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Muehlbauer T, Eckardt L, Höptner L, Hill MW. Effect of low versus high balance training complexity on balance performance in male adolescents. BMC Res Notes 2024; 17:149. [PMID: 38807232 PMCID: PMC11135006 DOI: 10.1186/s13104-024-06811-x] [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: 06/21/2023] [Accepted: 05/20/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVE The current study aimed to determine the effects of low (i.e., balance task only) versus high (i.e., balance task combined with an additional motor task like dribbling a basketball) balance training complexity (6 weeks of training consisting of 2 × 30 min balance exercises per week) on measures of static and dynamic balance in 44 healthy male adolescents (mean age: 13.3 ± 1.6 years). RESULTS Irrespective of balance training complexity, significant medium- to large-sized pretest to posttest improvements were detected for static (i.e., One-Legged Stance test, stance time [s], 0.001 < p ≤ 0.008) and dynamic (i.e., 3-m Beam Walking Backward test, steps [n], 0.001 < p ≤ 0.002; Y-Balance-Test-Lower-Quarter, reach distance [cm], 0.001 < p ≤ 0.003) balance performance. Further, in all but one comparison (i.e., stance time with eyes opened on foam ground) no group × test interactions were found. These results imply that balance training is effective to improve static and dynamic measures of balance in healthy male adolescents, but the effectiveness seems unaffected by the applied level of balance training complexity.
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Affiliation(s)
- Thomas Muehlbauer
- Division of Movement and Training Sciences, Biomechanics of Sport, University of Duisburg- Essen, Essen, Germany.
| | - Lucas Eckardt
- Division of Movement and Training Sciences, Biomechanics of Sport, University of Duisburg- Essen, Essen, Germany
| | - Lukas Höptner
- Division of Movement and Training Sciences, Biomechanics of Sport, University of Duisburg- Essen, Essen, Germany
| | - Mathew W Hill
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
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Gerdesmeyer L, Vester J, Schneider C, Wildemann B, Frank C, Schultz M, Seilheimer B, Smit A, Kerkhoffs G. Topical Treatment Is Effective and Safe for Acute Ankle Sprains: The Multi-Center Double-Blind Randomized Placebo-Controlled TRAUMED Trial. J Clin Med 2024; 13:841. [PMID: 38337536 PMCID: PMC10856131 DOI: 10.3390/jcm13030841] [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: 11/27/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Topical NSAIDs are widely used to treat ankle sprains. Traumed (Tr14) gel is a multicomponent formulation, demonstrating inflammation-resolution properties. METHODS This multicenter, double-blind trial investigated the efficacy and safety of Tr14 gel versus placebo gel and non-inferiority versus 1% diclofenac gel, applied 3×/day for 7 days after acute lateral ankle sprain (EudraCT Number: 2016-004792-50). The primary outcome was AUC for pain on passive movement, assessed by VAS from baseline to Days 4 and 7. RESULTS The trial population included 625 patients aged 18 to 78 years. The AUC scores were 187.88 and 200.75 on Day 4 (p = 0.02) and 294.14 and 353.42 on Day 7 (p < 0.001) for Tr14 and placebo, respectively. For Tr14 compared to diclofenac, the AUC scores were 187.50 and 197.19 on Day 4 (p = 0.3804) and 293.85 and 327.93 on Day 7 (p = 0.0017), respectively. On the FAAM-ADL subscale, Tr14 was superior to placebo and non-inferior to diclofenac at all time points. Time to 50% pain improvement was lowest for Tr14 (6.0 days), compared to placebo (7.1 days) and diclofenac (7.0 days). Adverse events were uncommon and minor. CONCLUSIONS Tr14 gel is effective and safe in acute ankle sprains, compared to placebo gel and diclofenac gel, and has faster pain resolution. TRIAL REGISTRATION The trial was registered in clinicaltrialsregister.eu, EudraCT number 2016-004792-50 on 07.06.2017.
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Affiliation(s)
- Ludger Gerdesmeyer
- Orthopedics and Trauma Surgery, Kiel Municipal Hospital, 24116 Kiel, Germany
| | | | | | - Britt Wildemann
- Experimental Trauma Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany
| | | | | | | | - Alta Smit
- Heel GmbH, 76532 Baden-Baden, Germany
| | - Gino Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
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Dolan P, Kenny I, Glynn L, Campbell M, Warrington GD, Cahalan R, Harrison A, Lyons M, Comyns T. Risk factors for acute ankle sprains in field-based, team contact sports: a systematic review of prospective etiological studies. PHYSICIAN SPORTSMED 2023; 51:517-530. [PMID: 35757862 DOI: 10.1080/00913847.2022.2093618] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this systematic review was to identify prospectively measured ankle sprain risk factors in field-based team contact sports. METHODS Eight databases including SPORTDiscus, CINAHL Complete, MEDLINE (EBSCO), Education Source, Web of Science, Scopus, Embase, and Pubmed were searched using specific Boolean terms. A modified-CASP diagnostic test assessed the quality of the included studies. Extensive data extraction included but was not limited to injury definition, protocols for injury diagnosis and recording, and outcomes associated with ankle sprain. RESULTS 4012 records were returned from the online search and 17 studies met the inclusion criteria for this review. Twelve different risk factors including anatomic alignment of the foot and ankle, joint laxity, height, mass, BMI (body mass index), age, ankle strength, hip strength, single leg landing performance (ground reaction force, pelvic internal rotation, and knee varus), and single leg reach were all found to be associated with ankle sprain incidence. Injury definitions and methods of diagnosis and recording varied across the 17 studies. CONCLUSION This review updates the literature on prospective risk factors for ankle sprain in a specific population rather than heterogeneous cohorts previously studied. From more than 20 categories of risk factors investigated for ankle sprain association across 17 studies in field-based team contact sports, 12 variables were found to be associated with increased incidence of ankle sprain. In order to reduce the risk of ankle sprain, BMI, ankle plantar and dorsiflexion strength, hip strength, and single leg landing performance should be factored in to athlete assessment and subsequent program design. More studies utilizing standardized definitions and methods of recording and reporting are needed. Future prospective etiological studies will allow strength and conditioning coaches, physiotherapists, and physicians to apply specific training principles to reduce the risk and occurrence of ankle sprain injuries.
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Affiliation(s)
- Patrick Dolan
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Ian Kenny
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
| | - Liam Glynn
- School of Medicine, University of Limerick, Limerick, Ireland
- HRB Primary Care Clinical Trials Network Ireland, Ireland
| | - Mark Campbell
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Lero, The Irish Software Research Centre, University of Limerick, Limerick, Ireland
| | - Giles D Warrington
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
| | - Roisin Cahalan
- School of Allied Health, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, University of Limerick, Limerick, Ireland
| | - Andrew Harrison
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
| | - Mark Lyons
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
| | - Thomas Comyns
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
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Chung S, Rodriguez A, Alijanpour E, McCann RS. Effects of A Single Balance Training Session on Neural Excitability in Individuals With Chronic Ankle Instability. J Sport Rehabil 2023; 32:847-854. [PMID: 37558224 DOI: 10.1123/jsr.2023-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/03/2023] [Accepted: 06/08/2023] [Indexed: 08/11/2023]
Abstract
CONTEXT Individuals with chronic ankle instability (CAI) demonstrate reduced spinal reflex modulation and corticospinal excitability of the soleus, which may contribute to decreased balance performance. OBJECTIVE To determine the effects of a single session of balance training on Spinal-reflexive excitability modulation and corticospinal excitability in those with CAI. DESIGN Randomized controlled trials. SETTING Research laboratory. PARTICIPANTS Thirty participants with CAI were randomly assigned to the balance training (BAL) or control (CON) group. MAIN OUTCOME MEASURES Modulation of soleus spinal-reflexive excitability was measured by calculating relative change in normalized Hoffmann reflexes (ratio of the H-reflex to the M-wave) from prone to single-leg standing. Corticospinal excitability was assessed during single-leg stance using transcranial magnetic stimulation, outcomes of which included active motor threshold (AMT), motor evoked potential, and cortical silent period (CSP). Balance performance was measured with center of pressure velocity in anterior to posterior and medial to lateral directions. Separate 2 × 2 repeated-measures analyses of variance were employed to determine the effect of group (BAL and CON) and time (baseline and posttraining) on each dependent variable. RESULTS There were significant group by time interactions in the modulation of soleus spinal-reflexive excitability (F1,27 = 4.763, P = .04); CSP at 100% AMT (F1,27 = 4.727, P = .04); and CSP at 120% AMT (F1,27 = 16.057, P < .01). A large effect size suggests increased modulation of spinal-reflexive excitability (d = 0.81 [0.03 to 1.54]) of the soleus in BAL compared with CON at posttest, while CSP at 100% (d = 0.95 [0.17 to 1.70]) and 120% AMT (d = 1.10 [0.29 to 1.84]) was reduced in BAL when compared with CON at posttest. CONCLUSION After a single session of balance training, individuals with CAI initiated increases in spinal reflex modulation and corticospinal excitability of the soleus. Thus, individuals with CAI who undergo balance training exhibit positive neural adaptations that are linked to improvements in balance performance.
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Affiliation(s)
- Sunghoon Chung
- School of Rehabilitation Sciences, Old Dominion University, Norfolk, VA,USA
| | | | - Elham Alijanpour
- School of Rehabilitation Sciences, Old Dominion University, Norfolk, VA,USA
| | - Ryan S McCann
- School of Rehabilitation Sciences, Old Dominion University, Norfolk, VA,USA
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Bullock GS, Thigpen CA, Collins GS, Arden NK, Noonan TJ, Kissenberth MJ, Wyland DJ, Shanley E. Organizational risk profiling and education associated with reduction in professional pitching arm injuries: a natural experiment. JSES REVIEWS, REPORTS, AND TECHNIQUES 2023; 3:295-302. [PMID: 37588509 PMCID: PMC10426659 DOI: 10.1016/j.xrrt.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Background Risk profiling and education are strategies implemented to help reduce injury risk; however, currently. there is little evidence on the effect of these interventions on injury incidence. The purpose of this study was to evaluate the influence of risk profiling and education on upper extremity injury incidence in minor league (MiLB) pitchers and to stratify by injury severity. Methods A prospective natural experiment study was conducted from 2013 to 2019 on MiLB pitchers. Beginning in the 2015 season, pitchers were examined and risk profiled for upper extremity injury. Shoulder external, internal, total range of motion, horizontal adduction, and humeral torsion were measured. Organizational risk profiling and education was implemented starting in 2015, based on preseason assessments. Chi-squared test was performed to investigate potential differences between shoulder range of motion risk categories between 2013-2014 (pre) and 2015-2019 (post) seasons. Interrupted time series analyses were performed to assess the association between organizational risk profiling and education on arm injury in MiLB pitchers and were repeated for 7-27 and 28+ day injury severity. Results 297 pitchers were included (pre: 119, post: 178). Upper extremity injury incidence was 1.5 injuries per 1000 athletic exposures. Pitchers in the 2015-2019 seasons demonstrated increased preseason shoulder injury risk for internal (P = .003) and external (P = .007), while the 2013-2014 seasons demonstrated greater horizontal adduction risk (P = .04). There were no differences between seasons for total range of motion risk (P =.76). Risk profiling and education resulted in an adjusted time loss upper extremity injury reduction for the 2015-2019 seasons (0.68 (95% CI: 0.47, 0.99)), which impacted 7-27 days (0.62 (95% CI: 0.42, 0.93)) but not for 28+ days (0.71 (95% CI: 0.47, 1.06)) time loss. There was no reduction in combined trunk and lower extremity injuries for the 2015-2019 seasons (1.55 (95% CI: 0.79, 3.01)). Conclusions Organizational risk profiling and education appear to reduce professional pitching overall and 7-27-day upper extremity injury risk by 33%-38%. There was no difference in trunk and lower extremity injuries over the period, strengthening the reduction in upper extremity injury risk results. This suggests that while injury risk increased over time, organizational risk profiling mitigated the expected increase in upper extremity injury rates. Risk profiling and education can be used as a clinical screening and intervention tool to help decrease upper extremity injuries in professional baseball populations.
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Affiliation(s)
- Garrett S. Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Charles A. Thigpen
- University of South Carolina Center for Rehabilitation and Reconstruction Sciences, Greenville, SC, USA
- ATI Physical Therapy, Greenville, SC, USA
| | - Gary S. Collins
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Nigel K. Arden
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Thomas J. Noonan
- Department of Orthopaedic Surgery, University of Colorado School of Medicine, Boulder, CO, USA
- University of Colorado Health, Steadman Hawkins Clinic, Englewood, CO, USA
| | | | | | - Ellen Shanley
- University of South Carolina Center for Rehabilitation and Reconstruction Sciences, Greenville, SC, USA
- ATI Physical Therapy, Greenville, SC, USA
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Alomar AI, Nuhmani S, Ahsan M, Muaidi QI. A comparison of the range of motion and dynamic stability of the ankle joint of athletes with an ankle sprain as compared to healthy controls: A cross-sectional study. Int J Crit Illn Inj Sci 2023; 13:138-144. [PMID: 38023574 PMCID: PMC10664039 DOI: 10.4103/ijciis.ijciis_2_23] [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: 01/08/2023] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background Ankle sprains are the most common lower-leg musculoskeletal injuries, frequently occurring among athletes and other physical activity individuals. The objective of this study was to compare the ankle range of motion and dynamic stability of healthy and injured athletes for their dominant and nondominant legs. Methods A cross-sectional study design was selected to investigate this study with 32 male soccer players with average age: 22.6 ± 3.3 years, weight: 69.6 ± 5.7 kg, height: 176.8 ± 5.32 cm, with a history of a lateral ankle sprain on the dominant leg for the past 2 years. Ankle range of motion was determined using dorsiflexion and plantar flexion by a goniometer. The dynamic stability was determined using the SWAY medical system. An independent t-test was used to study the differences between healthy and injured groups and between dominant and nondominant legs for dynamic stability, dorsiflexion, and plantar flexion range. Results There were higher significant differences for dynamic stability in healthy participants than in injured participants for their dominant (P = 0.001) and nondominant (P = 0.001) legs. There were significant differences in dynamic stability in the dominant and nondominant leg (healthy [P = 0.033] and injured [P = 0.000] participants). The dominant leg shows higher dynamic stability in healthy group, whereas nondominant leg shows higher dynamic stability in the injured group. Conclusion The study found significant differences between the injured and sound legs. The injured dominant and nondominant leg revealed a striking disparity in the ankle range of motion. Therefore, the study demonstrated that ankle sprain causes due to less stability of the ankle joint, which limits ankle movements.
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Affiliation(s)
- Ahmed I. Alomar
- Department of Physical Therapy, Security Force Hospital, Dammam, Saudi Arabia
| | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammad Ahsan
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Qassim I. Muaidi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Cheever K, Nedimyer AK, Dewig D, Register-Mihalik JK, Kossman MK. The Identification and Comparison of Factors Affecting Musculoskeletal and Concussion Injury Disclosure. J Athl Train 2023; 58:563-572. [PMID: 36252227 PMCID: PMC10496445 DOI: 10.4085/1062-6050-0291.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Despite the increased risk of musculoskeletal (MSK) injury after a concussion, little is known about the determinants of such a risk. Moreover, the authors of previous reports of increased risk of MSK injury after a concussion have neglected to account for the high level of undisclosed concussions. OBJECTIVE To explore the association between the intention to disclose a possible concussion and the intention to disclose an MSK injury. DESIGN Cross-sectional study. SETTING Online survey. PATIENTS OR OTHER PARTICIPANTS One hundred seven National Collegiate Athletic Association Division I athletes (females = 79%, age = 19.4 ± 1.4 years). MAIN OUTCOME MEASURE(S) Online survey exploring determinants such as injury knowledge, attitudes, perceived social norms, and perceived behavioral control surrounding concussive and MSK injury disclosure. RESULTS A significant association between high intention to disclose a concussion and high intention to disclose an MSK injury (χ2 = 19.276, P < .001, Cramer V = 0.482) was observed. Spearman rank correlations suggested no correlation between concussion nondisclosure (25%) and MSK injury nondisclosure (52%). Multivariate binomial regressions indicated that perceived social norms were the strongest determinant (β = 1.365, P = .002) of high intention to disclose concussion, while attitudes toward MSK injury (β = 1.067, P = .005) and perceived social norms (β = 1.099, P = .013) were the strongest determinants of high intention to report MSK injury. CONCLUSIONS Individuals with high intention to report concussion symptoms also demonstrated high intention to report MSK injury. Strong positive associations were seen between known determinants of intention to disclose concussion and adapted versions of those same determinant domains in intention to disclose MSK injury. As those with high intention to disclose concussion also displayed high intention to disclose MSK injury, intention to disclose injuries generally may play a role in explaining the increase in MSK injury after a concussion.
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Affiliation(s)
- Kelly Cheever
- Applied Biomechanics Laboratory, Department of Kinesiology, University of Texas at San Antonio
| | - Aliza K. Nedimyer
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill
| | - Derek Dewig
- Rockefeller Neuroscience Institute, West Virginia University, Morgantown
| | - Johna K. Register-Mihalik
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill
- STAR Heel Performance Laboratory, University of North Carolina at Chapel Hill
- Motion Science Institute, University of North Carolina at Chapel Hill
- Injury Prevention Research Center, University of North Carolina at Chapel Hill
| | - Melissa K. Kossman
- School of Health Professions, University of Southern Mississippi, Hattiesburg
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Wagemans J, Taeymans J, Kuppens K, Baur H, Bleakley C, Vissers D. Determining key clinical predictors for chronic ankle instability and return to sports with cost of illness analysis: protocol of a prospective cohort study. BMJ Open 2023; 13:e069867. [PMID: 37164478 PMCID: PMC10174038 DOI: 10.1136/bmjopen-2022-069867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
INTRODUCTION Ankle sprains are common in sports and the general population. Although considered innocuous, a large proportion has residual complaints such as recurrent ankle sprains and develop chronic ankle instability. Although some predicting factors are identified, there is no unequivocality regarding the development of chronic ankle instability, nor about the optimal rehabilitation for an acute ankle sprain. Alongside the biomechanical impairments, ankle sprains are a burden on society due to substantial economic costs. Therefore, we aim to identify key clinical predictors of chronic ankle instability or recovery after acute lateral ankle sprain. Additionally, we aim to determine cost-of-illness of patients who developed chronic ankle instability. METHODS AND ANALYSIS This prospective cohort study (Clinicaltrials.gov: NCT05637008 - pre-results) aims to recruit adult (18-55 years) patients with an acute lateral ankle sprain who are active in sports. Clinical assessments and patient-reported outcome measures will be used to collect data at 7-14 days, 6 weeks, 12 weeks and 12 months after enrolment in the study. The primary outcome will be chronic ankle instability at 12-month follow-up. Salient outcomes will be analysed by logistic regression to determine association with the development of chronic ankle instability. Participants will fill in a cost diary containing direct and indirect costs related to their injury. ETHICS AND DISSEMINATIONS The ethical committee of the Antwerp University Hospital (B3002022000138) has given approval of the protocol and consent forms on 10 October 2022. We perform this study according to the Helsinki Declaration. We will present results at conferences or webinars and publish in peer-reviewed articles.NCT05637008.
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Affiliation(s)
- Jente Wagemans
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Jan Taeymans
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Kevin Kuppens
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| | - Heiner Baur
- Department of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Chris Bleakley
- School of Health Sciences, Faculty of Life and Health Science, Ulster University, Newtownabbey, UK
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
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Moschella EA, Quilter C, Potter SJ. Comprehensive policies for victims of sexual assault returning to the campus classroom: Lessons from university sports-related concussion policies. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1241-1249. [PMID: 34242541 DOI: 10.1080/07448481.2021.1926264] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 03/24/2021] [Accepted: 05/02/2021] [Indexed: 05/31/2023]
Abstract
ObjectiveThe current paper presents a comparison of university policies and health and academic accommodations offered to undergraduate students following sexual assault (SA) and sports-related concussions (SRC). Procedures and protocols for universities to consider adapting from their SRC policies to their SA policies are detailed.Participants: The SRC and SA policies at the 50 United States public flagship universities were analyzed.Methods: The research team coded for a number of policy details including health referrals, academic and financial accommodations, and requirements for follow-up with university personnel.Results: Compared to SA polices, SRC policies at the public flagship universities offer more comprehensive academic accommodations and physical and mental health resources. Conclusions: Comprehensive policies for student SA survivors, like those available for students who suffer SRCs, would improve student health and academic outcomes and increase SA survivors' likelihood of graduating college, thereby reducing individual and societal human capital loses.
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Affiliation(s)
- Elizabeth A Moschella
- Prevention Innovations Research Center, University of New Hampshire, Durham, New Hampshire, USA
| | - Cheyenne Quilter
- United States Military Academy at West Point, West Point, New York, USA
| | - Sharyn J Potter
- Prevention Innovations Research Center, University of New Hampshire, Durham, New Hampshire, USA
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Kikumoto T, Suzuki S, Takabayashi T, Kubo M. Center of Pressure Deviation during Posture Transition in Athletes with Chronic Ankle Instability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085506. [PMID: 37107788 PMCID: PMC10139045 DOI: 10.3390/ijerph20085506] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/29/2023] [Accepted: 04/12/2023] [Indexed: 05/11/2023]
Abstract
Center of pressure (COP) tracking during posture transition is an ideal scale for determining the recurrence of an ankle injury, thereby preventing chronic ankle instability (CAI). However, the same is difficult to determine because the reduced ability of certain patients (who experienced sprain) to control posture at the ankle joint is masked by the chain of hip and ankle joint motion. Thus, we observed the effects of knee joint immobilization/non-immobilization on postural control strategies during the posture transition task and attempted to evaluate the detailed pathophysiology of CAI. Ten athletes with unilateral CAI were selected. To examine differences in COP trajectories in the CAI side and non-CAI legs, patients stood on both legs for 10 s and one leg for 20 s with/without knee braces. COP acceleration during the transition was significantly higher in the CAI group with a knee brace. The COP transition from the double- to single-leg stance phase was significantly longer in the CAI foot. In the CAI group, the fixation of the knee joint increased COP acceleration during postural deviation. This suggests that there is likely an ankle joint dysfunction in the CAI group that is masked by the hip strategy.
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Affiliation(s)
- Takanori Kikumoto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City 950-3198, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City 950-3198, Niigata, Japan
- Correspondence: ; Tel.: +81-25-257-4308
| | - Shunsuke Suzuki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City 950-3198, Niigata, Japan
| | - Tomoya Takabayashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City 950-3198, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City 950-3198, Niigata, Japan
| | - Masayoshi Kubo
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City 950-3198, Niigata, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata City 950-3198, Niigata, Japan
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Hoch MC, Hertel J, Gribble PA, Heebner NR, Hoch JM, Kosik KB, Long D, Sessoms PH, Silder A, Torp DM, Thompson KL, Fraser JJ. Effects of foot intensive rehabilitation (FIRE) on clinical outcomes for patients with chronic ankle instability: a randomized controlled trial protocol. BMC Sports Sci Med Rehabil 2023; 15:54. [PMID: 37032355 PMCID: PMC10084629 DOI: 10.1186/s13102-023-00667-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Lateral ankle sprains account for a large proportion of musculoskeletal injuries among civilians and military service members, with up to 40% of patients developing chronic ankle instability (CAI). Although foot function is compromised in patients with CAI, these impairments are not routinely addressed by current standard of care (SOC) rehabilitation protocols, potentially limiting their effectiveness. The purpose of this randomized controlled trial is to determine if a Foot Intensive REhabilitation (FIRE) protocol is more effective compared to SOC rehabilitation for patients with CAI. METHODS This study will use a three-site, single-blind, randomized controlled trial design with data collected over four data collection points (baseline and post-intervention with 6-, 12-, and 24-month follow-ups) to assess variables related to recurrent injury, sensorimotor function, and self-reported function. A total of 150 CAI patients (50 per site) will be randomly assigned to one of two rehabilitation groups (FIRE or SOC). Rehabilitation will consist of a 6-week intervention composed of supervised and home exercises. Patients assigned to SOC will complete exercises focused on ankle strengthening, balance training, and range of motion, while patients assigned to FIRE will complete a modified SOC program along with additional exercises focused on intrinsic foot muscle activation, dynamic foot stability, and plantar cutaneous stimulation. DISCUSSION The overall goal of this trial is to compare the effectiveness of a FIRE program versus a SOC program on near- and long-term functional outcomes in patients with CAI. We hypothesize the FIRE program will reduce the occurrence of future ankle sprains and ankle giving way episodes while creating clinically relevant improvements in sensorimotor function and self-reported disability beyond the SOC program alone. This study will also provide longitudinal outcome findings for both FIRE and SOC for up to two years. Enhancing the current SOC for CAI will improve the ability of rehabilitation to reduce subsequent ankle injuries, diminish CAI-related impairments, and improve patient-oriented measures of health, which are critical for the immediate and long-term health of civilians and service members with this condition. Trial Registration Clinicaltrials.gov Registry: NCT #NCT04493645 (7/29/20).
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Grants
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
- W81XWH-20-2-0035 U.S. Army Medical Research and Development Command, Peer Reviewed Orthopaedic Research Program
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Affiliation(s)
- Matthew C Hoch
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA.
| | - Jay Hertel
- Sports Medicine and Chair, Department of Kinesiology, University of Virginia, 550 Brandon Avenue, Charlottesville, VA, 22904-4407, USA
| | - Phillip A Gribble
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Nicholas R Heebner
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Johanna M Hoch
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Kyle B Kosik
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Doug Long
- Department of Physical Therapy, College of Health Sciences, University of Kentucky, 900 South Limestone, Lexington, KY, 40536-0200, USA
| | - Pinata H Sessoms
- Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
| | - Amy Silder
- Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
| | - Danielle M Torp
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40506, USA
| | - Katherine L Thompson
- Dr. Bing Zhang Department of Statistics, University of Kentucky, 725 Rose Street, Lexington, KY, 40536, USA
| | - John J Fraser
- Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
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Lynall RC, Wasser JG, Brooks DI, Call JA, Hendershot BD, Kardouni JR, Schmidt JD, Mauntel TC. Investigating post-mild traumatic brain injury neuromuscular function and musculoskeletal injury risk: A protocol for a prospective, observational, case-controlled study in service members and active individuals. BMJ Open 2023; 13:e069404. [PMID: 36948547 PMCID: PMC10039998 DOI: 10.1136/bmjopen-2022-069404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
INTRODUCTION Musculoskeletal injury (MSKI) risk is increased following mild traumatic brain injury (mTBI). Increased MSKI risk is present up to 2 years following post-mTBI return-to-duty/activity relative to both non-mTBI peers and to their pre-mTBI selves across a range of populations, including military service members, and professional, college and high school athletes. Despite the well documented increased post-mTBI MSKI risk, the underlying neuromuscular mechanisms contributing to this increased risk have yet to be definitively determined. A number of potential mechanisms have been suggested (eg, aberrant kinematics, dynamic balance impairments, lower voluntary muscle activation), but none have been confirmed with a comprehensive, prospective study. This study aims to: (1) elucidate the neuromuscular control mechanisms following mTBI that contribute to increased MSKI risk, and (2) prospectively track patient outcomes (up to 12 months; MSKI occurrences and patient-reported outcomes (PRO)). METHODS AND ANALYSIS This is a multicentre prospective, case-matched control observational study to identify deficiencies in neuromuscular function following mTBI that may contribute to increased MSKI risk. Participants (aim to recruit 148, complete data collection on 124) will be classified into two cohorts; mTBI and control. All participants will undergo longitudinal (initial, 6 weeks post-initial, 12 weeks post-initial) comprehensive three-dimensional biomechanical (jump-landing; single leg hop; cut; gait), neuromuscular (interpolated twitch technique, muscular ramp contraction) and sensory (joint repositioning; light touch sensation) assessments to elucidate the underlying neuromuscular control mechanisms post-mTBI that may contribute to increased MSKI. Occurrences of MSKI and PROs (National Institutes of Health Patient-Reported Outcome Measurement Information System: Physical Function, Pain Interference, Depression, Anxiety; Brief Resilience Scale; Tampa Scale of Kinesiophobia), will be tracked monthly (up to 1 year) via electronic data capture platforms. ETHICS AND DISSEMINATION The study received approval from the Walter Reed National Military Medical Center Institutional Review Board. Results will be made available to the associated funding agency and other researchers via conference proceedings and journal articles. TRIAL REGISTRATION NUMBER NCT05122728.
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Affiliation(s)
- Robert C Lynall
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - Joseph G Wasser
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, USA
| | - Daniel I Brooks
- Clinical Quality Management, Defense Health Agency, Falls Church, VA, USA
| | - Jarrod A Call
- Department of Physiology and Pharmacology, University of Georgia, Athens, GA, USA
- Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Brad D Hendershot
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, VA, USA
- Department of Physical Medicine & Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | | | - Timothy C Mauntel
- Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, VA, USA
- Department of Clinical Investigations, Womack Army Medical Center, Fort Bragg, NC, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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13
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Mullins JF, Hoch MC, Gribble P, Heebner N, Kosik K, Westgate P, Nitz AJ. Examination of Dry Needling Dose and Effect Duration for Individuals With Chronic Ankle Instability. J Manipulative Physiol Ther 2023; 46:132-142. [PMID: 37422747 DOI: 10.1016/j.jmpt.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 04/20/2023] [Accepted: 05/15/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effect of a single treatment vs serial dry needling (DN) treatments of the fibularis longus on individuals with chronic ankle instability and to determine the longevity of any effect found. METHODS Thirty-five adults with chronic ankle instability (24.17 ± 7.01 years, 167.67 ± 9.15 cm, 74.90 ± 13.23 kg) volunteered for a university laboratory repeated-measures study. All participants completed patient-reported outcomes and were objectively tested using the Star Excursion Balance Test (SEBT), threshold to detect passive motion (TTDPM) measurements, and single limb time-to-boundary measurements. Participants received DN treatment to the fibularis longus once weekly for 4 weeks on the affected lower extremity by a single physical therapist. Data were collected 5 times: baseline 1 week before initial treatment (T0), pre-treatment (T1A), immediately after the first treatment (T1B), after 4 weekly treatments (T2), and 4 weeks after the cessation of treatment (T3). RESULTS Significant improvements were found for clinician-oriented (SEBT-Composite P < .001; SEBT-Posteromedial P = .024; SEBT-Posterolateral P < .001; TTDPM-Inversion P = .042) and patient-oriented outcome measures (Foot and Ankle Ability Measure-Activities of Daily Living P < .001; Foot and Ankle Ability Measure-Sport P = .001; Fear Avoidance Belief Questionnaire P = .021) following a single DN treatment. Compounding effects from additional treatments exhibited improvement of TTDPM (T1B to T2). No significant losses were noted 4 weeks after cessation of treatment (T2 to T3). CONCLUSION For the participants in this study, outcomes improved immediately following the first DN treatment. This improvement was sustained but not further improved with subsequent treatments.
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Affiliation(s)
- Jennifer F Mullins
- Army-Baylor Physical Therapy Doctoral Program, Joint Base San Antonio, Texas.
| | - Matthew C Hoch
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
| | - Phillip Gribble
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
| | - Nicholas Heebner
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
| | - Kyle Kosik
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
| | - Philip Westgate
- Department of Biostatistics, University of Kentucky, Lexington, Kentucky
| | - Arthur J Nitz
- Department of Rehabilitation Science, University of Kentucky, Lexington, Kentucky
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Bullock G, Collins G, Adams R, Thigpen C, Shanley E. Personalized Injury Reduction Strategies in Sports Medicine: Lessons Learned from Advances in Breast Cancer Treatment: A Clinical Commentary. Int J Sports Phys Ther 2023; 18:253-261. [PMID: 36793581 PMCID: PMC9897041 DOI: 10.26603/001c.57680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/30/2022] [Indexed: 02/04/2023] Open
Abstract
Background Injury rates across sport have risen over the past twenty years, despite increased efforts in training and injury prevention. The rise in injury rates suggest that current approaches to estimating injury risk and risk management are not effective. One factor limiting progress is the inconsistency in screening, risk assessment, and risk management strategies to guide injury mitigation approaches. Clinical Question How can sports physical therapists identify and apply lessons learned from other healthcare fields to improve athlete injury risk and risk management strategies? Key Results Breast cancer mortality has consistently decreased over the last 30 years, largely attributed to advances in personalizing the prevention and treatment strategies which include modifiable and non-modifiable factors when assessing risk, the transition to personalized medicine, and the systematic approach used to investigate individual risk factors. Three critical phases have facilitated the identification and importance of individual risk factors and developing targeted, personalized strategies for breast cancer risk including: 1) Establishing the potential relationship between factors and outcomes; 2) Prospectively investigate the strength and direction of the relationship; 3) Investigating if intervening on identified factors alters prognosis. Clinical Application Applying lessons learned from other healthcare fields could improve shared decision making between the clinician and athlete concerning risk assessment and management. Examples include calculating only non-modifiable risk, creating individualized screening schedules based on risk assessment, or calculating the influence of each intervention on the athlete's injury risk. A systematic approach to identify and intervene on risk is needed to improve athlete outcomes.
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Affiliation(s)
- Garrett Bullock
- Department of Orthopaedic Surgery Wake Forest School of Medicine
- Department of Biostatistics and Data Science Wake Forest School of Medicine
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis University of Oxford
| | - Gary Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences University of Oxford
- Oxford University Hospitals NHS Foundation Trust
| | - Rober Adams
- Department of Radiation Oncology University of North Carolina School of Medicine
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15
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Wang X, Qiu J, Fong DT. The applications of wearable devices in the rehabilitation of ankle injuries: A systematic review and meta-analysis. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2023. [DOI: 10.1016/j.medntd.2023.100210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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16
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Bullock G, Prats-Uribe A, Thigpen C, Martin H, Loper B, Shanley E. Influence of High School Socioeconomic Status on Athlete Injuries during the COVID-19 Pandemic: An Ecological Study. Int J Sports Phys Ther 2022; 17:1383-1395. [PMID: 36518837 PMCID: PMC9718687 DOI: 10.26603/001c.39610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/09/2022] [Indexed: 11/12/2023] Open
Abstract
Background It is presently unclear how the cessation of high school sport has affected injury incidence at different socioeconomic levels. The COVID-19 pandemic may have disproportionately affected athletes of lower socioeconomic status, potentially increasing injury risk in this population. Purpose To 1) Describe athlete injury incidence prior to and during the 2019-2020 and 2020-2021 school years in high school athletes by socioeconomic status; 2) Investigate the association between socioeconomic status and injury incidence in high school athletes. Study Design Ecological Study. Methods High schools were matched between the 2019-2020 and 2020-2021 school years. All athletes from all sports were included. High school socioeconomic status was determined by the school district median household income. Socioeconomic strata were defined as <$30,000, $30,000-50,000, $50,001-100,000, and >$100,000. Injury incidence proportion with 95% confidence interval (95% CI) was calculated for each academic year. Mixed effects negative binomial models with robust errors were performed to assess the association between the incidence proportion ratio and high school median household income. Six states and 176 high schools were included (2019-2020: 98,487 athletes; 2020-2021: 72,521 athletes). Results Injury incidence increased in three of four socioeconomic strata during the 2020-2021 year (<$30,000: 2019-2020: 15.6 (13.1-18.1), 2020-2021: 26.3 (23.1-29.6); $30,000-50,000: 2019-2020: 7.8 (7.1-8.6), 2020-2021: 14.9 (13.8-15.9); $50,001-100,000: 2019-2020: 15.1 (14.7-15.4), 2020-2021: 21.3 (20.9-21.8); >$100,000: 2019-2020: 18.4 (18.1-18.8), 2020-2021: 17.3 (16.8-17.7)). An association was observed between injury incidence ratio and log median high school household income in 2019-2020 [1.6 (1.1-2.5)] but not 2020-2021 [1.1 (0.8-1.6)] school years. Conclusions Athletes from lower socioeconomic high schools reported increased injury incidence compared to higher socioeconomic high schools during the 2020-2021 academic school year. These results highlight the increased COVID-19 pandemic vulnerability in athletes from lower socioeconomic high schools. High school sport stakeholders should consider how abrupt sport stoppage can affect lower socioeconomic athletes. Level of Evidence 2.
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Affiliation(s)
- Garrett Bullock
- Department of Orthopaedic Surgery & Rehabilitation, Wake Forest School of Medicine; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford
| | | | - Charles Thigpen
- ATI Physical Therapy; University of South Carolina Center for Effectiveness Research in Orthopedics
| | | | | | - Ellen Shanley
- ATI Physical Therapy; University of South Carolina Center for Effectiveness Research in Orthopedics
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17
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Bullock G, Thigpen C, Collins G, Arden N, Noonan T, Kissenberth M, Shanley E. Development of an Injury Burden Prediction Model in Professional Baseball Pitchers. Int J Sports Phys Ther 2022; 17:1358-1371. [PMID: 36518836 PMCID: PMC9718727 DOI: 10.26603/001c.39741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/16/2022] [Indexed: 11/11/2023] Open
Abstract
Background Baseball injuries are a significant problem and have increased in incidence over the last decade. Reporting injury incidence only gives context to rate but not in relation to severity or injury time loss. Hypothesis/Purpose The purpose of this study was to 1) incorporate both modifiable and non-modifiable factors to develop an arm injury burden prediction model in Minor League Baseball (MiLB) pitchers; and 2) understand how the model performs separately on elbow and shoulder injury burden. Study Design Prospective longitudinal study. Methods The study was conducted from 2013 to 2019 on MiLB pitchers. Pitchers were evaluated in spring training arm for shoulder range of motion and injuries were followed throughout the season. A model to predict arm injury burden was produced using zero inflated negative binomial regression. Internal validation was performed using ten-fold cross validation. Subgroup analyses were performed for elbow and shoulder separately. Model performance was assessed with root mean square error (RMSE), model fit (R2), and calibration with 95% confidence intervals (95% CI). Results Two-hundred, ninety-seven pitchers (94 injuries) were included with an injury incidence of 1.15 arm injuries per 1000 athletic exposures. Median days lost to an arm injury was 58 (11, 106). The final model demonstrated good prediction ability (RMSE: 11.9 days, R2: 0.80) and a calibration slope of 0.98 (95% CI: 0.92, 1.04). A separate elbow model demonstrated weaker predictive performance (RMSE: 21.3; R2: 0.42; calibration: 1.25 [1.16, 1.34]), as did a separate shoulder model (RMSE: 17.9; R2: 0.57; calibration: 1.01 [0.92, 1.10]). Conclusions The injury burden prediction model demonstrated excellent performance. Caution should be advised with predictions between one to 14 days lost to arm injury. Separate elbow and shoulder prediction models demonstrated decreased performance. The inclusion of both modifiable and non-modifiable factors into a comprehensive injury burden model provides the most accurate prediction of days lost in professional pitchers. Level of Evidence 2.
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Affiliation(s)
- Garrett Bullock
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis University of Oxford
- Department of Orthopaedic Surgery & Rehabilitation Wake Forest University School of Medicine
| | - Charles Thigpen
- University of South Carolina Center for Rehabilitation and Reconstruction Sciences
- ATI Physical Therapy
| | - Gary Collins
- Centre for Statistics in Medicine University of Oxford
- Oxford University Hospitals NHS Foundation Trust
| | - Nigel Arden
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis University of Oxford
- Department of Orthopaedic Surgery & Rehabilitation Wake Forest University School of Medicine
| | - Thomas Noonan
- Department of Orthopaedic Surgery University of Colorado School of Medicine
- University of Colorado Health, Steadman Hawkins Clinic
| | | | - Ellen Shanley
- University of South Carolina Center for Rehabilitation and Reconstruction Sciences
- ATI Physical Therapy
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Götz M, Riederer A, Richter R. Auswirkungen des Trainings der intrinsischen Fußmuskulatur bei Patienten*innen mit Sprunggelenkinstabilität – ein narrativer Review. SPORTVERLETZUNG · SPORTSCHADEN 2022; 36:188-199. [DOI: 10.1055/a-1888-4848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Zusammenfassung
Hintergrund Sprunggelenkdistorsionen stellen eine der häufigsten Verletzungen im Sport dar und können sich als chronische Sprunggelenkinstabilität manifestieren. In der Therapie und Prävention hat sich ein sensomotorischer Trainingsansatz der sprunggelenkumgebenden Strukturen als wirksam erwiesen. Es gibt Hinweise, dass auch ein Training der intrinsischen Fußmuskulatur beispielsweise die Balance verbessern kann.
Ziel Ziel dieses narrativen Reviews ist die Darstellung der Evidenz eines Trainings der intrinsischen Fußmuskulatur bei Patient*innen mit Sprunggelenkinstabilität.
Methode Im Januar 2022 wurde in den Datenbanken PubMed, Cochrane Library, EBSCOhost, PEDro, SPONET und BISp-Surf eine systematische Literaturrecherche durchgeführt, die durch eine Freihandsuche ergänzt wurde. Dabei sollten Metaanalysen, Systematic Reviews und Interventionsstudien inkludiert werden, die Effekte einer Trainingsform der intrinsischen Fußmuskulatur bei Patient*innen mit Sprunggelenkinstabilität untersuchten. Die qualitative Bewertung der Literatur und Evidenz erfolgte anhand des Risk-of-Bias-Tools (RoB-Tool) des Cochrane Handbook sowie angelehnt an das GRADE-System.
Ergebnisse Fünf randomisierte kontrollierte Studien mit insgesamt 150 Proband*innen wurden inkludiert. Vier Studien nutzten die Short-Foot Exercise (SFE), eine Studie die Towel-Curl Exercise (TCE) und eine wandte ein Training der Zehen an. Drei Studien wiesen einen großen, signifikant positiven Effekt (p<0,05) der SFE auf die subjektive Instabilität auf. Die SFE und das Zehentrainingsprogramm hatten signifikant positive Effekte (p<0,05) auf die Balance, wobei die Einbeziehung der SFE in ein Trainingsprogramm zu keinem Vorteil führte. Eine Studie stellte signifikant positive Auswirkungen (p<0,05) der SFE auf die Somatosensibilität fest. Alle 3 Trainingsformen führten zu deutlichen, signifikanten (p<0,05) Verbesserungen funktioneller Aspekte.
Schlussfolgerung Es zeigen sich positive Effekte durch das Training der intrinsischen Fußmuskulatur bei Patient*innen mit Sprunggelenkinstabilität auf die subjektive Instabilität, Balance, Somatosensibilität sowie auf funktionelle Aspekte. Effektive Trainingsformen scheinen die SFE und ein Zehentraining zu sein, diese könnten eine sinnvolle Ergänzung zur konventionellen Therapie darstellen. Die Qualität der Evidenz ist jedoch zu gering, um eine klare Empfehlung aussprechen zu können.
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Affiliation(s)
- Matthias Götz
- Hochschule Furtwangen, Fakultät Gesundheit, Sicherheit, Gesellschaft, Studienzentrum Freiburg, Furtwangen, GERMANY
| | - Angela Riederer
- Hochschule Furtwangen, Fakultät Gesundheit, Sicherheit, Gesellschaft, Studienzentrum Freiburg, Furtwangen, GERMANY
| | - Robert Richter
- Hochschule Furtwangen, Fakultät Gesundheit, Sicherheit, Gesellschaft, Studienzentrum Freiburg, Furtwangen, GERMANY
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Efficacy of Injury Prevention Using Functional Movement Screen Training in High-School Baseball Players: Secondary Outcomes of a Randomized Controlled Trial. Healthcare (Basel) 2022; 10:healthcare10122409. [PMID: 36553933 PMCID: PMC9777794 DOI: 10.3390/healthcare10122409] [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: 11/02/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
This study of a randomized controlled trial aimed to clarify the effect of functional movement screen (FMS) training on the FMS score and the number of injuries in high-school baseball players. Accordingly, 71 high-school baseball players (age: 15-17 years) were randomized into an intervention group (n = 37; FMS training 4 times per week for 12 weeks on the ground of each team) or a control group (n = 34; team practice without limits). No significant differences were observed in terms of the participant characteristics of the two groups. The FMS score of the intervention group significantly increased after 12 weeks of training compared with the control group. However, there was no difference between the groups in terms of the FMS score after 24 weeks. Injuries in the intervention group were significantly reduced after 24 weeks. The time lost due to noncontact injuries (12 weeks/follow-up) was 56.5 h/113 h in the intervention group and 33 h/325.5 h in the control group. Injuries were found all over the body. Based on these results, FMS training was proven to reduce injury in high-school baseball players. Although continued training is required to improve FMS scores, the number of injuries decreased after training.
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20
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Bullock GS, Shanley E, Thigpen CA, Arden NK, Noonan TK, Kissenberth MJ, Wyland DJ, Collins GS. Improving Clinical Utility of Real-World Prediction Models: Updating Through Recalibration. J Strength Cond Res 2022; 37:1057-1063. [PMID: 36730571 DOI: 10.1519/jsc.0000000000004369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
ABSTRACT Bullock, GS, Shanley, E, Thigpen, CA, Arden, NK, Noonan, TK, Kissenberth, MJ, Wyland, DJ, and Collins, GS. Improving clinical utility of real-world prediction models: updating through recalibration. J Strength Cond Res XX(X): 000-000, 2022-Prediction models can aid clinicians in identifying at-risk athletes. However, sport and clinical practice patterns continue to change, causing predictive drift and potential suboptimal prediction model performance. Thus, there is a need to temporally recalibrate previously developed baseball arm injury models. The purpose of this study was to perform temporal recalibration on a previously developed injury prediction model and assess model performance in professional baseball pitchers. An arm injury prediction model was developed on data from a prospective cohort from 2009 to 2019 on minor league pitchers. Data for the 2015-2019 seasons were used for temporal recalibration and model performance assessment. Temporal recalibration constituted intercept-only and full model redevelopment. Model performance was investigated by assessing Nagelkerke's R-square, calibration in the large, calibration, and discrimination. Decision curves compared the original model, temporal recalibrated model, and current best evidence-based practice. One hundred seventy-eight pitchers participated in the 2015-2019 seasons with 1.63 arm injuries per 1,000 athlete exposures. The temporal recalibrated intercept model demonstrated the best discrimination (0.81 [95% confidence interval [CI]: 0.73, 0.88]) and R-square (0.32) compared with original model (0.74 [95% CI: 0.69, 0.80]; R-square: 0.32) and the redeveloped model (0.80 [95% CI: 0.73, 0.87]; R-square: 0.30). The temporal recalibrated intercept model demonstrated an improved net benefit of 0.34 compared with current best evidence-based practice. The temporal recalibrated intercept model demonstrated the best model performance and clinical utility. Updating prediction models can account for changes in sport training over time and improve professional baseball arm injury outcomes.
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Affiliation(s)
- Garrett S Bullock
- Department of Orthopaedic Surgery and Rehabilitation, Wake Forest School of Medicine, North Carolina.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, United Kingdom
| | - Ellen Shanley
- University of South Carolina Center for Rehabilitation and Reconstruction Sciences, Greenville, South Carolina.,ATI Physical Therapy, Greenville, South Carolina.,Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina
| | - Charles A Thigpen
- University of South Carolina Center for Rehabilitation and Reconstruction Sciences, Greenville, South Carolina.,ATI Physical Therapy, Greenville, South Carolina
| | - Nigel K Arden
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, United Kingdom
| | - Thomas K Noonan
- Department of Orthopaedic Surgery, University of Colorado School of Medicine, Boulder, Colorado.,Steadman Hawkins Clinic, University of Colorado Health, Englewood, Colorado
| | | | - Douglas J Wyland
- Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina
| | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; and.,Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
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21
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Bullock GS, Thigpen CA, Noonan TK, Kissenberth MJ, Shanley E. Initial kinematic chain injuries increase hazard of subsequent arm injuries in professional baseball pitchers. J Shoulder Elbow Surg 2022; 31:1773-1781. [PMID: 35598837 DOI: 10.1016/j.jse.2022.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Currently, there are few studies that have evaluated the relationship between a lower extremity or trunk injury (kinematic chain) and subsequent arm injury. The purpose of this study was (1) to investigate the relationship between initial kinematic chain (lower extremity or trunk) injury and subsequent arm injury; and (2) to investigate the relationship between initial shoulder or elbow injury and subsequent arm injury. METHODS A 7-year prospective injury risk study was conducted with Minor League Baseball pitchers. Pitches, pitching appearances, athlete exposures (AEs), and arm injuries (≥1-day time loss) were documented throughout the season. Cox survival analyses with 95% confidence intervals (95% CIs) were performed. Confounders controlled for included age, body mass index, arm dominance, pitching role, previous arm injury, number of pitching appearances, and seasonal pitch load. RESULTS A total of 297 pitchers participated (total player days = 85,270). Arm injury incidence was 11.4 arm injuries/10,000 AEs, and kinematic chain incidence was 5.2 injuries/10,000 AEs. Pitchers who sustained a kinematic chain injury demonstrated a greater hazard (2.6 [95% CI: 1.2, 5.6], P = .019) of sustaining an arm injury. Pitchers who sustained an initial shoulder injury demonstrated a greater hazard (9.3 [95% CI: 1.1, 83], P = .047) of sustaining a subsequent shoulder or elbow injury compared with pitchers who sustained an initial elbow injury. CONCLUSIONS Pitchers who sustained an initial lower extremity or trunk injury demonstrated an increased subsequent arm injury hazard compared with pitchers who did not. Pitchers who sustained an initial shoulder injury demonstrated a greater hazard of sustaining a subsequent arm injury compared with pitchers who sustained an initial elbow injury. However, this secondary analysis should be interpreted with caution. Clinicians should monitor risk with workload accumulation, which may be related to pitching compensatory strategies in a fatigued state. Pitchers who sustain a shoulder injury should be evaluated and perform both shoulder and elbow rehabilitation strategies before return to sport.
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Affiliation(s)
- Garrett S Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK.
| | - Charles A Thigpen
- Department of Observational Clinical Research, ATI Physical Therapy, Greenville, SC, USA; University of South Carolina Center for Rehabilitation and Reconstruction Sciences, Greenville, SC, USA
| | - Thomas K Noonan
- Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver, CO, USA; Steadman Hawkins Clinic, University of Colorado Health, Englewood, CO, USA
| | | | - Ellen Shanley
- Department of Observational Clinical Research, ATI Physical Therapy, Greenville, SC, USA; University of South Carolina Center for Rehabilitation and Reconstruction Sciences, Greenville, SC, USA
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22
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Bullock G, Prats-Uribe A, Thigpen CA, Boyer L, Varnado K, Pequette J, Shanley E. The Impact of Statewide Limitations of Practice on High School Injury Incidence During the COVID-19 Season: An Ecological Study. Sports Health 2022; 14:656-664. [PMID: 35766456 DOI: 10.1177/19417381221106693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Abrupt training stoppage can increase injury incidence and risk following return to sport. The rate of coronavirus disease 2019 (COVID-19) infections in the general population has resulted in the abrupt stoppage of high school education and sport. The objective of this study was to (1) compare injury incidence proportion (IP) and excess injury in high school athletes before and during the COVID-19 pandemic; and (2) stratify by identified gender. HYPOTHESIS The COVID-19 academic year will demonstrate increased injury incidence, and injury incidence will be similar between genders. STUDY DESIGN Ecological. LEVEL OF EVIDENCE Level 2. METHODS High schools (6 states; 176 high schools) were matched between prepandemic and pandemic years. Injury IP with 95% confidence interval (CI) was calculated. Interrupted time series models with robust errors were performed to assess the IP ratio and excess injury incidence between prepandemic and pandemic academic calendar years. RESULTS A total of 98,487 athletes participated in high school sport in the prepandemic year and 72,521 athletes in the pandemic year; 15,477 injuries were reported in the prepandemic year compared with 14,057 injuries during the pandemic year. Injury IP (CI) was 15.7 (15.5-15.9) and 19.4 (19.1-19.7) for the prepandemic and pandemic years, respectively. Injury incidence ratio increased by 1.3 (1.2-1.5) between the prepandemic and pandemic years. Excess injuries were 1812 greater in the pandemic year compared with the prepandemic year. Female and male athlete incidence ratios were similar. CONCLUSION Prolonged sport stoppage due to the COVID-19 pandemic resulted in increased injury incidence compared with the previous high school academic year. CLINICAL RELEVANCE High school sports stakeholders should consider longer periods of ramp up for training in lieu of future sport stoppages compared with usual preseason training. These data may also have more generalizable implications to other abrupt sport and physical activity stoppage scenarios such as earthquakes and hurricanes.
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Affiliation(s)
- Garrett Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK
| | - Albert Prats-Uribe
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Charles A Thigpen
- ATI Physical Therapy.,University of South Carolina Center for Effectiveness Research in Orthopedics, Greenville, South Carolina
| | | | | | | | - Ellen Shanley
- ATI Physical Therapy.,University of South Carolina Center for Effectiveness Research in Orthopedics, Greenville, South Carolina
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23
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Seow D, Massey A. Correlation between preseason body composition and sports injury in an English Premier League professional football team. BMJ Open Sport Exerc Med 2022; 8:e001193. [PMID: 35692439 PMCID: PMC9134165 DOI: 10.1136/bmjsem-2021-001193] [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: 04/29/2022] [Indexed: 11/03/2022] Open
Abstract
Objectives To identify the correlation between preseason body composition and incidence coupled with injury burden throughout the season in adult male professional football players. Methods A retrospective case series was performed for linear regression analysis of preseason body composition variables and injury data. R2 >0.10 was deemed of adequate correlation. Results All 36 professional football players in the male first team of an English Premier League professional football team were recruited, with none lost to follow-up. The total and mean incidence of injuries was 83.00 and 2.31 (95% CI 1.72 to 2.89), respectively. The mean injury burden was 58.32 (95% CI 37.67 to 78.98) days missed. Simple linear regression analysis indicated no significant or adequate correlations between incidence and preseason body composition variables. Injury burden revealed non-significant adequate negative correlations to body mass (R2=0.17), body mass index (BMI) (R2=0.15), waist circumference (R2=0.17), total bone mineral density (BMD) (R2=0.11) and mean embedded structures (R2=0.10). Conclusions Players with decreased body mass, BMI, waist circumference, total BMD and mean embedded structures may be prone to greater injury burden. Further studies with a larger sample size that incorporates multiple football teams are warranted to investigate this.
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24
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Bullock GS, Mylott J, Hughes T, Nicholson KF, Riley RD, Collins GS. Just How Confident Can We Be in Predicting Sports Injuries? A Systematic Review of the Methodological Conduct and Performance of Existing Musculoskeletal Injury Prediction Models in Sport. Sports Med 2022; 52:2469-2482. [PMID: 35689749 DOI: 10.1007/s40279-022-01698-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND An increasing number of musculoskeletal injury prediction models are being developed and implemented in sports medicine. Prediction model quality needs to be evaluated so clinicians can be informed of their potential usefulness. OBJECTIVE To evaluate the methodological conduct and completeness of reporting of musculoskeletal injury prediction models in sport. METHODS A systematic review was performed from inception to June 2021. Studies were included if they: (1) predicted sport injury; (2) used regression, machine learning, or deep learning models; (3) were written in English; (4) were peer reviewed. RESULTS Thirty studies (204 models) were included; 60% of studies utilized only regression methods, 13% only machine learning, and 27% both regression and machine learning approaches. All studies developed a prediction model and no studies externally validated a prediction model. Two percent of models (7% of studies) were low risk of bias and 98% of models (93% of studies) were high or unclear risk of bias. Three studies (10%) performed an a priori sample size calculation; 14 (47%) performed internal validation. Nineteen studies (63%) reported discrimination and two (7%) reported calibration. Four studies (13%) reported model equations for statistical predictions and no machine learning studies reported code or hyperparameters. CONCLUSION Existing sport musculoskeletal injury prediction models were poorly developed and have a high risk of bias. No models could be recommended for use in practice. The majority of models were developed with small sample sizes, had inadequate assessment of model performance, and were poorly reported. To create clinically useful sports musculoskeletal injury prediction models, considerable improvements in methodology and reporting are urgently required.
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Affiliation(s)
- Garrett S Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 475 Vine St, Bowman Gray Medical Building, Winston-Salem, NC, 27101, USA. .,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK.
| | - Joseph Mylott
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 475 Vine St, Bowman Gray Medical Building, Winston-Salem, NC, 27101, USA.,Baltimore Orioles Baseball Club, Baltimore, USA
| | - Tom Hughes
- Manchester United Football Club, Manchester, UK.,Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Kristen F Nicholson
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 475 Vine St, Bowman Gray Medical Building, Winston-Salem, NC, 27101, USA
| | - Richard D Riley
- Centre for Prognosis Research, School of Medicine, Keele University, Keele, UK
| | - Gary S Collins
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, UK.,Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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25
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Nusbickel AJ, Vasilopoulos T, Zapf AD, Tripp BL, Herman DC. The effect of concussion on subsequent musculoskeletal injury risk in high school athletes. PM R 2022; 14:597-603. [PMID: 35488457 DOI: 10.1002/pmrj.12828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Studies have demonstrated an increased risk of musculoskeletal (MSK) injury after concussion in collegiate and professional athletes, but there has been relatively little study of this relationship in younger athletes. OBJECTIVE To determine the odds of experiencing a subsequent MSK injury after concussion in high school athletes. It was hypothesized that concussion would increase the risk of MSK injury within 365 days of the concussion event. DESIGN Retrospective observational study. SETTING Twelve high school sports programs. PARTICIPANTS Athletes (n = 14,461) from athletic training room records queried between 2010 and 2017. INDEPENDENT VARIABLES History of concussion and history of concussion and MSK injury in the year preceding MSK injury. MAIN OUTCOME MEASURES General estimating equation analyses were conducted to examine the odds of MSK injury related to (1) concussion within the preceding 365 days of injury; and (2) concussion and MSK injury within the preceding 365 days of concussion. RESULTS Respectively, 8% and 8.3% of athletes were identified with a concussion and MSK injury. After controlling for gender and sport, athletes with a concussion and prior MSK injury (odds ratio = 2.19, 95% confidence interval: 1.02-4.67) and athletes with a concussion alone (odds ratio = 1.67, 95% confidence interval: 1.15-2.44) both had higher odds of experiencing a subsequent MSK injury compared to athletes without prior concussion. CONCLUSIONS High school athletes who sustain a concussion have elevated odds of MSK injury at rates comparable to those for collegiate athletes. These findings support the use of neuromuscular-based rehabilitation and injury prevention protocols in the post-concussion period. These findings may also suggest exploring methods to modify concussion return-to-play criteria with the goal to reduce the risk of future MSK injury.
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Affiliation(s)
- Alex J Nusbickel
- Department of Internal Medicine, University of Florida, Gainesville, Florida, USA
| | - Terrie Vasilopoulos
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA.,Department of Anesthesiology, University of Florida, Gainesville, Florida, USA
| | - Ashley D Zapf
- Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA
| | - Brady L Tripp
- Department of Applied Kinesiology and Physiology, University of Florida, Gainesville, Florida, USA
| | - Daniel C Herman
- Department of Physical Medicine and Rehabilitation, University of California at Davis, Sacramento, California, USA
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26
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Is Kinesio Taping Effective for Sport Performance and Ankle Function of Athletes with Chronic Ankle Instability (CAI)? A Systematic Review and Meta-Analysis. Medicina (B Aires) 2022; 58:medicina58050620. [PMID: 35630037 PMCID: PMC9146435 DOI: 10.3390/medicina58050620] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 12/26/2022] Open
Abstract
Background and Objectives: Ankle injuries are the most common type of injury in healthy active individuals. If not treated properly, recurrent sprains can lead to a condition of chronic ankle instability (CAI). The aim of the present review is to evaluate the effects of Kinesio Taping (or KT) on sports performances and ankle functions in athletes with CAI. Materials and Methods: This systematic review with meta-analysis was carried out following the criteria of the Prisma Statement system (registered on Open Science Framework, number: 10.17605/OSF.IO/D8QN5). For the selection of the studies, PubMed, Scopus and Web of Science were used as databases in which the following string was used: (“kinesiology tape” OR “tape” OR “taping” OR “elastic taping” OR “kinesio taping” OR “neuro taping”) AND (unstable OR instability) AND (ankle OR (ankle OR “ankle sprain” OR “injured ankle” OR “ankle injury”)). The Downs and Black Scale was used for the quality analysis. The outcomes considered were gait functions, ROM, muscle activation, postural sway, dynamic balance, lateral landing from a monopodalic drop and agility. Effect sizes (ESs) were synthesised as standardized mean differences between the control and intervention groups. Calculation of the 95% confidence interval (CI) for each ES was conducted according to Hedges and Olkin. Results: In total, 1448 articles were identified and 8 studies were included, with a total of 270 athletes. The application of the tape had a significant effect size on gait functions, ROM, muscle activation and postural sway. Conclusions: The meta-analysis showed a significant improvement in gait functions (step velocity, step and stride length and reduction in the base of support in dynamics), reduction in the joint ROM in inversion and eversion, decrease in the muscle activation of the long peroneus and decrease in the postural sway in movement in the mid-lateral direction. It is possible to conclude that KT provides a moderate stabilising effect on the ankles of the athletes of most popular contact sports with CAI.
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27
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Sabbagh RS, Shah NS, Kanhere AP, Hoge CG, Thomson CG, Grawe BM. Effect of the COVID-19 Pandemic on Sports-Related Injuries Evaluated in US Emergency Departments. Orthop J Sports Med 2022; 10:23259671221075373. [PMID: 35224117 PMCID: PMC8873554 DOI: 10.1177/23259671221075373] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/08/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Organized athletics are undergoing a gradual resumption after a prolonged hiatus in 2020 because of the coronavirus disease 2019 (COVID-19) pandemic. Purpose/Hypothesis: The purpose of this study was to evaluate the effect of the 2020 COVID-19 period on emergency department (ED) visits for sports-related injuries in the United States. It was hypothesized that such visits decreased in response to the pandemic conditions. Study Design: Descriptive epidemiology study. Methods: A selection of sports (baseball, basketball, softball, soccer, American football, weightlifting, track and field, martial arts, boxing, golf, personal fitness, cycling, tennis, and ice hockey) were classified as being an organized team, organized individual, or nonorganized sport. The National Electronic Injury Surveillance System database was then queried for ED visits for sports-related injuries between January 1, 2018, and December 31, 2020, and we compared weighted national injury estimates and injury characteristics from athletes presenting to EDs in 2018 and 2019 versus those from the 2020 COVID-19 pandemic period and between March 1 and May 31, 2020 (government-imposed lockdown period). Bivariate comparisons between variables were conducted using chi-square analysis, with strength of association assessed using odds ratios. Results: The 164,151 unweighted cases obtained from the query resulted in a weighted national estimate of 5,664,795 sports-related injuries during the study period. Overall, there was a 34.6% decrease in sports-related ED visits in 2020 compared with the yearly average between 2018 and 2019 (baseline). The number of ED visits in 2020 decreased by 53.9% versus baseline for injuries incurred by participation in an organized team sport and by 34.9% for injuries incurred by participation in an organized individual sport. The number of ED visits during the 2020 lockdown period decreased by 76.9% versus baseline for injuries incurred by participation in an organized team sport and by 65.8% for injuries incurred by participation in an organized individual sport. Injuries sustained while participating in a nonorganized sport remained relatively unaffected and decreased by only 8.1% in 2020. Conclusion: ED visits in the United States for injuries sustained while participating in an organized team or individual sport underwent a decrease after the beginning of the COVID-19 pandemic in 2020, especially during the lockdown period.
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Affiliation(s)
- Ramsey S. Sabbagh
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Nihar S. Shah
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Arun P. Kanhere
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Connor G. Hoge
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Cameron G. Thomson
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Brian M. Grawe
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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28
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YAKAL S, ERTUNA A, TAHIRBEGOLLI B, BAYRAKTAR B. Cost analysis of sports injuries diagnosis in a university hospital sports medicine department. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.20.04473-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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29
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Bullock GS, Thigpen CA, Collins GS, Arden NK, Noonan TK, Kissenberth MJ, Shanley E. Hazard of Arm Injury in Professional Starting and Relief Pitchers. J Athl Train 2022; 57:65-71. [PMID: 35040985 PMCID: PMC8775284 DOI: 10.4085/1062-6050-0262.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT How different pitching roles affect the risk of arm injury in professional pitchers is currently unclear. OBJECTIVES To investigate differences between professional baseball starting and relief pitchers in the hazard of (1) arm injury and (2) elbow and shoulder injury. DESIGN Prospective cohort study. SETTING Minor League Baseball (MiLB) from 2013 to 2019. PATIENTS OR OTHER PARTICIPANTS Pitchers in MiLB. MAIN OUTCOME MEASURE(S) Pitchers were followed for the entire MiLB season, and athlete-exposures and injuries were recorded. Risk ratios and risk difference were calculated between starting and relieving MiLB pitchers. A Cox survival analysis was then performed in relation to time to arm injury between starting and relieving MiLB pitchers. Subgroup analyses were conducted for elbow and shoulder injuries. RESULTS A total of 297 pitchers were included, with 85 270 player-days recorded. The incidence of arm injuries was 11.4 per 10 000 athlete-exposures. Starting pitchers demonstrated a greater risk ratio (1.2 [95% CI = 1.1, 1.3]), risk difference (13.6 [95% CI = 5.6, 21.6]), and hazard of arm injury (2.4 [95% CI = 1.5, 4.0]) than relief pitchers. No differences were observed for the hazard of elbow injury between starting and relief pitchers (1.9; 95% CI = 0.8, 4.2). Starting pitchers had a greater hazard of shoulder injury than relief pitchers (3.8 [95% CI = 2.0, 7.1]). CONCLUSIONS Starting pitchers displayed a 2.4 times greater hazard of arm injury than relief pitchers. Subgroup analyses indicated that starters exhibited a greater hazard of shoulder injury than relievers, but no differences occurred for the hazard of elbow injury. However, due to the wide CIs, these subgroup analyses should be interpreted with caution. Clinicians may need to consider cumulative exposure and fatigue and how these factors relate to different pitching roles when assessing the risk of pitching arm injury.
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Affiliation(s)
- Garrett S. Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC
,Center for sport, Exercise, and Osteoarthritis Research Versus Arthritis, University of Oxford, UK
,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, UK
| | - Charles A. Thigpen
- University of South Carolina, Center for Rehabilitation and Reconstruction Sciences, Greenville
,ATI Physical Therapy, Greenville, SC
| | - Gary S. Collins
- Center for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, United Kingdom
,Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver
| | - Nigel K. Arden
- Center for sport, Exercise, and Osteoarthritis Research Versus Arthritis, University of Oxford, UK
,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, UK
| | - Thomas K. Noonan
- Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver
,University of Colorado Health, Steadman Hawkins Clinic, Englewood
| | | | - Ellen Shanley
- University of South Carolina, Center for Rehabilitation and Reconstruction Sciences, Greenville
,ATI Physical Therapy, Greenville, SC
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30
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Correia FD, Molinos M, Neves C, Janela D, Carvalho D, Luis S, Francisco GE, Lains J, Bento V. Digital Rehabilitation for Acute Ankle Sprains: Prospective Longitudinal Cohort Study. JMIR Rehabil Assist Technol 2021; 8:e31247. [PMID: 34499038 PMCID: PMC8517823 DOI: 10.2196/31247] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/16/2021] [Accepted: 07/30/2021] [Indexed: 12/21/2022] Open
Abstract
Background Ankle sprains are one of the most prevalent soft-tissue injuries worldwide. Physical therapy, especially progressive exercise, has proven effective in improving function, while preventing recurrence. Objective We aim to present the results of a fully remote and digitally guided rehabilitation program for acute ankle sprains. Methods We performed a prospective longitudinal cohort study of individuals eligible for workers’ compensation, who were referred for digital rehabilitation therapy for a sprained ankle. Therapeutic exercise sessions were to be performed independently by the patient at home using the biofeedback device provided by SWORD Health. Primary endpoints were the change in self-reported Numerical Pain Rating Scale (NPRS) and Foot and Ankle Ability Measure–activities of daily living (FAAM–ADL) and FAAM–Sports scores. Participants were assessed at baseline, end of the program, and 6 months after program completion. Secondary outcomes included digital therapy dosage, pain and fatigue during sessions, and satisfaction. Results In total, 93 (89.4%) patients completed the program and 79 (76.0%) were available for follow-up. Changes in the primary outcomes between baseline and the 6-month follow-up were both significant (P<.001) and clinically meaningful: mean difference of –2.72 points (95% CI –3.31 to –2.13) on the NPRS (49.8% reduction), 21.7 points (95% CI 17.13-26.27) on the FAAM–ADL (41.1% increase), and 37.8 points (95% CI 30.45-45.15) on the FAAM-Sports (151.8% increase). Longer waiting periods between the accident date and treatment initiation were found to negatively impact functional status at baseline and at the end of the program, triggering an extension in the program duration. The total training volume (12.5 hours, SD 10.5 hours) was similar to that of other interventions for ankle sprains, but the dosage per week was much higher (2.4 hours per week, SD 0.87 hours per week). The mean patient satisfaction score was 8.8 (SD 1.57) out of 10. Among program completers, 83.9% attained full recovery and were discharged with no residual disability. Conclusions Being far less demanding in terms of human resources, the digital program presented constituted a viable, clinically effective, and convenient solution for ankle sprain rehabilitation, particularly during the pandemic. This is the first study presenting a fully remote home-based rehabilitation program for acute ankle sprains, with patients achieving sustained long-term results. This was a prospective cohort study and, as such, did not include a control group, but the results appear comparable to those published for face-to-face interventions. Trial Registration ClinicalTrials.gov NCT04819022; https://clinicaltrials.gov/ct2/show/NCT04819022
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Affiliation(s)
- Fernando D Correia
- Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - Maria Molinos
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Carlos Neves
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Dora Janela
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Diana Carvalho
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Sara Luis
- SWORD Health Technologies, Inc, Draper, UT, United States
| | - Gerard E Francisco
- Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center, Houston, TX, United States.,TIRR Memorial Hermann, Houston, TX, United States
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal.,Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | - Virgilio Bento
- SWORD Health Technologies, Inc, Draper, UT, United States
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31
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Bullock GS, Nicholson KF, Waterman BR, Niesen E, Salamh P, Thigpen CA, Shanley E, Devaney LL, Tokish JM, Collins GS, Arden NK, Filbay SR. Persistent joint pain and arm function in former baseball players. JSES Int 2021; 5:912-919. [PMID: 34505105 PMCID: PMC8411053 DOI: 10.1016/j.jseint.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Baseball has specific sport and positional demands that may modify joint pain compared with other sports. Persistent joint pain reduces function and is an underlying reason for seeking medical care. The pain and functional status of players after they stop competitive play are unknown. Such knowledge can assist clinicians in creating personalized physical examinations and interventions for baseball players as they transition to retirement. The purpose of this study was to (1) evaluate persistent joint pain and arm function in former baseball players and (2) determine whether playing position is associated with increased odds of joint pain and reduced arm function in former baseball players. Methods A cross-sectional survey was performed. Eligibility criteria consisted of (1) played ≥1 collegiate baseball season, (2) aged ≥18 years, and (3) formerly played baseball (currently retired). Outcomes assessed included persistent joint pain and Single Assessment Numeric Evaluation (SANE). Explanatory variables included playing position (position, two-way, or pitcher). Multivariable logistic and linear regressions were performed. Models were adjusted for age, body mass index, arm dominance, playing standard, years played baseball, and injury and surgery history. Results A total of 117 former baseball players participated (age: 36.8 [13.7] years). The mean dominant SANE score was 70.2 (standard deviation 24.1), and the mean nondominant SANE score was 85.2 (standard deviation 19.4). There was no difference in dominant arm SANE scores when stratified by arm injury history (4.6 [95% confidence interval: −14.9, 5.8]) or arm surgery history (−3.8 [95% confidence interval: 13.4, 5.8]). The shoulders had the greatest persistent joint pain prevalence (28% of all participants) and elbows (21% of all participants). There was no relationship between dominant arm pain or function and playing position. Conclusion This is the first study to demonstrate an increase in dominant arm disability in former baseball players. The high prevalence of persistent arm pain and poor arm function among former baseball players is concerning considering participants were younger than 40 years of age. No differences were observed in arm function when stratifying by arm history, surgery, or position demonstrating the potential relationship between baseball participation and arm disability after cessation of play. Clinicians should consider working with baseball players to develop long-term strategies to maintain joint health, especially in the throwing arm, when baseball players are transitioning to retirement. Future research is needed to understand the long-term effectiveness of clinical treatments and the implications of specific arm injuries such as ulnar collateral ligament tears on persistent arm pain and function.
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Affiliation(s)
- Garrett S Bullock
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kristen F Nicholson
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Brian R Waterman
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eric Niesen
- Athletic Department, University of Georgetown, Washington DC, USA
| | - Paul Salamh
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | | | | | - Laurie L Devaney
- Department of Kinesiology, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, USA
| | - John M Tokish
- Orthopedics & Sports Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Nigel K Arden
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Stephanie R Filbay
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Centre for Health, Exercise and Sports Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
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Bleakley CM, Matthews M, Smoliga JM. Most ankle sprain research is either false or clinically unimportant: A 30-year audit of randomized controlled trials. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:523-529. [PMID: 33188966 PMCID: PMC8500808 DOI: 10.1016/j.jshs.2020.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/08/2020] [Accepted: 09/22/2020] [Indexed: 05/29/2023]
Abstract
BACKGROUND Lateral ankle sprain is the most common musculoskeletal injury. Although clinical research in this field is growing, there is a broader concern that clinical trial outcomes are often false and fail to translate into patient benefits. METHODS We audited 30 years of experimental research related to lateral ankle sprain management (n = 74 randomized controlled trials) to determine if reports of treatment effectiveness could be validated beyond statistical certainty. RESULTS A total of 77% of trials reported positive treatment effects, but there was a high risk of false discovery. Most trials were unregistered and relied solely on statistical significance, or lack of statistical significance, rather than on interpreting key measures of minimum clinical importance (e.g., minimal detectable change, minimal clinically important difference). CONCLUSION Future clinical trials must adopt higher standards of reporting and data interpretation. This includes consideration of the ethical responsibility to preregister their research and interpretation of clinical outcomes beyond statistical significance.
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Affiliation(s)
- Chris M Bleakley
- School of Health Science, Ulster University, County Antrim, Northern Ireland, BT37 0QB, UK.
| | - Mark Matthews
- School of Sport, Ulster University, County Antrim, Northern Ireland, BT37 0QB, UK
| | - James M Smoliga
- Department of Physical Therapy, Congdon School of Health Science, High Point University, High Point, NC 27268, USA
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Ritzer EE, Yang J, Kistamgari S, Collins CL, Smith GA. An epidemiologic comparison of acute and overuse injuries in high school sports. Inj Epidemiol 2021; 8:51. [PMID: 34380551 PMCID: PMC8356388 DOI: 10.1186/s40621-021-00344-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background Acute and overuse injuries affect millions of high school athletes annually and a better understanding of differences between these injuries is needed to help guide prevention, treatment, and rehabilitation strategies. This study compares acute and overuse injuries using a nationally representative sample of high school athletes. Methods Injuries among United States high school athletes participating in 5 boys’ sports (football, soccer, basketball, wrestling, baseball) and 4 girls’ sports (soccer, volleyball, basketball, softball) reported in the High School RIO™ surveillance system during the 2006-07 through 2018-19 school years were classified as acute or overuse. National estimates and injury rates were calculated. Results Of 17 434 646 estimated injuries, 92.0 % were acute and 8.0 % were overuse. The acute injury rate was higher than the overuse injury rate among both male (Rate Ratio [RR] 16.38, 95 % CI: 15.70–17.10) and female (RR 8.14, 95 % CI: 7.71–8.60) athletes. The overuse injury rate per 10,000 athlete exposures among female athletes (1.8) was slightly higher than among males (1.4). The rate of acute injury compared with the rate of overuse injury was higher during competition (RR 32.00, 95 % CI: 29.93–34.22) than practice (RR 7.19, 95 % CI: 6.91–7.47). Boys’ football contributed the most acute (42.1 %) and overuse (23.7 %) injuries among the 9 sports. Among female sports, girls’ soccer contributed the most acute (15.6 % of all acute injuries) and overuse (19.4 % of all overuse injuries) injuries. The lower extremity was most commonly injured in acute (48.9 %) and overuse (65.9 %) injuries. Ligament sprain (31.7 %) and concussion (21.0 %) were the most common acute injury diagnoses, while muscle strain (23.3 %) and tendonitis (23.2 %) were the most common overuse injury diagnoses. Compared with acute injuries, overuse injuries were more likely to result in time loss from sports participation of < 1 week among both boys and girls and across most sports. Acute injuries were more likely than overuse injuries to cause a time loss of 1–3 weeks or medical disqualification from sports participation. Conclusions Acute and overuse injuries display many differences that provide opportunities for data-informed athlete preparation, treatment, and rehabilitation, which may reduce injuries and improve injury outcomes in high school athletics.
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Affiliation(s)
- Erin E Ritzer
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Lake Erie College of Osteopathic Medicine, 5000 Lakewood Ranch Blvd, FL, 34211, Bradenton, USA
| | - Jingzhen Yang
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sandhya Kistamgari
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Christy L Collins
- Datalys Center for Sports Injury Research and Prevention, 401 West Michigan Street, Suite 500, Indianapolis, IN, USA
| | - Gary A Smith
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. .,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA. .,Child Injury Prevention Alliance, Columbus, OH, USA.
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Paula DAGD, Cunha RAD, Andreoli CV. HEALTH PROBLEMS OF BASKETBALL REFEREES:A PROSPECTIVE STUDY. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127022021_0128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
ABSTRACT Introduction: Basketball referees are the authorities responsible for ensuring that rules and regulations are followed and for making decisions. The ability of referees to respond to the physical and physiological demands imposed during the game is essential for good performance on the court. Objective: To understand the context in which health problems faced by basketball referees occur and to outline the epidemiological profile of musculoskeletal injuries. Methods: A prospective cohort study was conducted in which basketball referees were evaluated using a standardized form. The participants were monitored online weekly for 12 weeks using the Oslo Sports Trauma Research Center questionnaire to assess health problems, such as diseases (affecting the respiratory, cardiovascular, digestive or neurological systems) or musculoskeletal injuries (acute or from overuse). Results: The study sample consisted of 78 referees with a mean age of 36.5 (±9.8) years. Most referees (97.4%) found it important to implement a preventive program. In relation to the health problems reported during follow-up, there was an incidence rate of 23.7 injuries per 1000 hours of play (95% CI 19.5 - 27.9) and the mean weekly prevalence of diseases was 3.2 (95% CI 0.4 – 6.0) and of injuries was 17.4 (95% CI 16.5 – 18.3). Conclusion: Through this study, it was possible to conclude that there was an incidence rate of 23.7 injuries per 1000 hours of play (95% CI 19.5 - 27.9) and a mean prevalence of diseases of 3.2 (95% CI 0.4 - 6.0) and musculoskeletal injuries of 17.4 (95% CI 16.5 - 18.3). The most common health problems that affected basketball referees were musculoskeletal overuse injuries of the lower limbs. Level of evidence I; Prospective cohort study .
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Lin CI, Houtenbos S, Lu YH, Mayer F, Wippert PM. The epidemiology of chronic ankle instability with perceived ankle instability- a systematic review. J Foot Ankle Res 2021; 14:41. [PMID: 34049565 PMCID: PMC8161930 DOI: 10.1186/s13047-021-00480-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/04/2021] [Indexed: 12/13/2022] Open
Abstract
Background Chronic ankle instability, developing from ankle sprain, is one of the most common sports injuries. Besides it being an ankle issue, chronic ankle instability can also cause additional injuries. Investigating the epidemiology of chronic ankle instability is an essential step to develop an adequate injury prevention strategy. However, the epidemiology of chronic ankle instability remains unknown. Therefore, the purpose of this study was to investigate the epidemiology of chronic ankle instability through valid and reliable self-reported tools in active populations. Methods An electronic search was performed on PubMed and Web of Science in July 2020. The inclusion criteria for articles were peer-reviewed, published between 2006 and 2020, using one of the valid and reliable tools to evaluate ankle instability, determining chronic ankle instability based on the criteria of the International Ankle Consortium, and including the outcome of epidemiology of chronic ankle instability. The risk of bias of the included studies was evaluated with an adapted tool for the sports injury review method. Results After removing duplicated studies, 593 articles were screened for eligibility. Twenty full-texts were screened and finally nine studies were included, assessing 3804 participants in total. The participants were between 15 and 32 years old and represented soldiers, students, athletes and active individuals with a history of ankle sprain. The prevalence of chronic ankle instability was 25%, ranging between 7 and 53%. The prevalence of chronic ankle instability within participants with a history of ankle sprains was 46%, ranging between 9 and 76%. Five included studies identified chronic ankle instability based on the standard criteria, and four studies applied adapted exclusion criteria to conduct the study. Five out of nine included studies showed a low risk of bias. Conclusions The prevalence of chronic ankle instability shows a wide range. This could be due to the different exclusion criteria, age, sports discipline, or other factors among the included studies. For future studies, standardized criteria to investigate the epidemiology of chronic ankle instability are required. The epidemiology of CAI should be prospective. Factors affecting the prevalence of chronic ankle instability should be investigated and clearly described.
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Affiliation(s)
- Chiao-I Lin
- Medical Sociology and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany. .,University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Am Neuen Palais 10, House 12, Potsdam, Germany.
| | - Sanne Houtenbos
- Medical Sociology and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany.,University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Am Neuen Palais 10, House 12, Potsdam, Germany
| | - Yu-Hsien Lu
- JC School of Public Health and Primary Care Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
| | - Frank Mayer
- University Outpatient Clinic, Centre of Sports Medicine, University of Potsdam, Am Neuen Palais 10, House 12, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus-Senftenberg, Am Neuen Palais 10, House 12, Potsdam, Germany
| | - Pia-Maria Wippert
- Medical Sociology and Psychobiology, Department of Physical Activity and Health, University of Potsdam, Am Neuen Palais 10, House 12, 14469, Potsdam, Germany.,Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus-Senftenberg, Am Neuen Palais 10, House 12, Potsdam, Germany
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Epidemiology of Sports-Related Injuries and Associated Risk Factors in Adolescent Athletes: An Injury Surveillance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094857. [PMID: 34063226 PMCID: PMC8125505 DOI: 10.3390/ijerph18094857] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 11/23/2022]
Abstract
The present study aimed to determine the epidemiology of sport-related injuries in amateur and professional adolescent athletes and the incidence of different risk factors on those injuries. Four hundred ninety-eight athletes aged 14 to 21 voluntarily participated in this prospective injury surveillance, conducted from 1 January 2019 to 31 December 2019. The information collected included: personal data, sports aspects, characteristics of the injuries, and lifestyle. Forty point four percent of the participants suffered an injury in 2019 (39% of them in a previously injured area). The average injury rate was 2.64 per 1000 h. Soccer presented the highest rate (7.21). The most common injuries were: lumbar muscle strains (12.24%), ankle sprains (11.98%), and bone fractures (9.31%). Ankles (36.12%), knees (19.32%), and shoulders (6.47%) concentrated the highest number of injuries. Fifty-nine point twenty-eight percent of the injuries occurred during practices, and 40.72% during competition or peri-competition. Higher injury rates were associated (in this order) with the following factors: (a) Greater number of hours of practice per week. (b) Not performing warm-ups. (c) Using inadequate sports facilities. (d) Being aged 14–17. (e) Not performing physical preparation. (f) Inappropriate training load. (g) Not performing injury-preventive activities. (h) Performing sports technique without the supervision of one sports coach. (i) Inadequate sports equipment. In conclusion, since most injury risk factors are modifiable, it is imperative to implement strategies to reduce amateur and professional adolescent athletes’ injury rates.
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Bullock GS, Murray E, Vaughan J, Kluzek S. Temporal trends in incidence of time-loss injuries in four male professional North American sports over 13 seasons. Sci Rep 2021; 11:8278. [PMID: 33859331 PMCID: PMC8050171 DOI: 10.1038/s41598-021-87920-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 04/06/2021] [Indexed: 11/21/2022] Open
Abstract
Sports-related injuries increase healthcare cost burden, and in some instances have harmful long term physical and psychological implications. There is currently a lack of comprehensive data on temporal injury trends across professional North American sports. The purpose of this study was to compare temporal trends, according to incidence and time-loss injuries, by body part in professional baseball, basketball, football, and ice hockey. Public injury data from Major League Baseball, National Basketball Association, National Football League, and National Hockey League from 2007 to December 2019 were extracted and used. A mean of 62.49 injuries per 100 players per season was recorded for all professional sports. The groin/hip/thigh reported the greatest season proportional injury incidence for baseball, football, and ice hockey, with the groin/hip/thigh as the third highest injury incidence in basketball. When stratifying by more specific body part groupings, the knee demonstrated the greatest injury proportional incidence for basketball, football, and ice hockey, with the knee as the third highest proportional injury incidence for baseball. There was an increased in basketball ankle injuries following 2011–2012 season. Football and ice hockey reported the greatest concussion proportion incidence, with football demonstrating an increase in concussions over time, and a substantial increase in concussions from the 2014 to 2015 season. These publicly extracted data and findings can be used as a shared resource for professional baseball, basketball, football, and ice hockey for future individual and across sport collaborations concerning resource allocation and decision making in order to improve player health.
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Affiliation(s)
- Garrett S Bullock
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK. .,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, B4495, Oxford, OX3 7LD, UK. .,Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | | | | | - Stefan Kluzek
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, Oxford, UK.,Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, B4495, Oxford, OX3 7LD, UK.,University of Nottingham, Nottingham, UK
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Dowling B, McNally MP, Chaudhari AMW, Oñate JA. A Review of Workload-Monitoring Considerations for Baseball Pitchers. J Athl Train 2021; 55:911-917. [PMID: 32991703 DOI: 10.4085/1062-6050-0511-19] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Because of the unique demands of a pitch, baseball players have the greatest percentage of injuries resulting in surgery among high school athletes, with a majority of these injuries affecting the shoulder and elbow due to overuse from throwing. These injuries are believed to occur because of repeated microtrauma to soft tissues caused by the repetitive mechanical strain of throwing. Researchers and practitioners have suggested that baseball pitchers' workloads are a significant risk factor for injury in adolescent players, resulting in lost time and slowing of performance development. The purpose of our review was to investigate the current research relative to monitoring workload in baseball throwers and discuss techniques for managing and regulating cumulative stress on the arm, with a focus on preventing injury and optimizing performance in adolescent baseball pitchers.
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Affiliation(s)
- Brittany Dowling
- Midwest Orthopaedics at Rush, Sports Performance Center, Oak Brook, IL
| | | | - Ajit M W Chaudhari
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - James A Oñate
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus.,Human Performance Collaborative, The Ohio State University, Columbus
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Development of a medical device compatible with MRI/CT to measure ankle joint laxity: the Porto Ankle Testing Device. Porto Biomed J 2021; 6:e122. [PMID: 33884318 PMCID: PMC8055483 DOI: 10.1097/j.pbj.0000000000000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/09/2020] [Accepted: 12/28/2020] [Indexed: 11/26/2022] Open
Abstract
Ankle sprains are common and often develop into chronic ankle instability. Ankle laxity is usually assessed by manual testing followed by magnetic resonance imaging to confirm the diagnosis. Manual testing however provides a subjective measure and is limited to the assessor sensibility. Current available technologies incorporate arthrometers to objectively measuring ankle laxity, but are not capable to assess the structural integrity of the capsuloligamentous structures. To overcome these limitations, we developed a novel medical device to assist in the diagnosis of ankle ligament injuries—the Porto Ankle Testing Device. With this device, it is possible to combine and correlate the assessment of the capsuloligamentous’ structural integrity with the joint functional competence (ie, joint multiplanar laxity). The main purpose of this work is to present the fundamental aspects and step-by-step development of the Porto Ankle Testing Device. We discuss the design specifications and technical requirements with the purpose to design and develop this medical device, described the features of the different components and explained the mechanical systems that are incorporated emulate manual testing and to measure the multiplanar ankle laxity. The preliminary findings are presented with the purpose to display the assessment protocol, the method of laxity measurement and the obtained results. We propose a unique and reliable medical device to safety and effectively assess ankle ligament injuries and contribute to enhance diagnosis, refine treatment indications and allow objective measurement of ligament laxity before and/or after stabilization surgery.
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40
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Simon JE, Yom J, Grooms DR. Symmetry does not Indicate Recovery: Single-leg Hop Before and After a Lower Extremity Injury. Int J Sports Med 2020; 42:344-349. [PMID: 33017852 DOI: 10.1055/a-1244-9959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Current recommendations for return-to-play decision-making involve comparison of the injured limb to the uninjured limb. However, the use of the uninjured limb as a comparison for hop testing lacks empirical evidence. Thus, the purpose of this study was to determine the effects of lower extremity injury on limb symmetry and performance on the single-leg hop for distance. Two-hundred thirty-six adolescent athletes completed the single-leg hop for distance before the beginning of the season (pre-injury). Forty-four adolescent athletes sustained a lower extremity injury (22 ankle and 12 knee) and missed at least three days of sports participation. All individuals had completed the single-leg hop for distance before the beginning of the season (pre-injury) and at discharge (post-injury). Injured limb single-leg hop for distance significantly decreased at return-to-play from pre-injury with a mean decrease of 48.9 centimeters; the uninjured limb also significantly decreased, with a mean decrease of 33.8 centimeters. Limb symmetry did not significantly change pre- to post-injury with a mean difference of 1.5%. Following a lower extremity injury, single-leg hop for distance performance degrades not only for the injured limb but also the uninjured limb. However, limb symmetry did not change following a lower extremity injury.
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Affiliation(s)
- Janet E Simon
- Division of Athletic Training, School of Applie 00d Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens.,Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens
| | - Jae Yom
- Allied Health, University of Illinois at Springfield, Springfield
| | - Dustin R Grooms
- Division of Athletic Training, School of Applie 00d Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens.,Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens.,Division of Physical Therapy, School of Rehabilitation and Communications Science, College of Health Sciences and Professions, Ohio University, Athens
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41
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Ryu HS, Jung B, Yeo J, Kim JH, Nam D, Ha IH. Analysis of medical services provided to patients with ankle sprains in Korea between 2015 and 2017: a cross-sectional study of the health insurance review and assessment service national patient sample database. BMJ Open 2020; 10:e039297. [PMID: 32973065 PMCID: PMC7517580 DOI: 10.1136/bmjopen-2020-039297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To provide useful information for policy-makers and clinicians by analysing the medical service use-divided into Western medicine (WM) and Korean medicine (KM)-of patients with ankle sprains in South Korea between 2015 and 2017. DESIGN Cross-sectional, retrospective, observational study. SETTING Tertiary hospitals, WM hospitals, WM clinics, KM hospitals, KM clinics and others in South Korea. PARTICIPANTS We analysed claim data and patient information from the 2015 to 2017 Health Insurance Review and Assessment National Patient Sample (HIRA-NPS) dataset, including 151 415 patients diagnosed with a 'dislocation, sprain and strain of joints and ligaments at ankle and foot level' (10th revision of the International Statistical Classification of Diseases code S93) who used medical services at least once in 3 years between January 2015 and December 2017 in South Korea. PRIMARY AND SECONDARY OUTCOME MEASURES Cost of medical care, number of consultations, type of institution visited, types of treatment. RESULTS There were 160 200 consultations and 53 044 patients in 2015, 149 956 consultations and 50 830 patients in 2016 and 140 651 consultations and 47 541 patients in 2017. The total treatment costs were US$3 355 044.21, US$3 245 827.70 and US$3 128 938.46 in 2015, 2016 and 2017, respectively. The most common age was 10-19 years. The most frequent type of visit was KM outpatient visit (56%). Physiotherapy was most common in WM outpatient visits, while acupuncture was most common in KM visits. Most patients used one institution, rather than alternating between WM and KM. CONCLUSIONS By identifying the trends and costs of treatment methods used for ankle sprains and comparing WM and KM, our data provide basic information for future health policy-making. In addition, the duality of the Korean medical system is highlighted as a possible cause of increased costs.
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Affiliation(s)
- Ho-Sun Ryu
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Republic of Korea
| | - Boyoung Jung
- Department of Health Administration, Hanyang Women's University, Seoul, Republic of Korea
| | - Jiyoon Yeo
- Jaseng Spine & Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Republic of Korea
| | - Jae-Hong Kim
- Acupuncture & Moxibustion, Dongshin University College of Korean Medicine, Naju, Republic of Korea
| | - Dongwoo Nam
- Department of Acupuncture & Moxibustion, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Republic of Korea
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42
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Landing Error Scoring System scores change with knowledge of scoring criteria and prior performance. Phys Ther Sport 2020; 46:155-161. [PMID: 32942243 DOI: 10.1016/j.ptsp.2020.09.004] [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: 06/16/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine if the knowledge of scoring criteria and prior performance influence Landing Error Scoring System (LESS) outcomes. DESIGN Cross-sectional. SETTING Laboratory. PARTICIPANTS Thirty individuals. MAIN OUTCOME MEASURES The LESS was tested at Baseline and one week later under two conditions: Pre and Post information. For the Post condition, LESS items were explained to participants, as were their individual Baseline scores. Mean LESS scores and number of individuals categorized at high and low risk were compared between Pre and Post using paired t-tests and McNemar's tests, respectively. McNemar's tests were also used to compare proportions of specific LESS errors between Pre and Post conditions. RESULTS Mean LESS Post scores (4.7 ± 1.2 errors) were significantly lower than Pre scores (6.6 ± 2.0 errors, p < 0.001) as was the number of individuals at high risk (25 vs 10 participants, p < 0.001). A significantly lower proportion of participants scored an error for the joint displacement item of LESS Post compared to Pre condition (p < 0.001). CONCLUSION When using the LESS, it is important that tested individuals have no knowledge of scoring criteria or previous errors for a valid assessment of innate jump-landing movement patterns and injury risk.
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Seow D, Graham I, Massey A. Prediction models for musculoskeletal injuries in professional sporting activities: A systematic review. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.181] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Feger MA, Donovan L, Herb CC, Hart JM, Saliba SA, Abel MF, Hertel J. Effects of 4-week impairment-based rehabilitation on jump-landing biomechanics in chronic ankle instability patients. Phys Ther Sport 2020; 48:201-208. [PMID: 33515967 DOI: 10.1016/j.ptsp.2020.07.005] [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: 04/21/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine effects of 4-weeks of impairment-based rehabilitation on lower extremity neuromechanics during jump-landing. DESIGN Descriptive laboratory study. PARTICIPANTS Twenty-six CAI subjects (age = 21.4 ± 3.1 sex=(M = 7,F = 19), height = 169.0 ± 8.8 cm, weight = 71.0 ± 13.8 kg) completed 15 jump-landing trials prior to and following 12 supervised rehabilitation sessions. MAIN OUTCOME MEASURES Frontal and sagittal lower extremity kinematics and kinetics and sEMG amplitudes (anterior tibialis, peroneus brevis, peroneus longus, and medial gastrocnemius). Means and 90% confidence intervals (CIs) were calculated for 100 ms prior to and 200 ms following ground contact. Areas where pre- and post-rehabilitation CIs did not overlap were considered significantly different. Kinematic and kinetic peaks and kinematic excursion were compared with paired t-test (P ≤ 0.05). RESULTS Following rehabilitation, CAI subjects exhibited less ankle (2.1° (0.8, 3.4), P < 0.01) and hip (2.0° (0.5, 3.7), P = 0.01) frontal plane excursion and lower peak hip abduction (2.5° (0.0, 5.0), P = 0.05). There was less ankle (5.0° (1.7, 8.3), P < 0.01) and knee (3.4° (0.8, 6.0), P = 0.01) sagittal plane excursion following rehabilitation. There was decreased peroneus longus activity from 9 ms to 135 ms post ground contact and decreased peak plantar flexion moment (0.08 N∗m/kg (0.01, 0.13), P = 0.02) following rehabilitation. CONCLUSION Progressive impairment-based rehabilitation resulted in reductions in kinematic excursion and peroneus longus muscle activity, suggesting a more efficient landing strategy.
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Affiliation(s)
- Mark A Feger
- University of Virginia, Department of Kinesiology, USA.
| | - Luke Donovan
- University of North Carolina at Charlotte, Department of Kinesiology, USA
| | - C Collin Herb
- Northern Kentucky University, School of Kinesiology, Counseling & Rehabilitative Sciences, USA
| | - Joseph M Hart
- University of Virginia, Department of Kinesiology, USA; University of Virginia, Department of Orthopedic Surgery, USA
| | | | - Mark F Abel
- University of Virginia, Department of Orthopedic Surgery, USA
| | - Jay Hertel
- University of Virginia, Department of Kinesiology, USA
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Gabriel EH, McCann RS, Hoch MC. Use of Social or Behavioral Theories in Exercise-Related Injury Prevention Program Research: A Systematic Review. Sports Med 2020; 49:1515-1528. [PMID: 31187453 DOI: 10.1007/s40279-019-01127-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of social or behavioral theories within exercise-related injury prevention program (ERIPP) research may lead to a better understanding of why adherence to the programs is low and inform the development of interventions to improve program adherence. There is a need to determine which theories have been used within the literature and at what level theory was used to further the field. OBJECTIVE To determine which social or behavioral science theories have been incorporated within ERIPP research and assess the level at which the theories were used. The key question guiding the search was "What social or behavioral theories have been used within ERIPP research?" METHODS A systematic review of the literature was completed with an appraisal of bias risk using a custom critical appraisal tool. An electronic search of EBSCOhost (Academic Search Complete, CINAHL, Medline, Psychology and Behavioral Sciences Collection) and PubMed was completed from inception to October 2018. Studies investigating attitudes towards ERIPP participation with the use of a social or behavioral theoretical model or framework were eligible for inclusion. RESULTS The electronic search returned 7482 results and two articles were identified though a hand search, which resulted in ten articles meeting inclusion criteria. Four different behavioral or social theoretical models or frameworks were identified including the health action process approach model, health belief model, self-determination theory, and theory of planned behavior. Six studies utilized the theory at a B level meaning a theoretical construct was measured while four utilized the theory at the C level meaning the theory was tested. The mean critical appraisal score was 78%, indicating a majority of the studies were higher quality. CONCLUSION There has been an increase in the use of theory within literature that is specific to ERIPP participation. Additionally, the use of theory has shifted from guiding program design to the measurement of theoretical constructs and testing of the theoretical models.
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Affiliation(s)
- Emily H Gabriel
- College of Health Professions, Mercer University, Macon, GA, 31207, USA.
| | - Ryan S McCann
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA, 23529, USA
| | - Matthew C Hoch
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY, 40536, USA
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Cheng WL, Jaafar Z. Effects of lateral ankle sprain on range of motion, strength and postural balance in competitive basketball players: a cross-sectional study. J Sports Med Phys Fitness 2020; 60:895-902. [PMID: 32487984 DOI: 10.23736/s0022-4707.20.10619-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Lateral ankle sprain is the most common injury in basketball, and many of these sprains resulted in residual functional deficits. This study aimed to compare ankle strength and range of motion, and postural balance between competitive basketball players with and without lateral ankle sprain. METHODS This was a cross-sectional study involving 42 male competitive basketball players. Subjects were divided into the injured and uninjured groups based on self-reported questionnaires. Ankle range of motion (ROM) was measured using a goniometer, ankle isokinetic strength testing performed using Biodex System 4 PRO, and single-leg stability tests performed using Biodex Balance System SD. RESULTS Between the injured and uninjured ankles, there was a decrease in plantarflexion ROM (44.89±6.85 vs. 50.75±9.31, P<0.05) and an increase in eversion ROM (14.50±5.63 vs. 11.74±4.53, P<0.05). There was a reduction in inversion and plantarflexion strength at 30°/s peak torque and 120 °/s peak torque (P<0.05). However, no significant difference observed in the postural stability indexes between the two groups. CONCLUSIONS This study proves that there are residual ROM and strength deficits after an ankle sprain, however, these deficits do not affect their balance ability.
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Affiliation(s)
- Wern L Cheng
- Department of Sports Medicine, University of Malaya Medical Center, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Zulkarnain Jaafar
- Department of Sports Medicine, University of Malaya Medical Center, Lembah Pantai, Kuala Lumpur, Malaysia -
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Gabriel EH, McCann RS, Hoch MC, Cramer RJ. An intervention based on the health belief model led to improvements in self-efficacy towards ERIPP participation and functional performance in club sport athletes: a pilot study. J Sci Med Sport 2020; 23:921-926. [PMID: 32402758 DOI: 10.1016/j.jsams.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 03/23/2020] [Accepted: 04/03/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine if an intervention based on the Health Belief Model (HBM) could improve attitudes towards exercise-related injury prevention program (ERIPP) participation and functional performance in club sport participants. DESIGN Repeated measures METHODS: Participants completed the HBM Scale (HBMS) and Theory of Planned Behavior Scale (TPBS) to assess attitudes towards ERIPP participation at three time points (pre-measure, post-measure, follow-up measure). The HBM based intervention was delivered immediately following the pre-measure containing: 1) education on ERIPPs, benefits and barriers to participating, strategies to overcome barriers, risk factors and consequences for lower extremity injuries, and strategies to prevent lower extremity injuries 2) individualized feedback on functional performance 3) demonstration and participation in the 11+. Attitudes towards injury prevention were compared using the subscales of the HBMS and TPBS at all three time points. Functional performance was compared at the pre-measure and follow-up measure. RESULTS Significant improvements with large effect sizes were detected in individual self-efficacy from pre-test (0.73±4.48) to post-test (2.93±4.30; P=0.05; ƞ2=0.18) and pre-test to follow-up (3.20±3.49; P=0.04; ƞ2=0.20) and community led self-efficacy from pre-test (4.40±2.75) to post-test (6.07±3.43; P=0.02; ƞ2=0.24) and pre-test to follow-up (7.07±2.05; P=0.001; ƞ2=0.44). Additionally, significant improvements were found in the LESS-RT following the intervention. CONCLUSIONS The intervention based on the HBM led to improvements in individual and community led self-efficacy indicating an enhancement in the participants' confidence in their ability to participate in an ERIPP. Future research should investigate the effectiveness of individualized interventions to improve attitudes towards and adherence to ERIPPs.
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Affiliation(s)
| | - Ryan S McCann
- School of Rehabilitation Sciences, Old Dominion University
| | - Matthew C Hoch
- Department of Athletic Training and Clinical Nutrition, University of Kentucky
| | - Robert J Cramer
- Department of Public Health Sciences, University of North Carolina at Charlotte
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Gebert A, Gerber M, Pühse U, Gassmann P, Stamm H, Lamprecht M. Costs resulting from nonprofessional soccer injuries in Switzerland: A detailed analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:240-247. [PMID: 32444148 PMCID: PMC7242620 DOI: 10.1016/j.jshs.2018.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/29/2018] [Accepted: 05/02/2018] [Indexed: 06/11/2023]
Abstract
BACKGROUND Soccer injuries constitute an important public health problem and cause a high economic burden. Nevertheless, comprehensive data regarding injury costs in nonprofessional soccer are missing. The aim of this study was to determine which groups of nonprofessional soccer athletes, injury types, and injury situations caused high injury costs. METHODS A cross-sectional, retrospective telephone survey was carried out with a random sample of persons who had sustained a soccer injury between July 2013 and June 2014 and who had reported this accident to the Swiss National Accident Insurance Fund (Suva). One year after the corresponding accident, every injury was linked to its costs and to the answers obtained in the interview about injury setting, injury characteristics, and injury causes. Finally, the costs of 702 injuries were analyzed. RESULTS The average cost of an injury in nonprofessional soccer amounted to €4030 (bias-corrected and accelerated 95% confidence interval (BCa 95%CI): 3427-4719). Persons aged 30 years and older experienced 35% of soccer injuries but accounted for 49% of all costs. A total of 58% of all costs were the result of injuries that occurred during amateur games. In particular, game injuries sustained by players in separate leagues for players aged 30+/40+ years led to high average costs of €8190 (BCa 95%CI: 5036-11,645). Knee injuries accounted for 25% of all injuries and were responsible for 53% of all costs. Although contact and foul play did not lead to above-average costs, twisting or turning situations were highly cost relevant, leading to an average sum of €7710 (BCa 95%CI: 5376-10,466) per injury. CONCLUSION Nonprofessional soccer players aged 30 years and older and particularly players in 30+/40+ leagues had above-average injury costs. Furthermore, the prevention of knee injuries, noncontact and nonfoul play injuries, and injuries caused by twisting and turning should be of highest priority in decreasing health care costs.
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Affiliation(s)
- Angela Gebert
- Lamprecht und Stamm Sozialforschung und Beratung, Zurich CH, 8032, Switzerland; Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel CH, 4052, Switzerland.
| | - Markus Gerber
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel CH, 4052, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel CH, 4052, Switzerland
| | - Philippe Gassmann
- Suva (Swiss National Accident Insurance Fund), CH, 6002 Luzern, Switzerland
| | - Hanspeter Stamm
- Lamprecht und Stamm Sozialforschung und Beratung, Zurich CH, 8032, Switzerland
| | - Markus Lamprecht
- Lamprecht und Stamm Sozialforschung und Beratung, Zurich CH, 8032, Switzerland
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Comparison of the Y-Balance Test and Star Excursion Balance Test: Utilization of a Discrete Event Simulation. J Sport Rehabil 2020; 30:214-219. [PMID: 32325427 DOI: 10.1123/jsr.2019-0425] [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: 09/24/2019] [Revised: 01/24/2020] [Accepted: 02/23/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT The Y-Balance Test (YBT) and Star Excursion Balance Test (SEBT) are commonly used to detect deficits in dynamic postural control. There is a lack of literature on the differences in reach distances and efficiency of the tests. OBJECTIVE To compare the reach distances of the YBT and SEBT. An additional aim was to compare the time necessary to administer the 2 tests and utilize a discrete event simulation to determine the number of participants who could be screened within different scenarios. DESIGN Cross-sectional. Laboratory Patients: Twenty-four physically active individuals between the ages of 18-35 years volunteered to participate in this study (M/F: 11/13; age 22.78 [2.63] y, height 68.22 [4.32] cm, mass 173.27 [10.96] kg). INTERVENTION The participants reported to the laboratory on one occasion and performed the YBT and SEBT. The anterior, posteromedial, and posterolateral reach distances were recorded for each test. In addition, the time to administer each test was recorded in seconds. MAIN OUTCOME MEASURES The average reach distances and time for each test were used for analysis. Paired t tests were utilized to compare the reach distances and time to administer the 2 tests. A discrete event simulation was used to determine how many participants could be screened using each test. RESULTS The anterior reach for the SEBT (64.52% [6.07%]) was significantly greater than the YBT (61.66% [6.37%]; P < .01). The administration time for the YBT (512.42 [123.97] s) was significantly longer than the administration time for the SEBT (364.96 [69.46] s; P < .01). The discrete event simulation revealed more participants could be screened using the SEBT when compared with the YBT for every situation. CONCLUSION Scores on the anterior reach of the SEBT are larger when compared with the YBT. The discrete event simulation can successfully be used to determine how many participants could be screened with a certain amount of resources given the use of a specific test.
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Donovan L, Hetzel S, Laufenberg CR, McGuine TA. Prevalence and Impact of Chronic Ankle Instability in Adolescent Athletes. Orthop J Sports Med 2020; 8:2325967119900962. [PMID: 32118082 PMCID: PMC7029541 DOI: 10.1177/2325967119900962] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 10/25/2019] [Indexed: 12/17/2022] Open
Abstract
Background: The prevalence and impact of chronic ankle instability (CAI) in adolescent athletes are unknown. To better develop and justify prevention strategies of lateral ankle sprains and CAI, it is important to understand the origin and associated long-term impact of CAI within populations other than adults. Purpose/Hypothesis: The purpose of this study was to determine the prevalence and impact of CAI on ankle function, health-related quality of life (HRQoL), and physical activity in adolescent athletes. The hypothesis was that the presence of CAI will be commonly reported among adolescent athletes and that participants with CAI will have lower self-reported ankle function, HRQoL, and physical activity when compared with participants without CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A cohort of 1002 healthy (able to fully participate) adolescent athletes (50.4% female; mean age, 15.6 ± 1.6 years) across 8 club sport facilities and high schools completed paper-and-pencil surveys to establish the presence of CAI (Identification of Functional Ankle Instability [IdFAI]) and estimate perceived ankle function (Foot and Ankle Ability Measure [FAAM]–Activities of Daily Living and FAAM-Sport), HRQoL (Pediatric Quality of Life Inventory 4.0 [PedsQL]), and physical activity (Hospital for Special Surgery Pediatric Functional Activity Brief Scale [HSS Pedi-FABS]). Results: The overall prevalence of CAI was 20.0%. Participants with unilateral CAI reported significantly lower (P < .001) ankle function (FAAM-Sport: 87.0 ± 14.8) and HRQoL (total PedsQL: 89.8 ± 9.8) than participants who did not have CAI (FAAM-Sport: 97.7 ± 6.0; total PedsQL: 93.5 ± 9.1). Physical activity was not different between participants with and without CAI. Conclusion: The prevalence of CAI was high among adolescent athletes. The presence of CAI negatively affected ankle function and HRQoL in adolescent athletes. Given the high prevalence and negative impact of CAI in an adolescent population, strategies to prevent ankle injuries and maintain physical activity are needed to alleviate future long-term consequences associated with developing CAI. These strategies should be implemented as soon as sport participation begins, as it appears that the origin of CAI may occur before adulthood.
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Affiliation(s)
- Luke Donovan
- Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
- Luke Donovan, PhD, ATC, Department of Kinesiology, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA () (Twitter: @LukeTDonovan)
| | - Scott Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Craig R. Laufenberg
- Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Timothy A. McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA
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