Injury Clinic, East London, UK
| | - Masashi Nagao
- Medical Technology Innovation Center, Juntendo University, Bunkyo-ku, Tokyo, Japan
- Department of Orthopaedic Surgery, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Sports Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - James O'Brien
- Red Bull Athlete Performance Center, Salzburg, Austria
| | | | | | - Guilherme Passos Ramos
- Brazilian Football Confederation (CBF), Rio de Janeiro, RJ, Brazil
- Endocrinology and Metabolism Laboratory, Department of Physiology and Biophysics, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Matthew Whalan
- Centre of Medical and Exercise Physiology, School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- Football Australia, Sydney, Australia
| | - Franco M Impellizzeri
- Faculty of Health, Sport and Exercise Discipline Group, University of Technology Sydney, Sydney, Australia
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Muhl C, Mulligan K, Bayoumi I, Ashcroft R, Godfrey C. Establishing internationally accepted conceptual and operational definitions of social prescribing through expert consensus: a Delphi study. BMJ Open 2023; 13:e070184. [PMID: 37451718 PMCID: PMC10351285 DOI: 10.1136/bmjopen-2022-070184] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVE The aim of this study was to establish internationally accepted conceptual and operational definitions of social prescribing. DESIGN A three-round Delphi study was conducted. SETTING This study was conducted virtually using an online survey platform. PARTICIPANTS This study involved an international, multidisciplinary panel of experts. The expert panel (n=48) represented 26 countries across five continents, numerous expert groups and a variety of years of experience with social prescribing, with the average being 5 years (range=1-20 years). RESULTS After three rounds, internationally accepted conceptual and operational definitions of social prescribing were established. The definitions were transformed into the Common Understanding of Social Prescribing (CUSP) conceptual framework. CONCLUSION This foundational work offers a common thread-a shared sense of what social prescribing is, which may be woven into social prescribing research, policy and practice to foster common understanding of this concept.
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Affiliation(s)
- Caitlin Muhl
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Kate Mulligan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Imaan Bayoumi
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Christina Godfrey
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
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13
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Valente HG, Oliveira RRD, Baroni BM. How are hamstring strain injuries managed in elite men's football clubs? A survey with 62 Brazilian physical therapists. Phys Ther Sport 2023; 61:73-81. [PMID: 36940549 DOI: 10.1016/j.ptsp.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE To describe perceptions and practices of physical therapists from elite men's football clubs on the management of athletes with hamstring strain injury (HSI). DESIGN Cross-sectional study. SETTING Online survey. PARTICIPANTS Physical therapists from clubs engaged in the two main divisions of Brazilian men's football. MAIN OUTCOME MEASURES Practices for assessment and rehabilitation of athletes with HSI. RESULTS This survey had 62 physical therapists from 35 of the 40 eligible clubs (87.5% representativeness). Despite heterogeneity on assessment practices, all respondents use imaging exams, adopt injury classification scales, and evaluate aspects related to pain, range of motion, muscle strength, and functional status of athletes with HSI. Rehabilitation programs are usually divided into 3 to 4 phases. All respondents usually apply electrophysical agents and stretching in HSI rehabilitation programs, 98.4% apply strengthening exercises (93.5% include eccentrics), 96.8% manual therapy, 95.2% exercises that mimic the functional demands of football, and 93.5% lumbopelvic stabilization exercises. Muscle strength was the most reported return to play criterion (71% of respondents). CONCLUSION The present study allowed the sports physical therapy community to become aware of the approaches usually adopted for management of athletes with HSI who play in the highest level of Brazilian men's football.
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Affiliation(s)
- Henrique Gonçalves Valente
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil; Department of Science, Health and Performance, Grêmio Foot-Ball Porto Alegrense, Porto Alegre, RS, Brazil
| | | | - Bruno Manfredini Baroni
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil.
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14
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Paton BM, Court N, Giakoumis M, Head P, Kayani B, Kelly S, Kerkhoffs GMMJ, Moore J, Moriarty P, Murphy S, Plastow R, Pollock N, Read P, Stirling B, Tulloch L, van Dyk N, Wilson MG, Wood D, Haddad F. London International Consensus and Delphi study on hamstring injuries part 1: classification. Br J Sports Med 2023; 57:254-265. [PMID: 36650035 DOI: 10.1136/bjsports-2021-105371] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/19/2023]
Abstract
Muscle injury classification systems for hamstring injuries have evolved to use anatomy and imaging information to aid management and prognosis. However, classification systems lack reliability and validity data and are not specific to individual hamstring muscles, potentially missing parameters vital for sport-specific and activity-specific decision making. A narrative evidence review was conducted followed by a modified Delphi study to build an international consensus on best-practice decision-making for the classification of hamstring injuries. This comprised a digital information gathering survey to a cohort of 46 international hamstring experts (sports medicine physicians, physiotherapists, surgeons, trainers and sports scientists) who were also invited to a face-to-face consensus group meeting in London . Fifteen of these expert clinicians attended to synthesise and refine statements around the management of hamstring injury. A second digital survey was sent to a wider group of 112 international experts. Acceptance was set at 70% agreement. Rounds 1 and 2 survey response rates were 35/46 (76%) and 99/112 (88.4%) of experts responding. Most commonly, experts used the British Athletics Muscle Injury Classification (BAMIC) (58%), Munich (12%) and Barcelona (6%) classification systems for hamstring injury. Issues identified to advance imaging classifications systems include: detailing individual hamstring muscles, establishing optimal use of imaging in diagnosis and classification, and testing the validity and reliability of classification systems. The most used hamstring injury classification system is the BAMIC. This consensus panel recommends hamstring injury classification systems evolve to integrate imaging and clinical parameters around: individual muscles, injury mechanism, sporting demand, functional criteria and patient-reported outcome measures. More research is needed on surgical referral and effectiveness criteria, and validity and reliability of classification systems to guide management.
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Affiliation(s)
- Bruce M Paton
- Institute of Sport Exercise and Health, University College London, London, UK .,Physiotherapy Department, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Surgery and Intervention Science, University College London, London, UK
| | | | | | - Paul Head
- School of Sport, Health and Applied Science, St. Mary's University, London, UK
| | - Babar Kayani
- Trauma and Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Gino M M J Kerkhoffs
- Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam IOC Research Center, Amsterdam, The Netherlands
| | - James Moore
- Centre for Human Health and Performance, London, UK
| | - Peter Moriarty
- Trauma and Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Ricci Plastow
- Trauma and Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK
| | - Noel Pollock
- Institute of Sport Exercise and Health, University College London, London, UK.,British Athletics, London, UK
| | - Paul Read
- Institute of Sport Exercise and Health, University College London, London, UK.,Division of Surgery and Intervention Science, University College London, London, UK.,School of Sport and Exercise, University of Goucester, Gloucester, UK
| | | | | | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,Section Sports Medicine, University of Pretoria, Pretoria, South Africa
| | - Mathew G Wilson
- Division of Surgery and Intervention Science, University College London, London, UK.,Princess Grace Hospital, London, UK
| | - David Wood
- Trauma & Orthopaedic Surgery, North Sydney Orthopaedic and Sports Medicine Centre, Sydney, New South Wales, Australia
| | - Fares Haddad
- Institute of Sport Exercise and Health, University College London, London, UK.,Division of Surgery and Intervention Science, University College London, London, UK.,Trauma and Orthopaedics, University College London Hospitals NHS Foundation Trust, London, UK.,Princess Grace Hospital, London, UK
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15
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Paton BM, Read P, van Dyk N, Wilson MG, Pollock N, Court N, Giakoumis M, Head P, Kayani B, Kelly S, Kerkhoffs GMMJ, Moore J, Moriarty P, Murphy S, Plastow R, Stirling B, Tulloch L, Wood D, Haddad F. London International Consensus and Delphi study on hamstring injuries part 3: rehabilitation, running and return to sport. Br J Sports Med 2023; 57:278-291. [PMID: 36650032 DOI: 10.1136/bjsports-2021-105384] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/19/2023]
Abstract
Hamstring injuries (HSIs) are the most common athletic injury in running and pivoting sports, but despite large amounts of research, injury rates have not declined in the last 2 decades. HSI often recur and many areas are lacking evidence and guidance for optimal rehabilitation. This study aimed to develop an international expert consensus for the management of HSI. A modified Delphi methodology and consensus process was used with an international expert panel, involving two rounds of online questionnaires and an intermediate round involving a consensus meeting. The initial information gathering round questionnaire was sent to 46 international experts, which comprised open-ended questions covering decision-making domains in HSI. Thematic analysis of responses outlined key domains, which were evaluated by a smaller international subgroup (n=15), comprising clinical academic sports medicine physicians, physiotherapists and orthopaedic surgeons in a consensus meeting. After group discussion around each domain, a series of consensus statements were prepared, debated and refined. A round 2 questionnaire was sent to 112 international hamstring experts to vote on these statements and determine level of agreement. Consensus threshold was set a priori at 70%. Expert response rates were 35/46 (76%) (first round), 15/35 (attendees/invitees to meeting day) and 99/112 (88.2%) for final survey round. Statements on rehabilitation reaching consensus centred around: exercise selection and dosage (78.8%-96.3% agreement), impact of the kinetic chain (95%), criteria to progress exercise (73%-92.7%), running and sprinting (83%-100%) in rehabilitation and criteria for return to sport (RTS) (78.3%-98.3%). Benchmarks for flexibility (40%) and strength (66.1%) and adjuncts to rehabilitation (68.9%) did not reach agreement. This consensus panel recommends individualised rehabilitation based on the athlete, sporting demands, involved muscle(s) and injury type and severity (89.8%). Early-stage rehab should avoid high strain loads and rates. Loading is important but with less consensus on optimum progression and dosage. This panel recommends rehabilitation progress based on capacity and symptoms, with pain thresholds dependent on activity, except pain-free criteria supported for sprinting (85.5%). Experts focus on the demands and capacity required for match play when deciding the rehabilitation end goal and timing of RTS (89.8%). The expert panellists in this study followed evidence on aspects of rehabilitation after HSI, suggesting rehabilitation prescription should be individualised, but clarified areas where evidence was lacking. Additional research is required to determine the optimal load dose, timing and criteria for HSI rehabilitation and the monitoring and testing metrics to determine safe rapid progression in rehabilitation and safe RTS. Further research would benefit optimising: prescription of running and sprinting, the application of adjuncts in rehabilitation and treatment of kinetic chain HSI factors.
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Affiliation(s)
- Bruce M Paton
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK .,Physiotherapy Department, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Surgery and Intervention Science, University College London, London, UK
| | - Paul Read
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK.,Division of Surgery and Intervention Science, University College London, London, UK.,School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,Section Sports Medicine, University of Pretoria, Pretoria, South Africa
| | - Mathew G Wilson
- Division of Surgery and Intervention Science, University College London, London, UK.,Princess Grace Hospital, London, UK
| | - Noel Pollock
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK.,British Athletics, London, UK
| | | | | | - Paul Head
- School of Sport, Health and Applied Science, St. Mary's University, London, UK
| | - Babar Kayani
- Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Sam Kelly
- Salford City Football Club, Salford, UK.,Blackburn Rovers Football Club, Blackburn, UK
| | - Gino M M J Kerkhoffs
- Orthopaedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam IOC Research Center, Amsterdam, The Netherlands
| | - James Moore
- Sports & Exercise Medicine, Centre for Human Health and Performance, London, UK
| | - Peter Moriarty
- Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Simon Murphy
- Medical Services, Arsenal Football Club, London, UK
| | - Ricci Plastow
- Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | - David Wood
- Trauma & Orthopaedic Surgery, North Sydney Orthopaedic and Sports Medicine Centre, Sydney, New South Wales, Australia
| | - Fares Haddad
- Institute of Sport Exercise and Health (ISEH), University College London, London, UK.,Division of Surgery and Intervention Science, University College London, London, UK.,Princess Grace Hospital, London, UK.,Trauma and Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
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16
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Plastow R, Kerkhoffs GMMJ, Wood D, Paton BM, Kayani B, Pollock N, Court N, Giakoumis M, Head P, Kelly S, Moore J, Moriarty P, Murphy S, Read P, Stirling B, Tulloch L, van Dyk N, Wilson M, Haddad F. London International Consensus and Delphi study on hamstring injuries part 2: operative management. Br J Sports Med 2023; 57:266-277. [PMID: 36650033 DOI: 10.1136/bjsports-2021-105383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 01/19/2023]
Abstract
The key indications for surgical repair of hamstring injuries (HSIs) remain unclear in the literature due to a lack of high-level evidence and expert knowledge. The 2020 London International Hamstring Consensus meeting aimed to highlight clear surgical indications and to create a foundation for future research. A literature review was conducted followed by a modified Delphi process, with an international expert panel. Purposive sampling was used with two rounds of online questionnaires and an intermediate round involving a consensus meeting. The initial information gathering (round 1) questionnaire was sent to 46 international experts, which comprised open-ended questions covering decision-making domains in HSI. Thematic analysis of responses outlined key domains, which were evaluated by a smaller international subgroup (n=15) comprising clinical academic sports medicine physicians, physiotherapists and orthopaedic surgeons in a consensus meeting. After group discussion of each domain, a series of consensus statements were prepared, debated and refined. A round 2 questionnaire was sent to 112 international hamstring experts to vote on these statements and determine level of agreement. The consensus threshold was set a priori at 70% agreement. Rounds 1 and 2 survey respondents were 35/46 (76%) and 99/112 (88.4%), respectively. The consensus group agreed that the indications for operative intervention included: gapping at the zone of tendinous injury (87.2% agreement) and loss of tension (70.7%); symptomatic displaced bony avulsions (72.8%); and proximal free tendon injuries with functional compromise refractory to non-operative treatment (72.2%). Other important considerations for operative intervention included: the demands of the athlete/patient and the expected functional outcome (87.1%) based on the anatomy of the injury; the risk of functional loss/performance deficit with non-operative management (72.2%); and the capacity to restore anatomy and function (87.1%). Further research is needed to determine whether surgery can reduce the risk of reinjury as consensus was not reached within the whole group (48.2%) but was agreed by surgeons (70%) in the cohort. The consensus group did not support the use of corticosteroids or endoscopic surgery without further evidence. These guidelines will help standardise treatment of HSIs, specifically the indications and decision-making for surgical intervention.
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Affiliation(s)
- Ricci Plastow
- Trauma & Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Gino M M J Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicin, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam IOC Research Center, Amsterdam, The Netherlands
| | - David Wood
- Trauma & Orthopaedic Surgery, North Sydney Orthopaedic and Sports Medicine Centre, Sydney, New South Wales, Australia
| | - Bruce M Paton
- Division of Medicine, Institute of Sport Exercise Health, University College London, London, UK.,Physiotherapy, University College London Hospitals NHS Foundation Trust, London, UK
| | - Babar Kayani
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Noel Pollock
- British Athletics Medical Team, London, UK.,Sports Medicine, Institute of Sport Exercise and Health, London, UK
| | | | | | - Paul Head
- School of Sport, Health and Applied Science, St. Mary's University, London, UK
| | - Sam Kelly
- Salford City Football Club, Salford, UK.,Blackburn Rovers FC, Blackburn, Lancashire, UK
| | - James Moore
- Sports & Exercise Medicine, Centre for Human Health and Performance, London, UK
| | - Peter Moriarty
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Simon Murphy
- Sports Medicine, Arsenal Football Club, London, UK
| | - Paul Read
- Institute of Sport Exercise & Health, London, UK.,Princess Grace Hospital, London, London, UK
| | | | | | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,Section Sports Medicine, University of Pretoria, Pretoria, South Africa
| | - Mathew Wilson
- Princess Grace Hospital, London, London, UK.,Targeted Intervention, University College London, London, UK
| | - Fares Haddad
- Trauma & Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.,Institute of Sport Exercise & Health, London, UK
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17
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Page RM, Field A, Langley B, Harper LD, Julian R. The Effects of Fixture Congestion on Injury in Professional Male Soccer: A Systematic Review. Sports Med 2023; 53:667-685. [PMID: 36527592 PMCID: PMC9758680 DOI: 10.1007/s40279-022-01799-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Professional soccer teams are often required to compete with ≤ 4 days recovery between matches. Since congested schedules reduce recovery time between matches, players are possibly at an increased injury risk. To date, there are no published systematic reviews on the impact of match congestion on injuries during professional male soccer. OBJECTIVE The aim of this systematic review was to assess the effects of fixture congestion on injuries during professional soccer. METHODS Following pre-registration on the Open Science Framework ( https://osf.io/86m25/ ) and conforming with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, systematic searches of four electronic databases (PubMed, Scopus, SPORTDiscus, and Web of Science) were conducted by independent researchers from inception until February 2022. Articles were included if they were original articles written in English and contained relevant time-loss injury data (injury that results in unavailability for training and/or match-play) for male professional soccer players regarding periods of fixture congestion (a minimum of two matches with ≤ 4 days recovery). RESULTS A total of eight articles were included in the review. Five studies identified that congested fixture schedules expose players to increased match injury incidence, although layoff duration was typically lower during congested periods. Two studies identified that training and overall injury incidence were higher during congested periods, with another study identifying a lower training injury incidence during congested periods. CONCLUSION Injury risk is, overall, increased during fixture-congested periods; however, the layoff duration is typically shorter. The current findings have implications for practitioners regarding the management, periodisation, monitoring, and design of training and competition schedules.
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Affiliation(s)
- Richard Michael Page
- Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK.
| | - Adam Field
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, M15 6BH, UK
| | - Ben Langley
- Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk, Lancashire, L39 4QP, UK
| | - Liam David Harper
- Department of Life Sciences, Manchester Metropolitan University, Manchester, M15 6BH, UK
| | - Ross Julian
- Institute of Sport and Exercise Sciences, University of Muenster, 48149, Muenster, Germany.,School of Sport and Exercise, Exercise and Sport Research Centre, University of Gloucestershire, The Park, Cheltenham, GL50 2RH, UK
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18
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Gajardo-Burgos R, Valdebenito-Tejos C, Gálvez-García G, Bascour-Sandoval C. Pain and Psychological Readiness to Return to Sport in Elite Volleyball Players: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2492. [PMID: 36767858 PMCID: PMC9915367 DOI: 10.3390/ijerph20032492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 06/18/2023]
Abstract
UNLABELLED Pain is modulated by multiple factors. A relevant psychological process peculiar to athletes and which could be associated with pain is Psychological Readiness to Return to Sport (PRRS). The analysis of this association in competition context is particularly important. OBJECTIVE To determine the correlation between the PRRS and pain intensity in elite volleyball players during their participation in a continental sporting event. METHODS A cross-sectional study was conducted. Data from 107 male volleyball players (23.50 ± 4.08 years of age) participating in the South American Volleyball Championship were used. The athletes answered a self-report questionnaire on the day the championship began regarding their history of injuries in the previous six months. The athletes who declared injuries were asked about the current pain intensity using the Pain Numeric Rating Scale (NRS) and Psychological Readiness to Return to Sport using the Injury-Psychological Readiness to Return to Sport scale (I-PRRS). RESULTS 43.93% (n = 47) of the athletes (23.70 ± 3.54 years) reported an injury in the six months prior to the championship. They presented a median on the NRS of three (interquartile range (IQR), 2-5), and 54 (IQR, 46-58) on the I-PRRS. The Spearman's Rho correlation test showed an inversely and moderate correlation (rs = -0.36; p = 0.011; CI: -0.64--0.08) between pain intensity and PRRS. CONCLUSIONS In male elite volleyball players who participate in a Continental Championship in South America, higher levels of PRRS was correlated to lower pain intensity.
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Affiliation(s)
- Rubén Gajardo-Burgos
- Instituto de Aparato Locomotor y Rehabilitación, Facultad de Medicina, Universidad Austral de Chile, Valdivia 5090000, Chile
- Programa de Magister en Terapia Física, Mención Musculoesquelética, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
| | - Camila Valdebenito-Tejos
- Dirección de Desarrollo Estudiantil, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
| | - Germán Gálvez-García
- Departamento de Psicología, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
- Departamento de Psicología Básica, Psicobiología y Metodología de las Ciencias del Comportamiento, Facultad de Psicología, Campus Ciudad Jardín, Universidad de Salamanca, 37005 Salamanca, Spain
| | - Claudio Bascour-Sandoval
- Programa de Magister en Terapia Física, Mención Musculoesquelética, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
- Departamento de Ciencias de la Rehabilitación, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco 4780000, Chile
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Establishing Internationally Accepted Conceptual and Operational Definitions of Social Prescribing Through Expert Consensus: A Delphi Study Protocol. Int J Integr Care 2023; 23:3. [PMID: 36741971 PMCID: PMC9881447 DOI: 10.5334/ijic.6984] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction There is currently no agreed definition of social prescribing. This is problematic for research, policy, and practice, as the use of common language is the crux of establishing a common understanding. Both conceptual and operational definitions of social prescribing are needed to address this gap. Therefore, the aim of the study that is outlined in this protocol is to establish internationally accepted conceptual and operational definitions of social prescribing. Methodology A Delphi study will be conducted to develop internationally accepted conceptual and operational definitions of social prescribing with an international, multidisciplinary panel of experts. It is anticipated that this study will involve approximately 40 participants (range = 20-60 participants) and consist of 3-5 rounds. Consensus will be defined a priori as ≥80% agreement. Discussion Not only will these definitions serve to unite the social prescribing community, but they will also inform research, policy, and practice. By laying the groundwork for the formation of a robust evidence base, this foundational work will support the advancement of social prescribing and help to unlock the full potential of the social prescribing movement. Conclusion This important work will be foundational and timely, given the rapid spread of the social prescribing movement around the world.
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20
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Naughton M, Scott T, Weaving D, Solomon C, McLean S. Defining and quantifying fatigue in the rugby codes. PLoS One 2023; 18:e0282390. [PMID: 36897849 PMCID: PMC10004502 DOI: 10.1371/journal.pone.0282390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
The rugby codes (i.e., rugby union, rugby league, rugby sevens [termed 'rugby']) are team-sports that impose multiple complex physical, perceptual, and technical demands on players which leads to substantial player fatigue post-match. In the post-match period, fatigue manifests through multiple domains and negatively influences recovery. There is, however, currently no definition of fatigue contextualised to the unique characteristics of rugby (e.g., locomotor and collision loads). Similarly, the methods and metrics which practitioners consider when quantifying the components of post-match fatigue and subsequent recovery are not known. The aims of this study were to develop a definition of fatigue in rugby, to determine agreement with this common definition of fatigue, and to outline which methods and metrics are considered important and feasible to implement to quantify post-match fatigue. Subject matter experts (SME) undertook a two-round online Delphi questionnaire (round one; n = 42, round two; n = 23). SME responses in round one were analysed to derive a definition of fatigue, which after discussion and agreement by the investigators, obtained 96% agreement in round two. The SME agreed that fatigue in rugby refers to a reduction in performance-related task ability which is underpinned by time-dependent negative changes within and between cognitive, neuromuscular, perceptual, physiological, emotional, and technical/tactical domains. Further, there were 33 items in the neuromuscular performance, cardio-autonomic, or self-report domains achieved consensus for importance and/or feasibility to implement. Highly rated methods and metrics included countermovement jump force/power (neuromuscular performance), heart rate variability (cardio-autonomic measures), and soreness, mood, stress, and sleep quality (self-reported assessments). A monitoring system including highly-rated fatigue monitoring objective and subjective methods and metrics in rugby is presented. Practical recommendations of objective and subjective measures, and broader considerations for testing and analysing the resulting data in relation to monitoring fatigue are provided.
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Affiliation(s)
- Mitchell Naughton
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- Applied Sports Science and Exercise Testing Laboratory, University of Newcastle, Ourimbah, New South Wales, Australia
| | - Tannath Scott
- Carnegie Applied Rugby Research Centre, Leeds Beckett University, Leeds, West Yorkshire, United Kingdom
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland, Australia
| | - Dan Weaving
- Carnegie Applied Rugby Research Centre, Leeds Beckett University, Leeds, West Yorkshire, United Kingdom
- * E-mail:
| | - Colin Solomon
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Scott McLean
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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Alfonso Mantilla JI. Readaptación deportiva y retorno deportivo en el alto rendimiento. Del laboratorio al campo de juego: Una revisión de la literatura. REVISTA IBEROAMERICANA DE CIENCIAS DE LA ACTIVIDAD FÍSICA Y EL DEPORTE 2022. [DOI: 10.24310/riccafd.2022.v11i3.15381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Introducción En la actualidad, la readaptación deportiva se conoce como un proceso dinámico a nivel estructural y funcional de elementos del movimiento corporal humano tales como la caracterización de cualidades físicas, sinergias articulares y musculares, eficiencia y eficacia del movimiento y potencialización de habilidades funcionales para el deporte de alto rendimiento después de una lesión deportiva Metodología revisión de la literatura basados en los criterios PRISMA donde se hizo la búsqueda en las principales bases de datos tales como: Pubmed, Ebsco, Medline, Scopus, Science Direct con los siguientes terminos DeCS: Return to sport, Performance, sports, Return to training, Return to play, Rehabilitation, sports idioma de evidencia inglés, español, portugués, catalán y francés Resultados se pudo obtener la información de 74 artículos donde se estableció que el proceso de readaptación deportiva se basa en pilares específicos tales como movimiento, patrones funcionales, control de carga, monitorización, criterios de seguimiento por fase que permiten desarrollar un retorno exitoso al alto rendimiento deportivo. Conclusión la readaptación deportiva es un proceso que permite tomar decisiones basados en un proceso sistematizado generando la evolución del concepto de readaptador deportivo como un pilar esencial en el trabajo en el deporte de alto rendimiento en cualquier disciplina deportiva.
PALABRAS CLAVE: Return to Sport, Performance, sports, Return to training, Return to play
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Isern-Kebschull J, Pedret C, Mechó S, Pruna R, Alomar X, Yanguas X, Valle X, Kassarjian A, Martínez J, Tomas X, Rodas G. MRI findings prior to return to play as predictors of reinjury in professional athletes: a novel decision-making tool. Insights Imaging 2022; 13:203. [PMID: 36575363 PMCID: PMC9794673 DOI: 10.1186/s13244-022-01341-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/20/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Because MRI has shown great accuracy in assessing acute muscle injuries, identification of risk factors for reinjury before return to play (RTP) in professional athletes during the healing process could be very relevant. We assessed the value of MRI findings prior to RTP as predictors of reinjury. METHODS Retrospective observational study of 59 professional athletes, mean age 26 years, with first-time acute muscle injury and successful rehabilitation ready to RTP. They underwent MRI within 6 days of the injury and within 7 days prior to RTP. The primary outcome was reinjury. Risk of reinjury was assessed using radiological signs in control MRI scans before RTP. The risk was classified as low, medium or high when none, one or two radiological signs were observed, respectively. RESULTS Reinjury occurred in 9 participants, with a rate of 15.2%. None of the baseline MRI-related variables was significantly associated with reinjury. In the control MRI scan performed within 7 days prior to RTP, three independent findings were significantly associated with reinjury. These included transversal and/or mixed connective tissue gap (p = 0.002), intermuscular oedema (p = 0.015) and callus gap (p = 0.046). In the predictive model of the risk of reinjury, the presence of two of these radiological signs, together with interstitial feathery oedema, was associated with a high risk of recurrence (OR 29.58, 95% CI 3.86-226.64; p = 0.001). CONCLUSIONS In professional athletes with acute muscle injuries of the lower limbs successfully rehabilitated, some radiological signs on MRI performed shortly before RTP were associated with a high risk of reinjury.
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Affiliation(s)
- Jaime Isern-Kebschull
- grid.5841.80000 0004 1937 0247Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, 08036 Barcelona, Spain
| | | | - Sandra Mechó
- Department of Radiology, Hospital de Barcelona, Barcelona, Spain
| | - Ricard Pruna
- FCBarcelona Medical Department, Barcelona, Spain
| | - Xavier Alomar
- Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain
| | | | - Xavier Valle
- FCBarcelona Medical Department, Barcelona, Spain
| | - Ara Kassarjian
- Musculoskeletal Radiology, Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain
| | | | - Xavier Tomas
- grid.5841.80000 0004 1937 0247Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, 08036 Barcelona, Spain
| | - Gil Rodas
- FCBarcelona Medical Department, Barcelona, Spain ,grid.410458.c0000 0000 9635 9413Medicine Sport Unit, Hospital Clínic-Sant Joan de Déu, Barcelona, Spain
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Armitage M, McErlain-Naylor SA, Devereux G, Beato M, Buckthorpe M. On-field rehabilitation in football: Current knowledge, applications and future directions. Front Sports Act Living 2022; 4:970152. [PMID: 36544545 PMCID: PMC9760760 DOI: 10.3389/fspor.2022.970152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/24/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Mark Armitage
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom,Performance Services Department, Norwich City Football Club, Norwich, United Kingdom,Faculty of Sport, Allied Health and Performance Science, St Mary's University Twickenham, London, United Kingdom,*Correspondence: Mark Armitage
| | - Stuart A. McErlain-Naylor
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Gavin Devereux
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom
| | - Marco Beato
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom
| | - Matthew Buckthorpe
- Faculty of Sport, Allied Health and Performance Science, St Mary's University Twickenham, London, United Kingdom
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Return to Play in Long-Standing Adductor-Related Groin Pain: A Delphi Study Among Experts. SPORTS MEDICINE - OPEN 2022; 8:11. [PMID: 35043267 PMCID: PMC8766680 DOI: 10.1186/s40798-021-00400-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022]
Abstract
Background Groin pain is a very common injury in multidirectional sports such as soccer, ice hockey, rugby and Australian football. Long-standing adductor-related groin pain is a persistent clinical condition and a frequent complaint in athletes involved in sports that require multiplanar movement patterns (change of direction, high-speed sprinting and kicking). To date, the lack of rehabilitation guidelines and return-to-play criteria makes this clinical entity difficult to manage. The aim of the present Delphi was to suggest, based on opinion and practical experience of a panel of experts, potential criteria that could be taken into consideration by clinicians in the RTP decision-making process in athletes suffering from long-standing adductor-related groin pain. Methods Thirty two out of 40 experts participated to a 3-Round Delphi questionnaire. In round 1, open-ended and closed questions about 9 different sections (palpation, flexibility, strength, patient-reported outcome measures, imaging, intersegmental control, performance tests, sport-specific skills, training load) were proposed to investigate return to play evaluation criteria used by each expert. Responses were analysed and coded to produce round 2 questionnaire that investigated only the sections and the items that reached the cut-off value (≥ 70%). Round 3 questionnaire was based on sections and items that reached cut-off value in previous rounds and experts rated their agreement for return to play criteria with a 5-point Likert Scale. Descriptive statistics enabled interpretation of consensus. Results High participation rate (80%) and response rate across the 3 rounds (100%) were recorded. 6 sections reached positive consensus in round 1, 1 section reached negative consensus. In round 2 positive consensus was confirmed only for 3 sections and negative consensus for 1 section. In round 3, positive agreement was established for strength (3 items), performance tests (3 items) and sport-specific skills (2 items) sections. Negative consensus was confirmed for imaging section. Conclusion Experts agreed that strength, performance tests and sport-specific skills can be used to support RTP decision, while imaging cannot be used. These findings could be useful in assisting clinicians in the RTP decision making. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-021-00400-z.
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McCormack S, Till K, Wenlock J, Whitehead S, Stokes KA, Bitcon M, Brown J, Cross M, Davies P, Falvey ÉC, Flahive S, Gardner A, Hendricks S, Johnston R, Mellalieu SD, Parmley J, Phillips G, Ramirez C, Stein J, Scantlebury S, West SW, Jones B. Contributors to negative biopsychosocial health or performance outcomes in rugby players (CoNBO): a systematic review and Delphi study protocol. BMJ Open Sport Exerc Med 2022; 8:e001440. [PMID: 36249486 PMCID: PMC9557262 DOI: 10.1136/bmjsem-2022-001440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2022] [Indexed: 11/13/2022] Open
Abstract
The importance of contributors that can result in negative player outcomes in sport and the feasibility and barriers to modifying these to optimise player health and well-being have yet to be established. Within rugby codes (rugby league, rugby union and rugby sevens), within male and female cohorts across playing levels (full-time senior, part-time senior, age grade), this project aims to develop a consensus on contributors to negative biopsychosocial outcomes in rugby players (known as the CoNBO study) and establish stakeholder perceived importance of the identified contributors and barriers to their management. This project will consist of three parts; part 1: a systematic review, part 2: a three-round expert Delphi study and part 3: stakeholder rating of feasibility and barriers to management. Within part 1, systematic searches of electronic databases (PubMed, Scopus, MEDLINE, SPORTDiscus, CINAHL) will be performed. The systematic review protocol is registered with PROSPERO. Studies will be searched to identify physical, psychological and/or social factors resulting in negative player outcomes in rugby. Part 2 will consist of a three-round expert Delphi consensus study to establish additional physical, psychological and/or social factors that result in negative player outcomes in rugby and their importance. In part 3, stakeholders (eg, coaches, chief executive officers and players) will provide perceptions of the feasibility and barriers to modifying the identified factors within their setting. On completion, several manuscripts will be submitted for publication in peer-reviewed journals. The findings of this project have worldwide relevance for stakeholders in the rugby codes. PROSPERO registration number CRD42022346751.
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Affiliation(s)
- Sam McCormack
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,England Performance Unit, Rugby Football League, Manchester, UK
| | - Kevin Till
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,Leeds Rhinos Rugby League club, Leeds, UK
| | - Jessica Wenlock
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,Leeds Rhinos Rugby League club, Leeds, UK
| | - Sarah Whitehead
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK
| | - Keith A Stokes
- Department for Health, University of Bath, Bath, UK,Rugby Football Union, Twickenham, UK
| | | | - James Brown
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,Institute of Sport and Exercise Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | | | - Éanna C Falvey
- World Rugby Limited, Dublin, Ireland,College of Medicine and Health, University College Cork, Cork, Ireland
| | | | - Andrew Gardner
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Sharief Hendricks
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa
| | - Rich Johnston
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,School of Behavioural and Health Sciences, Australia Catholic University, Brisbane, Queensland, Australia
| | - Stephen D Mellalieu
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University—Cyncoed Campus, Cardiff, Cardiff, UK
| | - James Parmley
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK
| | - Gemma Phillips
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,England Performance Unit, Rugby Football League, Manchester, UK,Hull Kingston Rovers Rugby League club, Hull, UK
| | - Carlos Ramirez
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,Scottich Rugby Union, Edinburgh, UK
| | - Joshua Stein
- National Rugby League, Sydney, New South Wales, Australia
| | - Sean Scantlebury
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,England Performance Unit, Rugby Football League, Manchester, UK
| | - Stephen W West
- Department for Health, University of Bath, Bath, UK,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) centre, Leeds Beckett University, Leeds, UK,England Performance Unit, Rugby Football League, Manchester, UK,Leeds Rhinos Rugby League club, Leeds, UK,Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa,School of Science and Technology, University of New England, Armidale, New South Wales, Australia
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Gomez-Espejo V, Olmedilla A, Abenza-Cano L, Garcia-Mas A, Ortega E. Psychological readiness to return to sports practice and risk of recurrence: Case studies. Front Psychol 2022; 13:905816. [PMID: 36211933 PMCID: PMC9540195 DOI: 10.3389/fpsyg.2022.905816] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022] Open
Abstract
Returning to sport after the sports injury is a difficult decision because it's multicausal and the fact that a rash decision can result in numerous negative consequences. Given the importance of psychological variables for the correct rehabilitation of the injured athlete and his or her optimal return to sports practice, there seems to be little information on this subject. In this sense, the objective is to determine the relationship between the subjective psychological disposition of the athlete in the process of Return to Play (RTP) with the type of mood profile and his mental health. This is based on the fact that each athlete evaluates his or her recovery differently and has different levels of anxiety, depression, and stress. For this purpose, four athletes participated in the study. Two males and two females from the sports of indoor soccer and soccer, who had just returned to sports after a moderate or severe injury. The average age was 24.25 years. Various measurements were taken after practices and after matches, to assess mood, psychological readiness, anxiety, stress, and depression. The results confirm Morgan's iceberg profile and the influence that subjective psychological perceptions and assessed emotional states have on athletes' incorporation into their sports practice with a guarantee of success.
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Affiliation(s)
| | - Aurelio Olmedilla
- Department of Personality, Evaluation and Psychological Treatment, University of Murcia, Murcia, Spain
| | | | - Alejandro Garcia-Mas
- Grupo de Investigación en Ciencias de la Actividad Fisica (GICAFE) (Research Group of Sports Sciences), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Enrique Ortega
- Department of Physical Activity and Sport, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
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Sport-Specific Rehabilitation, but Not PRP Injections, Might Reduce the Re-Injury Rate of Muscle Injuries in Professional Soccer Players: A Retrospective Cohort Study. J Funct Morphol Kinesiol 2022; 7:jfmk7040072. [PMID: 36278733 PMCID: PMC9589983 DOI: 10.3390/jfmk7040072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
Platelet-rich plasma (PRP) injections are extremely popular in the management of sports injuries in elite athletes. However, data on the use of various administration protocols of PRP are contradictory. The efficacy of platelet-rich plasma in the treatment of muscle injuries in professional soccer players has to be contextualized within the sport-specific rehabilitation program. Despite the questionable role of PRP, a well-structured rehabilitation program is still regarded as the gold standard. We examined the efficacy of various PRP protocols in the management of muscle injuries in professional soccer players in respect to treatment duration and injury recurrence. A retrospective cohort study. Muscle injuries in professional soccer players (n = 79, height 182.1 ± 5.9 cm, weight 76.8 ± 5.8 kg, BMI 23.1 ± 1.4 kg/m2) from three elite soccer clubs from the Russian Premier League were recorded during the 2018−2019 season. The injuries were graded based on MRI, using the British Athletic Muscle Injury Classification. Treatment protocols included the POLICE regimen, short courses of NSAID administration, and the specific rehabilitation program. The sample group of players were administered PRP injections. The average treatment duration with PRP injection was significantly longer than conventional treatment without PRP, 21.5 ± 15.7 days and 15.3 ± 11.1 days, respectively (p = 0.003). Soccer-specific rehabilitation and obtaining MRI/US before the treatment was associated with significantly reduced injury recurrence rate (p < 0.001). There was no significant difference between the PRP injection protocol applied to any muscle and the treatment duration in respect of grade 2A−2B muscle injuries. The total duration of treatment of type 2A−2B injuries was 15 days among all players. In the group receiving local injections of PRP, the total duration of treatment was 18 days; in the group without PRP injections, the treatment duration was 14 days. In our study, PRP treatment was associated with longer treatment duration, regardless of which muscle was injured. This may reflect the tendency to use PRP in higher-degree injuries. Soccer-specific rehabilitation significantly reduced the injury recurrence rate when compared to the administration of PRP injections. MRI/US imaging before returning to play was also associated with a lower injury recurrence rate. There was no significant difference between the PRP injection protocol applied to any muscle and the treatment duration in treatment of type 2A−2B muscle injuries.
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Gijon-Nogueron G, Ortega-Avila AB, Kaldau NC, Fahlstrom M, Felder H, Kerr S, King M, McCaig S, Marchena-Rodriguez A, Cabello-Manrique D. Data Collection Procedures and Injury Definitions in Badminton: A Consensus Statement According to the Delphi Approach. Clin J Sport Med 2022; 32:e444-e450. [PMID: 35588081 DOI: 10.1097/jsm.0000000000001048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/12/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Previous studies involving injury surveillance in badminton players have used nonstandardized injury definitions and data collection methodologies. The purpose of this study was to apply a Delphi method to (1) reach a consensus on an injury definition in badminton and (2) develop a standardized badminton injury report form. An Injury Consensus Group was established under the auspices of the Badminton World Federation, and initial injury definitions and injury report form were developed. An internal panel was formed from the Injury Consensus Group, and an external panel was selected based on a combination of profession, experience in the field, sport-specific knowledge/expertise, and geographical location to obtain a widely representative sample. Through 2 rounds of voting by the external panel, consensus was reached on both the definition of an injury in badminton and a standardized injury report form. The agreed injury definition was "Any physical injury sustained by a player during a match or training regardless if further diagnostic tests were done or if playing time was lost" and the injury report form contained the following 7 sections: Injury record, Diagnosis, Injury mechanism, Regarding pain, Pain and return to play/training after injury, Grade of severity, and Recurrence. We recommend the use of the definitions and methods presented in this consensus statement for the reporting of injury in all international and domestic badminton players. This should make future injury surveillance reports directly comparable and hence more informative in recognizing trends over time and differences between countries.
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Affiliation(s)
- Gabriel Gijon-Nogueron
- Department of Nursing and Podiatry, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Ana Belen Ortega-Avila
- Department of Nursing and Podiatry, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Niels Christian Kaldau
- Sports Orthopedic Research Center-Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager & Hvidovre Hospital, Hvidovre, Denmark
| | - Martin Fahlstrom
- Department of Clinical Science, Professional Development, Umeå University, Umeå, Sweden
| | - Hanno Felder
- Department of Biomechanics, Olympic Training Center, Saarbrücken, Germany
| | - Stewart Kerr
- Life Fit Wellness, Healthcare & Exercise Centre, Falkirk, Scotland, United Kingdom
| | - Mark King
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Steve McCaig
- English Institute of Sport, EIS/L'Boro Performance Centre, Loughborough University, Loughborough, United Kingdom
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Alfonso Mantilla JI. Monitorización y periodización del rendimiento desde la fisioterapia deportiva ¿Hacia dónde vamos? REVISTA IBEROAMERICANA DE CIENCIAS DE LA ACTIVIDAD FÍSICA Y EL DEPORTE 2022. [DOI: 10.24310/riccafd.2022.v11i2.14741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
RESUMEN
Introducción El concepto de monitorización y periodización es un visión que se ha desarrollado en la última década, donde se busca que se pueda tener un control de la carga interna y externa en los deportistas de distintas disciplinas deportivas producidas por el proceso de interacción con variables de prescripción de ejercicio que causan modificaciones a nivel fisiológico, bioquímico, biomecanico, muscular, neuromuscular ocasionando la tensión en los subsistemas del movimiento corporal humano generando adaptaciones especificas ante una carga determinada la cual puede ser medida mediante el uso de tecnología especifica o test indirectos Metodología Revisión de la literatura con la combinación de palabras clave como Monitoring, Performance, sports training load, Periodization en bases de datos como Pubmed, Ebsco, Medline, Scopus, Science Direct Resultados se pudo identificar 65 artículos que referencian la existencia de herramientas tecnológicas para realizar un proceso de monitorización y periodización desde la rehabilitación , prevención, control de carga, recuperación y readaptación deportiva que permiten la generación de datos estadísticos y crear perfiles desde cada área de actuación del fisioterapeuta deportivo. Conclusión la fisioterapia es una profesión encargada de muchos procesos deportivos que deben ser monitorizados y generen datos que permitan estandarizar procesos, crear perfiles de seguimiento específicos para facilitar la toma de decisiones desde el equipo biomédico e investigaciones en el deporte de alto rendimiento fusionando la practica con la evidencia científica.
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Heyward O, Emmonds S, Roe G, Scantlebury S, Stokes K, Jones B. Applied sports science and sports medicine in women’s rugby: systematic scoping review and Delphi study to establish future research priorities. BMJ Open Sport Exerc Med 2022; 8:e001287. [PMID: 35979431 PMCID: PMC9310180 DOI: 10.1136/bmjsem-2021-001287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2022] [Indexed: 11/04/2022] Open
Abstract
ObjectivesIn part 1, the objective was to undertake a systematic scoping review of applied sports science and sports medicine in women’s rugby, and in part 2 to develop a consensus statement on future research priorities.DesignIn part 1, a systematic search of PubMed (MEDLINE), Scopus and SPORTDiscus (EBSCOhost) was undertaken from the earliest records to January 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, the PRISMA extension for Scoping Reviews, and the PRISMA extension protocols were followed. In part 2, 31 international experts in women’s rugby (ie, elite players, sports scientists, medical clinicians, sports administrators) participated in a three-round Delphi consensus method. These experts reviewed the findings from part 1 and subsequently provided a list of priority research topics in women’s rugby. Research topics were grouped into expert-based themes and expert-based subthemes via content analysis. Expert-based themes and expert-based subthemes were ranked from very low to very high research priority on a 1–5 Likert scale. Consensus was defined by ≥70% agreement. The median research priority agreement and IQR were calculated for each expert-based theme and subtheme.Data sourcesPubMed (MEDLINE), Scopus and SPORTDiscus (EBSCOhost).Eligibility criteria for selecting studiesStudies were eligible for inclusion if they investigated applied sports science or sports medicine in women’s rugby.ResultsIn part 1, the systematic scoping review identified 123 studies, which were categorised into six sports science and sports medicine evidence-based themes: injury (n=48), physical performance (n=32), match characteristics (n=26), fatigue and recovery (n=6), nutrition (n=6), and psychology (n=5). In part 2, the Delphi method resulted in three expert-based themes achieving consensus on future research priority in women’s rugby: injury (5.0 (1.0)), female health (4.0 (1.0)) and physical performance (4.0 (1.0)).Summary/ConclusionThis two-part systematic scoping review and Delphi consensus is the first study to summarise the applied sports science and sports medicine evidence base in women’s rugby and establish future research priorities. The summary tables from part 1 provide valuable reference information for researchers and practitioners. The three expert-based themes that achieved consensus in part 2 (injury, female health and physical performance) provide clear direction and guidance on future research priorities in women’s rugby. The findings of this two-part study facilitate efficient and coordinated use of scientific resources towards high-priority research themes relevant to a wide range of stakeholders in women’s rugby.
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Scantlebury S, Ramirez C, Cummins C, Stokes K, Tee J, Minahan C, Emmonds S, McCormack S, Phillips G, Jones B. Injury risk factors and barriers to their mitigation for women playing rugby league: a Delphi study. J Sports Sci 2022; 40:1436-1449. [PMID: 35694782 DOI: 10.1080/02640414.2022.2085433] [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: 10/18/2022]
Abstract
This study aimed to 1) develop a consensus (≥70% agreement between experts) on injury risk factors specific to women playing rugby league, 2) establish the importance of the identified injury risk factors and the feasibility of mitigating these risk factors and 3) establish context specific barriers to injury risk management. Aim 1: A Delphi panel, consisting of 12 experts in rugby league and injury (e.g., physiotherapists, research scientists) were asked to identify injury risk factors specific to women playing rugby league. Aim 2: seven coaches of women's rugby league teams were asked to rate each risk factor that achieved consensus by their importance and feasibility to manage. Aim 3: Coaches reported barriers which restrict injury risk factor mitigation. Of the 53 injury risk factors which achieved consensus, the five injury risk factors with the highest combination of importance and feasibility ratings were: "poor tackle technique", "a lack of pre-season intensity", "training session are too short", "the current medical standards", and "limited access to physiotherapists". Following the identification of injury risk factors, their feasibility to manage and context specific barriers, this study proposes three constraint driven, integrated solutions which may reduce the barriers which limit injury risk factor management.
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Affiliation(s)
- Sean Scantlebury
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,England Performance Unit, Rugby Football League, Leeds, UK
| | - Carlos Ramirez
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,England Performance Unit, Rugby Football League, Leeds, UK
| | - Cloe Cummins
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,School of Science and Technology, University of New England, Armidale, Australia.,National Rugby League, Armidale, Australia
| | - Keith Stokes
- Department for Health, University of Bath, Bath, UK.,Rugby Football Union, Twickenham, UK
| | - Jason Tee
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,Department of Physiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Clare Minahan
- Griffith Sports Science, Griffith University, Australia
| | - Stacey Emmonds
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,England Performance Unit, Rugby Football League, Leeds, UK
| | - Sam McCormack
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,England Performance Unit, Rugby Football League, Leeds, UK
| | - Gemma Phillips
- England Performance Unit, Rugby Football League, Leeds, UK.,Hull Kingston Rovers, Hull, UK
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,England Performance Unit, Rugby Football League, Leeds, UK.,School of Science and Technology, University of New England, Armidale, Australia.,Griffith Sports Science, Griffith University, Australia.,Leeds Rhinos Rugby League club, Leeds, UK.,Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, The University of Cape Town and the Sports Science Institute of South Africa, Cape Town, South Africa
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Return to sport and beyond following intramuscular hamstring injury: A case report of an English Premier League football player. Phys Ther Sport 2022; 56:38-47. [DOI: 10.1016/j.ptsp.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/22/2022]
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Mason BRJ, Pumpa KL, McKune AJ, Gill ND, Ball NB. A Multidisciplinary Approach to Game Day Preparation for Team Sports: A Delphi Study With Expert Consensus. J Strength Cond Res 2022; 36:1345-1352. [PMID: 35482545 DOI: 10.1519/jsc.0000000000004232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Mason, BRJ, Pumpa, KL, McKune, AJ, Gill, ND, and Ball, NB. A multidisciplinary approach to game day preparation for team sports: A Delphi study with expert consensus. J Strength Cond Res 36(5): 1345-1352, 2022-The aim of this study was to identify game day preparation strategies used by performance staff to improve team sport performance and to determine consensus regarding the application and importance of these strategies. Twenty-five performance staff working in high performance or professional team sports participated in this Delphi study, which implemented 3 survey rounds. The first round sought responses to open-ended questions relating to the use of game day preparation strategies. These responses were developed into statements and recirculated (round-2 survey), with subjects asked to rate their level of agreement with each statement. The third and final survey presented revised versions of statements that did not reach a consensus in the previous round, along with new statements derived from subject responses. A thematic analysis of the open-ended responses in the first survey identified 5 key themes relating to game day preparation strategies: "exercise," "nutrition," "psychological," "technical and tactical," and "other." The round-2 survey included 38 statements across the 5 themes, with 22 reaching the consensus threshold (≥75%) for agreement. The remaining 16 statements did not reach consensus. The final survey included 18 statements (16 revised and 2 new) with 12 reaching the consensus threshold for agreement. Key preparation strategies identified in this study include structured and progressive warm-ups, strength and power-based priming sessions, individualized nutrition plans, and precooling in hot conditions. Performance staff working in similar environments should consider adopting these strategies to improve athlete or team performance.
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Affiliation(s)
- Billy R J Mason
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, Australia
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, Australia
| | - Kate L Pumpa
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, Australia
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, Australia
| | - Andrew J McKune
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, Australia
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, Australia
- School of Health Sciences, Biokinetics, Exercise and Leisure Sciences, University of KwaZulu-Natal, Durban, South Africa ; and
| | - Nicholas D Gill
- Te Huataki Waiora School of Health, Adams Center for High Performance, University of Waikato, Mount Maunganui, New Zealand
| | - Nick B Ball
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Bruce, Australia
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, Australia
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Mendonça LDM, Schuermans J, Denolf S, Napier C, Bittencourt NF, Romanuk A, Tak I, Thorborg K, Bizzini M, Ramponi C, Paterson C, Hägglund M, Malisoux L, Al Attar WSA, Samukawa M, Esteve E, Bakare U, Constantinou M, Schneiders A, Cavallieri Gomes A, Florentz D, Ozer Kaya D, Indra Lesmana S, Harøy J, Kuparinen V, Philips N, Jenkins W, Wezenbeek E, Witvrouw E. Sports injury prevention programmes from the sports physical therapist's perspective: An international expert Delphi approach. Phys Ther Sport 2022; 55:146-154. [DOI: 10.1016/j.ptsp.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
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Garcia AG, Andrade R, Afonso J, Runco JL, Maestro A, Espregueira-Mendes J. Hamstrings injuries in football. J Orthop 2022; 31:72-77. [PMID: 35464813 PMCID: PMC9026901 DOI: 10.1016/j.jor.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Hamstrings injuries are a major concern in football (soccer), affecting both recreational players and professional athletes. Although being a recognized issue within the football community, its incidence has been increasing over the last years and still poses a challenge to all practitioners involved. Study objectives and rationale The goal of this narrative review is to outline hamstrings injuries epidemiology and mechanisms of injury, identify and discuss its risk factors, provide an approach to a proper early diagnosis, evaluate the efficacy of current treatment options and return to sports, and present the best strategies for hamstrings injury prevention. These guidelines will help the sports medicine staff team on how to better manage their players with or at risk of hamstrings injuries. Conclusion Despite several breakthroughs in research of hamstrings injuries, there is still heterogeneity across studies and lack of consensus in regards to classification, diagnosis, treatment and prevention. Hamstrings injuries compromise the athlete's performance with time loss due to injury, shortens their highest-level career longevity with higher risk of reinjury rates, and is a defying problem for clubs to balance financial losses due to having their players off the pitch. Further research is warranted to keep moving forward with evidence on treating and preventing hamstrings injuries to mitigate its high incidence and keep the players safe.
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Affiliation(s)
- André Gismonti Garcia
- Casa de Saúde São José, Rio de Janeiro, Brazil
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
| | - Renato Andrade
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - José Afonso
- Centre of Research, Education Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Portugal
| | | | - Antonio Maestro
- Instituto Asturiano de Traumatologia Real Sporting de Gijon, Gijon, Spain
- Corresponding author.
| | - João Espregueira-Mendes
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
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Hoppen MI, Reurink G, de Boode VA, van der Kaaden L, Jagtman L, Glazenburg T, Bruning B, Tol JL. Return to match running performance after a hamstring injury in elite football: a single-centre retrospective cohort study. BMJ Open Sport Exerc Med 2022; 8:e001240. [PMID: 35309372 PMCID: PMC8883270 DOI: 10.1136/bmjsem-2021-001240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 11/04/2022] Open
Abstract
Objectives To determine the number of matches to return to pre-injury match running performance after sustaining an acute hamstring injury. Methods In this retrospective cohort study, the injuries of the players of the first, Under21, Under19, Under18 and Under17 teams of a professional football club in the period 2017-2020 were analysed. Acute hamstring injuries with a minimal absence from training or match play of 7 days were included. For running performance, we assessed the following variables: maximal velocity (km/hour), total distance, high-intensity distance (17.5-22.5 km/hour) and sprint distance (>22.5 km/hour). We calculated the average and 95% CI for these variables during the last five matches before the injury. The primary outcome was the number of matches to reach maximal velocity within the 95% CI of the player's individual pre-injury performance. Secondary outcome scores included the duration (in days and matches) to reach the other running performance variables. Results 18 hamstring injuries in 15 players were included. 15 out of 18 injuries (83%) showed a return to pre-injury maximal velocity in the second match after return to play. The median number of matches to return to pre-injury maximal velocity was 2 (IQR 1-2). In the first match after return to play, pre-injury total distance was reached in 100% of the injuries, pre-injury sprint distance was reached in 94% of the injuries and pre-injury high-intensity distance was reached in 89% of the injuries. Conclusion Following an acute hamstring injury in elite football, pre-injury match running performance is reached in the first or second match.
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Affiliation(s)
- Marloes I Hoppen
- Academic Centre for Evidence-based Sports Medicine (ACES), University of Amsterdam, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.,Medical-Performance-Science Department, AFC Ajax, Amsterdam, The Netherlands.,Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Gustaaf Reurink
- Academic Centre for Evidence-based Sports Medicine (ACES), University of Amsterdam, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.,Medical-Performance-Science Department, AFC Ajax, Amsterdam, The Netherlands
| | - Vosse A de Boode
- Medical-Performance-Science Department, AFC Ajax, Amsterdam, The Netherlands
| | | | - Lotte Jagtman
- Medical-Performance-Science Department, AFC Ajax, Amsterdam, The Netherlands
| | - Tim Glazenburg
- Medical-Performance-Science Department, AFC Ajax, Amsterdam, The Netherlands
| | - Bastiaan Bruning
- Medical-Performance-Science Department, AFC Ajax, Amsterdam, The Netherlands
| | - Johannes L Tol
- Academic Centre for Evidence-based Sports Medicine (ACES), University of Amsterdam, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.,Medical-Performance-Science Department, AFC Ajax, Amsterdam, The Netherlands.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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37
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The exchange of health and performance information when transitioning from club to National football teams; A Delphi survey of National team practitioners”. J Sci Med Sport 2022; 25:486-491. [DOI: 10.1016/j.jsams.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 02/02/2022] [Accepted: 03/20/2022] [Indexed: 11/21/2022]
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Abstract
Hamstring strain injuries are common among athletes and often require rehabilitation to prepare players for a timely return to sport performance while also minimizing reinjury risk. Return to sport is typically achieved within weeks of the injury; however, subsequent athlete performance may be impaired, and reinjury rates are high. Improving these outcomes requires rehabilitation practitioners (eg, athletic trainers and physical therapists) to understand the causes and mechanisms of hamstring strain injury, know how to perform a thorough clinical examination, and progress loading to the site of injury safely and effectively. This narrative review discusses current clinical concepts related to these aspects of rehabilitation for hamstring strain injury, with the aim of helping practitioners improve athletes' outcomes. Collectively, this knowledge will inform the implementation of evidence-based rehabilitation interventions.
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Affiliation(s)
- Jack T. Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne
,Sports Performance, Recovery, Injury and New Technologies Research Centre, Australian Catholic University, Melbourne
| | - David A. Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne
,Sports Performance, Recovery, Injury and New Technologies Research Centre, Australian Catholic University, Melbourne
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van der Horst N, Denderen R. Isokinetic hamstring and quadriceps strength interpretation guideline for football (soccer) players with ACL reconstruction: a Delphi consensus study in the Netherlands. SCI MED FOOTBALL 2022; 6:434-445. [DOI: 10.1080/24733938.2021.2024592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nick van der Horst
- Fifa Medical Centre of Excellence, Royal Netherlands Football Association (Knvb), Zeist, The Netherlands
| | - Remy Denderen
- Fifa Medical Centre of Excellence, Royal Netherlands Football Association (Knvb), Zeist, The Netherlands
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Epidemiological analysis of injury occurrence and current prevention strategies on international amateur football level during the UEFA Regions Cup 2019. Arch Orthop Trauma Surg 2022; 142:271-280. [PMID: 33740068 PMCID: PMC8783909 DOI: 10.1007/s00402-021-03861-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/08/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Football is the most popular sport worldwide and results in a high frequency of injuries. So far, mainly injuries in professional football have been investigated, and the literature lacks data regarding detailed injury epidemiology and current prevention data in amateur football tournaments. MATERIALS AND METHODS A prospective cohort study investigated an international amateur football tournament, the UEFA Regions' Cup, which took place in 2019 in Germany. Injury epidemiology, current prevention strategies of the teams and the implementation of the UEFA concussion protocol were investigated in detail by means of standardized injury definitions and data samples for football (Fuller et al., Scand J Med Sci Sports 16:83-92, https://doi.org/10.1111/j.1600-0838.2006.00528.x , 2006). RESULTS 138 player of 8 teams participated in this study, while 39 players were excluded. Overall injury incidence was 12.5 per 1000 h total football exposure, 43.5 per 1000 h for match exposure. No injuries were registered during training. Injury prevalence was 14.1% per player and 1.1 injuries per match were registered. The lower extremity was predominantly affected by injuries (71.4%) and the majority of injuries (78.6%) were non-severe injury types like contusions (50%) and sprains (18.2%). Two head injuries, one contusion and one skin lesion, were handled by the guidelines of the UEFA concussion protocol. 44.4% of the players indicated at least one previous injury before tournament, 45.3% of them during the last two football seasons before start of the tournament. Injury prevention performance was included in all participating teams during the tournament by warm up or training strategies (100%). During the warm-up program just 5 exercises of the FIFA 11 + program was detected by this investigation in participating teams to be done by more half of the teams. Running exercises were the most frequently performed exercises, while trunk muscle exercises were less represented (14.3%). CONCLUSION This study presents for the first time epidemiological injury and prevention data of the UEFA Regions Cup. Injury incidence was higher compared to injury reports of regular seasons, but lower compared to other amateur football tournaments. Currently used prevention programs revealed trunk muscle exercises as often neglected.
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Nara G, Samukawa M, Oba K, Koshino Y, Ishida T, Kasahara S, Tohyama H. The deficits of isometric knee flexor strength in lengthened hamstring position after hamstring strain injury. Phys Ther Sport 2021; 53:91-96. [PMID: 34890906 DOI: 10.1016/j.ptsp.2021.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To investigate the effects of knee flexion angle on peak torque, rate of torque development (RTD) during isometric contraction and hamstring flexibility after hamstring strain injury (HSI). DESIGN Cross-sectional. SETTING Controlled laboratory research. PARTICIPANTS Fourteen male athletes with a history of HSI and 14 athletes without HSI (controls). MAIN OUTCOME MEASURES Hamstring flexibility was evaluated using active knee extension test. Isometric knee flexion peak torque and RTD were determined at 30°, 60°, and 90° of knee flexion measured by an isokinetic dynamometer. RESULTS Individuals with a history of HSI had statistically significant, moderate deficits in isometric peak torque at 30° of knee flexion (P = 0.037; effect size = 0.55) in the HSI limb than in the uninjured limb, but not at 60° and 90° of knee flexion. In the control group, no significant differences in isometric peak torque at any angle were found between limbs. No differences in peak RTD and flexibility were found between limbs in both groups. CONCLUSIONS Isometric peak torque at 30° of knee flexion was lower in the injured limb than in the uninjured limb. Isometric strength deficits after HSI tended to be affected by lengthened hamstring angles.
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Affiliation(s)
- Ginji Nara
- Rehabilitation Center, NTT Medical Center Sapporo, Sapporo, Japan; Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Kensuke Oba
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan; Department of Rehabilitation, Hitsujigaoka Hospital, Sapporo, Japan
| | - Yuta Koshino
- Rehabilitation Center, NTT Medical Center Sapporo, Sapporo, Japan; Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tomoya Ishida
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Taberner M, Allen T, O'keefe J, Cohen DD. Contextual considerations using the 'control-chaos continuum' for return to sport in elite football - Part 1: Load planning. Phys Ther Sport 2021; 53:67-74. [PMID: 34839202 DOI: 10.1016/j.ptsp.2021.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/28/2021] [Accepted: 10/31/2021] [Indexed: 12/26/2022]
Abstract
The 'control-chaos continnum' is an adaptable framework developed to guide the on-pitch rehabilitation process in elite football. One of the key objectives of the continuum is to progressively return players to their preinjury chronic running load, while incorporating the qualitative aspects of movement and cognitive stresses integral to competitive match-play. Whilst injury and player-specific considerations are key to an individualised rehabilitation approach, a host of contextual factors also play an important role in return to sport (RTS) planning. In this article, we highlight some key intrinsic and extrinsic contextual factors for the practitioner to consider in the RTS planning process to help mitigate reinjury risk upon a return to team training. While a return to chronic running load is generally a critical component of the framework, we highlight circumstances in elite football where it is a less relevant factor in RTS decision-making.
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Affiliation(s)
- M Taberner
- Performance and Medical Department, Orlando Magic Basketball Club, Orlando, USA; School of Sport and Exercise Sciences, Liverpool John Moore's University, Liverpool, UK.
| | - T Allen
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK; Institute of Coaching and Performance, University of Central Lancashire, Preston, UK. https://twitter.com/tallen_5
| | - J O'keefe
- Academy Sports Science Department, Everton Football Club, Liverpool, UK. https://twitter.com/JasonOkeefe10
| | - D D Cohen
- Masira Research Institute, University of Santander (UDES), Bucaramanga, Colombia; Sports Science Center (CCD), Colombian Ministry of Sport (Mindeporte), Colombia. https://twitter.com/danielcohen1971
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Naughton M, McLean S, Scott TJ, Weaving D, Solomon C. Quantifying Fatigue in the Rugby Codes: The Interplay Between Collision Characteristics and Neuromuscular Performance, Biochemical Measures, and Self-Reported Assessments of Fatigue. Front Physiol 2021; 12:711634. [PMID: 34776996 PMCID: PMC8586499 DOI: 10.3389/fphys.2021.711634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/30/2021] [Indexed: 11/25/2022] Open
Abstract
Locomotor and collision actions that rugby players complete during match-play often lead to substantial fatigue, and in turn, delays in recovery. The methods used to quantify post-match fatigue and recovery can be categorised as subjective and objective, with match-related collision characteristics thought to have a primary role in modulating these recovery measures. The aim of this review was to (1) evaluate how post-match recovery has been quantified in the rugby football codes (i.e., rugby league, rugby union, and rugby sevens), (2) to explore the time-course of commonly used measures of fatigue post-match, and (3) to investigate the relationships between game-related collisions and fatigue metrics. The available evidence suggests that upper-, and lower-body neuromuscular performance are negatively affected, and biomarkers of muscular damage and inflammation increase in the hours and days following match-play, with the largest differences being at 12–36 h post-match. The magnitude of such responses varies within and between neuromuscular performance (Δ ≤ 36%, n = 13 studies) and tissue biomarker (Δ ≤ 585%, n = 18 studies) measures, but nevertheless appears strongly related to collision frequency and intensity. Likewise, the increase in perceived soreness in the hours and days post-match strongly correlate to collision characteristics across the rugby football codes. Within these findings, there are specific differences in positional groups and recovery trajectories between the codes which relate to athlete characteristics, and/or locomotor and collision characteristics. Finally, based on these findings, we offer a conceptual model of fatigue which details the multidimensional latent structure of the load to fatigue relationship contextualised to rugby. Research to date has been limited to univariate associations to explore relationships between collision characteristics and recovery, and multivariate methods are necessary and recommended to account for the latent structures of match-play external load and post-match fatigue constructs. Practitioners should be aware of the typical time windows of fatigue recovery and utilise both subjective and objective metrics to holistically quantify post-match recovery in rugby.
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Affiliation(s)
- Mitchell Naughton
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia.,Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Scott McLean
- Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Tannath J Scott
- New South Wales Rugby League, Sydney Olympic Park, NSW, Australia.,Carnegie Applied Rugby Research Centre, Leeds Beckett University, Leeds, United Kingdom
| | - Dan Weaving
- Carnegie Applied Rugby Research Centre, Leeds Beckett University, Leeds, United Kingdom.,Leeds Rhinos Rugby League Club, Leeds, United Kingdom
| | - Colin Solomon
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia.,Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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44
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Predictors of time to return to play and re-injury following hamstring injury with and without intramuscular tendon involvement in adult professional footballers: A retrospective cohort study. J Sci Med Sport 2021; 25:216-221. [PMID: 34740516 DOI: 10.1016/j.jsams.2021.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES In one English Premier League football club over four seasons, 1) describe the number of hamstring strain injuries (HSI) sustained using the British Athletics Muscle Injury Classification (BAMIC); 2) determine if intramuscular tendon HSI influenced the time to return to play (TTRTP) and reinjury rate; 3) determine the predictors of TTRTP and reinjury. DESIGN Retrospective cohort design. METHODS All first team players who sustained a HSI between 2014 and 2018 were included. Players underwent an MRI scan that was graded by a Radiologist using the BAMIC (0a-4) criteria. TTRTP, reinjury rate and information on suspected predictors were recorded. RESULTS Thirty-five HSI experienced by 24 players (age = 26 ± 4 years) were recorded over the 4 seasons. There was a difference in TTRTP between grades 1a and 2c (P = 0.007), but not between 2b and 2c (P = 0.845). Grade of HSI (P ≤ 0.001) and removal of the player (P < 0.001) were predictors of TTRTP, with each increase in grade resulting in an additional 3 days of TTRTP, and being removed, an additional 11 days. Grade and all other predictors did not influence reinjury rate, albeit higher odds were evident for previous HSI, experiencing the HSI during sprinting, passing a ball or stretching, and reported increase days of pain during walking. CONCLUSIONS HSIs extending into the intramuscular tendon (2b cf. 2c) did not influence TTRTP or re-injury, albeit TTRTP was affected by the BAMIC grade and if the player was removed from activity.
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45
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Heyward O, Emmonds S, Roe G, Scantlebury S, Stokes K, Jones B. Applied sport science and medicine of women's rugby codes: a systematic-scoping review and consensus on future research priorities protocol. BMJ Open Sport Exerc Med 2021; 7:e001108. [PMID: 34394953 PMCID: PMC8317073 DOI: 10.1136/bmjsem-2021-001108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 11/24/2022] Open
Abstract
Women's rugby (rugby league, rugby union and rugby sevens) has recently grown in participation and professionalisation. There is under-representation of women-only cohorts within applied sport science and medicine research and within the women's rugby evidence base. The aims of this article are: Part 1: to undertake a systematic-scoping review of the applied sport science and medicine of women's rugby, and Part 2: to develop a consensus statement on future research priorities. This article will be designed in two parts: Part 1: a systematic-scoping review, and Part 2: a three-round Delphi consensus method. For Part 1, systematic searches of three electronic databases (PubMed (MEDLINE), Scopus, SPORTDiscus (EBSCOhost)) will be performed from the earliest record. These databases will be searched to identify any sport science and medicine themed studies within women's rugby. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews will be adhered to. Part 2 involves a three-round Delphi consensus method to identify future research priorities. Identified experts in women's rugby will be provided with overall findings from Part 1 to inform decision-making. Participants will then be asked to provide a list of research priority areas. Over the three rounds, priority areas achieving consensus (≥70% agreement) will be identified. This study has received institutional ethical approval. When complete, the manuscript will be submitted for publication in a peer-reviewed journal. The findings of this article will have relevance for a wide range of stakeholders in women's rugby, including policymakers and governing bodies.
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Affiliation(s)
- Omar Heyward
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Rugby Football Union, Twickenham, UK
- Leeds Rhinos Rugby League club, Leeds, UK
| | - Stacey Emmonds
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Leeds, UK
| | - Gregory Roe
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Bath Rugby, Bath, UK
| | - Sean Scantlebury
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, Rugby Football League, Leeds, UK
| | - Keith Stokes
- Rugby Football Union, Twickenham, UK
- Department for Health, University of Bath, Bath, UK
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Leeds Rhinos Rugby League club, Leeds, UK
- England Performance Unit, Rugby Football League, Leeds, UK
- School of Science and Technology, University of New England, Armidale, New South Wales, Australia
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of South Africa, Cape Town, South Africa
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46
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Edouard P, Lahti J, Nagahara R, Samozino P, Navarro L, Guex K, Rossi J, Brughelli M, Mendiguchia J, Morin JB. Low Horizontal Force Production Capacity during Sprinting as a Potential Risk Factor of Hamstring Injury in Football. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157827. [PMID: 34360125 PMCID: PMC8345704 DOI: 10.3390/ijerph18157827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/18/2021] [Accepted: 07/06/2021] [Indexed: 01/09/2023]
Abstract
Clear decreases in horizontal force production capacity during sprint acceleration have been reported after hamstring injuries (HI) in football players. We hypothesized that lower FH0 is associated with a higher HI occurrence in football players. We aimed to analyze the association between sprint running horizontal force production capacities at low (FH0) and high (V0) velocities, and HI occurrence in football. This prospective cohort study included 284 football players over one season. All players performed 30 m field sprints at the beginning and different times during the season. Sprint velocity data were used to compute sprint mechanical properties. Players' injury data were prospectively collected during the entire season. Cox regression analyses were performed using new HI as the outcome, and horizontal force production capacity (FH0 and V0) was used at the start of the season (model 1) and at each measurement time point within the season (model 2) as explanatory variables, adjusted for individual players' (model 2) age, geographical group of players, height, body mass, and previous HI, with cumulative hours of football practice as the time scale. A total of 47 new HI (20% of all injuries) were observed in 38 out of 284 players (13%). There were no associations between FH0 and/or V0 values at the start of the season and new HI occurrence during the season (model 1). During the season, a total of 801 measurements were performed, from one to six per player. Lower measured FH0 values were significantly associated with a higher risk of sustaining HI within the weeks following sprint measurement (HR = 2.67 (95% CI: 1.51 to 4.73), p < 0.001) (model 2). In conclusion, low horizontal force production capacities at low velocity during early sprint acceleration (FH0) may be considered as a potential additional factor associated with HI risk in a comprehensive, multifactorial, and individualized approach.
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Affiliation(s)
- Pascal Edouard
- UJM-Saint-Etienne, Laboratory Interuniversity of Human Movement Sciences, University Lyon, EA 7424, F-42023 Saint-Etienne, France; (J.R.); (J.-B.M.)
- Sports Medicine Unity, Department of Clinical and Exercise Physiology, Faculty of Medicine, University Hospital of Saint-Etienne, CEDEX 2, F-42055 Saint-Etienne, France
- Correspondence: ; Tel.: +33-674-574-691
| | - Johan Lahti
- LAMHESS, Université Côte d’Azur, F-06200 Nice, France;
| | - Ryu Nagahara
- Sports Research and Development Core, University of Tsukuba, Ibaraki 305-8574, Japan;
- Faculty of Sports and Budo Coaching Studies, National Institute of Fitness and Sports in Kanoya, Kagoshima 891-2393, Japan
| | - Pierre Samozino
- Laboratory Interuniversity of Human Movement Sciences, University Savoie Mont Blanc, EA 7424, F-73000 Chambéry, France;
| | - Laurent Navarro
- Mines Saint-Etienne, Centre CIS, Université de Lyon, Université Jean Monnet, INSERM, U 1059 Sainbiose, F-42023 Saint-Etienne, France;
| | - Kenny Guex
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland;
- Department of Sprints, Hurdles and Relays, Swiss Athletics, Haus des Sports, 3063 Ittigen, Switzerland
| | - Jérémy Rossi
- UJM-Saint-Etienne, Laboratory Interuniversity of Human Movement Sciences, University Lyon, EA 7424, F-42023 Saint-Etienne, France; (J.R.); (J.-B.M.)
| | - Matt Brughelli
- Sports Performance Research Institute New Zealand, Auckland University of Technology, 1010 Auckland, New Zealand;
| | - Jurdan Mendiguchia
- Department of Physical Therapy, Zentrum Rehabilitation and Performance Center, 31002 Pamplona, Spain;
| | - Jean-Benoît Morin
- UJM-Saint-Etienne, Laboratory Interuniversity of Human Movement Sciences, University Lyon, EA 7424, F-42023 Saint-Etienne, France; (J.R.); (J.-B.M.)
- LAMHESS, Université Côte d’Azur, F-06200 Nice, France;
- Sports Performance Research Institute New Zealand, Auckland University of Technology, 1010 Auckland, New Zealand;
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47
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Smith MD, Vicenzino B, Bahr R, Bandholm T, Cooke R, Mendonça LDM, Fourchet F, Glasgow P, Gribble PA, Herrington L, Hiller CE, Lee SY, Macaluso A, Meeusen R, Owoeye OBA, Reid D, Tassignon B, Terada M, Thorborg K, Verhagen E, Verschueren J, Wang D, Whiteley R, Wikstrom EA, Delahunt E. Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework-an international multidisciplinary consensus. Br J Sports Med 2021; 55:1270-1276. [PMID: 34158354 DOI: 10.1136/bjsports-2021-104087] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute lateral ankle sprain injuries. We aimed to develop a list of assessment items to address this gap. METHODS We used a three-round Delphi survey approach to develop consensus of opinion among 155 globally diverse health professionals working in elite field or court sports. This involved surveys that were structured in question format with both closed-response and open-response options. We asked panellists to indicate their agreement about whether or not assessment items should support the RTS decision after an acute lateral ankle sprain injury. The second and third round surveys included quantitative and qualitative feedback from the previous round. We defined a priori consensus being reached at >70% agree or disagree responses. RESULTS Sixteen assessment items reached consensus to be included in the RTS decision after an acute lateral ankle sprain injury. They were mapped to five domains with 98% panellist agreement-PAASS: Pain (during sport participation and over the last 24 hours), Ankle impairments (range of motion; muscle strength, endurance and power), Athlete perception (perceived ankle confidence/reassurance and stability; psychological readiness), Sensorimotor control (proprioception; dynamic postural control/balance), Sport/functional performance (hopping, jumping and agility; sport-specific drills; ability to complete a full training session). CONCLUSION Expert opinion indicated that pain severity, ankle impairments, sensorimotor control, athlete perception/readiness and sport/functional performance should be assessed to inform the RTS decision following an acute lateral ankle sprain injury. TRIAL REGISTRATION NUMBER ACTRN12619000522112.
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Affiliation(s)
- Michelle D Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Roald Bahr
- Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway.,Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Thomas Bandholm
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Department of Physical and Occupational Therapy and Department of Clinical Research, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Orthopedic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rosalyn Cooke
- English Institute of Sport, Manchester Institute for Health and Performance, Manchester, UK
| | - Luciana De Michelis Mendonça
- Physical Therapy Department, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.,Graduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - François Fourchet
- Physiotherapy Department, Hôpital de La Tour, Meyrin, Switzerland.,Laboratoire Interuniversitaire de Biologie de la Motricité, UJM-Saint-Etienne, University of Lyon, Lyon, France
| | - Philip Glasgow
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,School of Sport, Ulster University, Jordanstown, UK
| | - Phillip A Gribble
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, Kentucky, USA
| | - Lee Herrington
- English Institute of Sport, Manchester Institute for Health and Performance, Manchester, UK.,Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
| | - Claire E Hiller
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Seoul, South Korea.,Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Seoul, South Korea
| | - Andrea Macaluso
- Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Roma, Italy.,Villa Stuart Sport Clinic, FIFA Medical Centre of Excellence, Roma, Italy
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Oluwatoyosi B A Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Saint Louis, Missouri, USA.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Duncan Reid
- Faculty of Health and Environmental Sciences, School of Clinical Sciences, AUT University, Auckland, New Zealand
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
| | - Kristian Thorborg
- Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre University Hospital, Copenhagen, Denmark.,Physical Medicine Rehabilitation Research-Copenhagen (PMR-C), Amager-Hvidovre University Hospital, Copenhagen, Denmark
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, VUmc site, Amsterdam, Netherlands
| | - Jo Verschueren
- Human Physiology and Sports Physiotherapy Research Group, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dan Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Rod Whiteley
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,School of Human Movement & Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Erik A Wikstrom
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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48
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Return to Play After a Hamstring Strain Injury: It is Time to Consider Natural Healing. Sports Med 2021; 51:2067-2077. [PMID: 34143413 DOI: 10.1007/s40279-021-01494-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 01/15/2023]
Abstract
Return to play (RTP) criteria after hamstring strain injuries (HSIs) help clinicians in deciding whether an athlete is ready to safely resume previous sport activities. Today, functional and sport-specific training tests are the gold standard in the decision-making process. These criteria lead to an average RTP time between 11 and 25 days after a grade 1 or 2 HSI. However, the high re-injury rates indicate a possible inadequacy of the current RTP criteria. A possible explanation for this could be the neglect of biological healing time. The present review shows that studies indicating time as a possible factor within the RTP-decision are very scarce. However, studies on biological muscle healing showed immature scar tissue and incomplete muscle healing at the average moment of RTP. Twenty-five percent of the re-injuries occur in the first week after RTP and at the exact same location as the index injury. This review supports the statement that functional recovery precedes the biological healing of the muscle. Based on basic science studies on biological muscle healing, we recommend a minimum period of 4 weeks before RTP after a grade 1 or 2 HSI. In conclusion, we advise a comprehensive RTP functional test battery with respect for the natural healing process. Before deciding RTP readiness, clinicians should reflect whether or not it is biologically possible for the injured tissue to have regained enough strength to withstand the sport-specific forces. In an attempt to reduce the detrimental injury-reinjury cycle, it is time to start considering (biological healing) time.
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49
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Rodas G, Soler-Rich R, Rius-Tarruella J, Alomar X, Balius R, Orozco L, Masci L, Maffulli N. Effect of Autologous Expanded Bone Marrow Mesenchymal Stem Cells or Leukocyte-Poor Platelet-Rich Plasma in Chronic Patellar Tendinopathy (With Gap >3 mm): Preliminary Outcomes After 6 Months of a Double-Blind, Randomized, Prospective Study. Am J Sports Med 2021; 49:1492-1504. [PMID: 33783227 DOI: 10.1177/0363546521998725] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patellar tendinopathy is common. The success of traditional management, including isometric or eccentric exercises combined with shockwave therapy and even surgery, is limited. Therefore, it is important to determine whether biological treatments such as ultrasound-guided intratendinous and peritendinous injections of autologous expanded bone marrow mesenchymal stem cells (BM-MSCs) or leukocyte-poor platelet-rich plasma (Lp-PRP) improve clinical outcomes in athletic patients with patellar tendinopathy. STUDY DESIGN Randomized controlled trial; Level of evidence, 2. METHODS A prospective, double-blinded, randomized, 2-arm parallel group, active controlled, phase 1/2 single-center clinical study was performed in patients who had proximal patellar tendinopathy with a lesion >3 mm. A total of 20 participants (age 18-48 years) with pain for >4 months (mean, 23.6 months) and unresponsive to nonoperative treatments were randomized into 2 groups. Of these, 10 participants were treated with BM-MSC (20 × 106 cells) and 10 with Lp-PRP. Both groups performed the same postintervention rehabilitation protocol. Outcomes included the Victorian Institute of Sport Assessment for pain (VISA-P), self-reported tendon pain during activity (visual analog scale [VAS]), muscle function by dynamometry, tendon thickness and intratendinous vascularity by ultrasonographic imaging and Doppler signal, ultrasound tissue characterization (UTC) echo type changes, and magnetic resonance imaging (MRI) T2-weighted mapping changes. Participants were followed longitudinally for 6 months. RESULTS The average VAS scores improved in both groups at all time points, and there was a significant reduction in pain during sporting activities (P < .05). In both groups, the average mean VISA-P scores at 6 months were significantly increased compared with baseline (66 BM-MSC group and 72.90 Lp-PRP group), with no significant differences in VAS or VISA-P scores between the groups. There were statistically significant greater improvements in tendon structure on 2-dimensional ultrasound and UTC in the BM-MSC group compared with the Lp-PRP group at 6 months. Similarly, the BM-MSC group demonstrated significant evidence of restoration of tendon structure on MRI compared with the Lp-PRP group at 6 months. Only the participants in the BM-MSC group showed evidence of normalization of tendon structure, with statistically significant differences between the groups on T2-weighted, fat-saturated sagittal and coronal scans and hypersignal in T2-weighted on spin-echo T2-weighted coronal MRI scan. Both treatments were safe, and no significant adverse events were reported in either group. CONCLUSION Treatment with BM-MSC or Lp-PRP in combination with rehabilitation in chronic patellar tendinopathy is effective in reducing pain and improving activity levels in active participants. Participants who received BM-MSC treatment demonstrated greater improvement in tendon structure compared with those who received Lp-PRP. REGISTRATION 2016-001262-28 (EudraCT identifier); NCT03454737 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Gil Rodas
- Medical Department FC Barcelona, Barcelona, Spain.,Sports Medicine Unit, Clínic Hospital and Sant Joan de Déu Hospital, Barcelona, Spain
| | - Robert Soler-Rich
- Institut de Teràpia Regenerativa Tissular, Centro Médico Teknon, Barcelona, Spain
| | - Joan Rius-Tarruella
- Institut de Teràpia Regenerativa Tissular, Centro Médico Teknon, Barcelona, Spain
| | - Xavier Alomar
- Diagnóstico por la Imagen, Clínica Creu Blanca, Barcelona, Spain
| | - Ramon Balius
- Consell Català de l'Esport, Generalitat de Catalunya, Barcelona, Spain
| | - Lluís Orozco
- Institut de Teràpia Regenerativa Tissular, Centro Médico Teknon, Barcelona, Spain
| | - Lorenzo Masci
- Institute of Sports Exercise and Health (ISEH), London, UK
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine, Surgery and Dentistry, Salerno, Italy.,Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK.,School of Pharmacy and Bioengineering, Keele University School of Medicine, Staffordshire, UK
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50
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Exercise-Based Strategies to Prevent Muscle Injury in Male Elite Footballers: An Expert-Led Delphi Survey of 21 Practitioners Belonging to 18 Teams from the Big-5 European Leagues. Sports Med 2021; 50:1667-1681. [PMID: 32676903 PMCID: PMC7441050 DOI: 10.1007/s40279-020-01315-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Purpose To define based on expert opinion and practical experience using a systematic and scientific approach, (1) the perceived most effective exercise-based strategies to prevent muscle injury in elite footballers; and, (2) when and how these exercise programs are prescribed based on the number of days between games i.e. implementation strategy. Methods A Delphi survey obtained opinions and assessed for agreement. Delphi respondents consisted of 21 experienced sports practitioners (12 ± 5.3 years in elite football and with an academic background) belonging to 18 teams from the Big-5 European football leagues; England, France, Germany, Italy, Spain. Three teams were represented collaboratively by two experts. The Delphi process involves sequential rounds each evolving based on the responses from the previous. The number of rounds is not pre-defined and continues until an agreement is either achieved or it is clear that no agreement will be reached. Frequency of responses was recorded where the agreement was sought (i.e. in closed questions) and an agreement was achieved if ≥ 13/18 (70%) respondents agreed. For open-ended questions, a qualitative content analysis was performed to identify recurring themes and when themes were specified by ≥ 13 (70%), these were also considered as reaching an agreement. Practitioners had the opportunity to raise concerns if they disagreed with the ‘agreement from recurrent themes’. Results There were four Delphi rounds (100% response for each round). Sprinting and High-Speed Running (HSR) focused exercises were agreed as most effective (perceived) to prevent muscle injuries. Eccentric exercise was perceived as the next most effective. It was agreed that sprinting and HSR be integrated into coaches training, and target 100% of players worst-case match scenario (e.g. volume, intensity) based on individual maximum speeds. Eccentric exercise was recommended to be implemented according to the context of the main football session and planned/actual sprinting and HSR content. It was agreed that eccentrics can be performed before or after training, context dependent. The day to perform specific sprinting and HSR or eccentric exercises depended on the proximity of previous and upcoming matches. Other exercises reaching agreement as ‘somewhat effective’ included concentric and isometric, horizontal and vertical plyometrics, coordination, core and dynamic flexibility in addition to core stability. No agreement was reached for multi-joint, resisted sprinting, kicking or agility exercises nor simultaneous single-leg strength and stability. Finally, no agreement was reached regarding programming variables e.g. sets, repetitions as deemed too contextual. Conclusion Regarding exercise-based strategies, particular importance agreed by the Delphi expert group was to focus on sprinting, HSR and eccentric exercises, integrated with a variety of other exercise modes which also carry some level of effectiveness in a multidimensional programme. Context was agreed to be key and decision-making about when to undertake/ how to prescribe exercise strategies to be made according to the content of normal football training and the proximity of matches.
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