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Stanković M, Čaprić I, Katanić B, Špirtović O, Maljanović D, Nailović H, Muković I, Jelaska I, Trajković N. Proprioceptive training methods (PTM) in female soccer players - a systematic review. BMC Sports Sci Med Rehabil 2024; 16:101. [PMID: 38689340 PMCID: PMC11061981 DOI: 10.1186/s13102-024-00892-8] [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: 12/01/2023] [Accepted: 04/25/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Although previous studies have reported that proprioceptive training methods (PTM) have positive effects, there is a relatively small number of studies regarding the impact of PTM in women's soccer. Therefore, there is a need to systematize the given results. In this regard, this systematic review aimed to investigate the effect of proprioceptive training methods in female soccer players. METHODS The studies' search and analysis were done according to the PRISMA guidelines. The following databases were checked (Google Scholar, PubMed Cochrane and ProQuest), with additional publication time criteria (2000-2023) using the following keywords: proprioceptive, balance, neuromuscular, training, exercise, intervention, method, activity, female football players, female soccer players, woman soccer players. RESULTS A total of 7 studies were included in the quantitative synthesis that meet all the criteria with the number of participants being 2.247. Based on the analysis of the previous research and detailed discussion, the main findings of the study resulted in the partial improvement of explosive strength (66%), strength (50%), muscle imbalance and flexibility (50%) and the prevention and reduction of lower extremity injuries in female soccer players (60%). Only one study reported no significant differences between groups, where rate of major injuries was higher in experimental group. CONCLUSION The obtained results indicate the necessity to implement proprioceptive training in female soccer training programs, in order to influence the prevention and reduction of injuries and improve balance, proprioceptive ability and body control.
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Affiliation(s)
- Mima Stanković
- Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva 10a, Niš, 18000, Serbia.
| | - Ilma Čaprić
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Borko Katanić
- Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva 10a, Niš, 18000, Serbia
| | - Omer Špirtović
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Džejla Maljanović
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Hamza Nailović
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Iso Muković
- Faculty of Sport and Physical Education, State University of Novi Pazar, Novi Pazar, 36300, Serbia
| | - Igor Jelaska
- Faculty of Kinesiology, University of Split, Split, 21000, Croatia
| | - Nebojša Trajković
- Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva 10a, Niš, 18000, Serbia
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Amundsen R, Thorarinsdottir S, Larmo A, Pedersen R, Andersen TE, Møller M, Bahr R. #ReadyToplay: hamstring injuries in women's football - a two-season prospective cohort study in the Norwegian women's premier league. SCI MED FOOTBALL 2024:1-9. [PMID: 38243669 DOI: 10.1080/24733938.2024.2305389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 01/21/2024]
Abstract
In this two-season prospective cohort study (2020-2021), we aimed to describe the characteristics, clinical findings and magnetic resonance imaging (MRI) findings of hamstring injuries in the Norwegian women's premier league. Hamstring injuries were examined by team physiotherapists using a standardised clinical examination and injury form. Injury location and severity (modified Peetrons classification) were graded based on MRI by two independent radiologists. Fifty-three hamstring injuries were clinically examined, 31 of these with MRI. Hamstring injuries caused 8 days (median) lost from football (interquartile range: 3-15 days, range: 0-188 days), most were non-contact and occurred during sprinting. Gradual-onset (53%) and sudden-onset injuries (47%) were evenly distributed. The injuries examined with MRI were classified as grade 0 (52%), grade 1 (16%) or grade 2 (29%). One proximal tendinopathy case was not graded. Grade 2 injuries caused more time loss than grade 0 (19 ± 8 vs. 7 ± 7 days, p = 0.002). Of injuries with MRI changes, 60% were in the m. biceps femoris, mainly the muscle-tendon junction, and 40% in the m. semimembranosus, most in the proximal tendon. Compared to previous findings from men's football, a higher proportion of hamstring injuries in women's football had a gradual onset and involved the m. semimembranosus, particularly its proximal tendon.
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Affiliation(s)
- R Amundsen
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - S Thorarinsdottir
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - A Larmo
- Radiology Department, Evidia Norge AS, Oslo, Norway
| | - R Pedersen
- Radiology Department, Unilabs Norge AS, Oslo, Norway
| | - T E Andersen
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- The Norwegian Football Association Medical Centre (Idrettens helsesenter), The Norwegian Football Association, Oslo, Norway
| | - M Møller
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - R Bahr
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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Theodorou A, Komnos G, Hantes M. Patellar tendinopathy: an overview of prevalence, risk factors, screening, diagnosis, treatment and prevention. Arch Orthop Trauma Surg 2023; 143:6695-6705. [PMID: 37542006 PMCID: PMC10541843 DOI: 10.1007/s00402-023-04998-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
Patellar tendinopathy (PT), or jumper's knee, is an overuse injury that occurs in professional, as well as recreational, athletes. This condition is a noncontact injury, typically characterized by gradually increasing pain in the patellar tendon. It is prevalent in participants of several sports, but it occurs mostly in jumping sports. The diagnosis of PT is primarily clinical; however, imaging techniques can be useful as well. Risk factors differ between sexes, playing conditions, the kind of sport, playing level and personal characteristics. Screening is an essential tool to assess PT. This condition affects athletic performance and often persists for years. The use of preventative methods is imperative because of the persistence of this condition, especially in elite athletes who sometimes end their career after long and failed treatments. There are a wide variety of treatment and rehabilitation options available, the majority of which are non-operative, such as eccentric exercises, cryotherapy, platelet-rich plasma (PRP) injections, and anti-inflammatory strategies. If conservative treatment fails, surgery is the next most preferable step. Even though there are many surgical treatment methods, there is no clear evidence on what is the most effective approach to address PT. Taking this into consideration, as well as the extent of this clinical entity, novel therapeutic techniques, as well as screening and prevention methods, are expected to emerge in the near future.
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Affiliation(s)
- Andreas Theodorou
- Faculty of Medicine, University of Thessaly, 41500, Larissa, Greece.
| | - Georgios Komnos
- Faculty of Medicine, University of Thessaly, 41500, Larissa, Greece
| | - Michael Hantes
- Faculty of Medicine, University of Thessaly, 41500, Larissa, Greece
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Edouard P, Reurink G, Mackey AL, Lieber RL, Pizzari T, Järvinen TAH, Gronwald T, Hollander K. Traumatic muscle injury. Nat Rev Dis Primers 2023; 9:56. [PMID: 37857686 DOI: 10.1038/s41572-023-00469-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/21/2023]
Abstract
Traumatic muscle injury represents a collection of skeletal muscle pathologies caused by trauma to the muscle tissue and is defined as damage to the muscle tissue that can result in a functional deficit. Traumatic muscle injury can affect people across the lifespan and can result from high stresses and strains to skeletal muscle tissue, often due to muscle activation while the muscle is lengthening, resulting in indirect and non-contact muscle injuries (strains or ruptures), or from external impact, resulting in direct muscle injuries (contusion or laceration). At a microscopic level, muscle fibres can repair focal damage but must be completely regenerated after full myofibre necrosis. The diagnosis of muscle injury is based on patient history and physical examination. Imaging may be indicated to eliminate differential diagnoses. The management of muscle injury has changed within the past 5 years from initial rest, immobilization and (over)protection to early activation and progressive loading using an active approach. One challenge of muscle injury management is that numerous medical treatment options, such as medications and injections, are often used or proposed to try to accelerate muscle recovery despite very limited efficacy evidence. Another challenge is the prevention of muscle injury owing to the multifactorial and complex nature of this injury.
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Affiliation(s)
- Pascal Edouard
- Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, Saint-Etienne, France.
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France.
| | - Gustaaf Reurink
- Department of Orthopedic Surgery and Sports Medicine, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Academic Medical Center, Amsterdam, Netherlands
- The Sports Physicians Group, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Richard L Lieber
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Departments of Physical Medicine and Rehabilitation and Biomedical Engineering, Northwestern University, Chicago, IL, USA
- Hines VA Medical Center, Maywood, IL, USA
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Tero A H Järvinen
- Tampere University and Tampere University Hospital, Tampere, Finland
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Niering M, Muehlbauer T. Changes After a Conventional vs. an Alternative Therapy Program on Physical, Psychological, and Injury-Related Parameters in Male Youth Soccer Players With Patellar Tendinopathy During Return to Competition. J Strength Cond Res 2023; 37:1834-1843. [PMID: 36752745 DOI: 10.1519/jsc.0000000000004467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
ABSTRACT Niering, M and Muehlbauer, T. Changes after a conventional vs. an alternative therapy program on physical, psychological and injury-related parameters in male youth soccer players with patellar tendinopathy during return to competition. J Strength Cond Res 37(9): 1834-1843, 2023-Changes after a conventional (CON) vs. alternative (ALT) therapy program on physical, psychological, and injury-related or pain-related parameters in soccer players with patellar tendinopathy (PT) during return to competition were examined. Thirty-four male youth soccer players (15-16 years) with PT were randomly assigned to a CON ( n = 18) or ALT ( n = 16) program. The ALT program consisted of 60 minutes of balance training, eccentric and isometric exercises, static stretching, and a dual-task progression. The CON program consisted of 30 minutes of eccentric and isometric exercises and static stretching. Both programs were conducted until painlessness was reported during full training load. Assessments of muscle power (drop jump, jump and reach), change of direction speed (CODS) (acyclic sprint), speed (tapping, 30-m linear sprint), endurance (Yo-Yo intermittent recovery test level-1), the Achievement Motives Scale Sport, and injury-related or pain-related correlates were performed immediately, 6 weeks, 16 weeks, and 20 weeks after the respective therapy program. Players in the ALT group required a shorter program duration (ALT: 47.1 ± 15.6 days, CON: 58.2 ± 24.6 days) and achieved the same (muscle power, speed, endurance) or greater (CODS) improvements in physical performances, the same enhancements in psychological measures (achievement motives), and better values for injury-related or pain-related correlates (injury incidence, pain-related training interruptions). Results indicate that both programs effectively improve relevant outcome parameters in players with PT. The ALT therapy is more time efficient than the CON therapy. Therapists should consider this multimodal training program for effective treatment of athletes to shorten their return to competition time and minimize the risk of secondary injuries.
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Affiliation(s)
- Marc Niering
- Department of Health and Social Affairs, FHM Bielefeld-University of Applied Sciences, Bielefeld, Germany; and
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
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Wang S, Lyu B. Are Current Prophylactic Programs Effective in Preventing Patellar Tendinopathy in Athletes and Recruits? A Meta-Analysis and Trial Sequential Analysis. Sports Health 2023; 15:382-385. [PMID: 36146934 PMCID: PMC10170222 DOI: 10.1177/19417381221121808] [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] [Indexed: 11/16/2022] Open
Abstract
CONTEXT Patellar tendinopathy (PT), or jumper's knee, is a chronic painful overuse patellar tendon injury. For PT, prevention is more important than treatment. However, there is still a lack of strong evidence to confirm the effectiveness of prevention. OBJECTIVE This study will analyze by meta-analysis the effect of a prophylactic program on high PT risk people (but without PT) in reducing PT occurrence. DATA SOURCES PubMed, Embase, the Cochrane Library, Scopus, and Ebscohost, from inception to January 11, 2022. STUDY SELECTION A study comparing the effects of prophylactic programs and controls on the risk of PT was included in the analysis. After a database search with search terms ((patellar tendinopathy) OR (jumper's knee) OR (patellar tendinitis) OR (patellar tendinosis) OR (patellar tendonitis)) AND ((Prevent*) OR (prophyla*)), a total of 1444 items were obtained. Of these, 11 studies with 6091 participants were eligible for inclusion in this meta-analysis. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 2. DATA EXTRACTION The first author's name, publication year, study design, country, population, mean age, sex, prophylactic program, control, study duration, and the frequency or incidence of PT in each group were extracted. RESULTS A total of 11 articles were included in the analysis. Overall, no significant difference was considered in the risk of PT between the prophylactic program and control groups based on the random-effect model (odds ratio [OR], 0.85; 95% CI, 0.67, 1.08; P = 0.18). In the recruit subgroup, there was even a tendency to elevate the risk of PT occurrence after prophylaxis was executed (OR, 1.89; 95% CI, 0.68, 5.28; P = 0.22). In athletes, the prophylactic program tended to decrease the risk of PT compared with the control (OR, 0.81; 95% CI, 0.63, 1.04; P = 0.10); however, the difference was not statistically significant. Trial sequential analysis results suggested that prophylaxis may still be effective for athletes, but this needs to be confirmed with a larger sample size. CONCLUSION The risk of PT cannot be reduced with the current prophylactic program. However, for athletes, the negative results may be due to insufficient sample size.
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Affiliation(s)
- Shaowei Wang
- College of Physical Education, Hebei Normal
University, Hebei, People’s Republic of China
| | - Buwei Lyu
- Faculty of Public Physical Education, Hebei
Normal University, Hebei, People’s Republic of China
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Bi AS, Azam MT, Butler JJ, Alaia MJ, Jazrawi LM, Gonzalez-Lomas G, Kennedy JG. Increased incidence of acute achilles tendon ruptures in the peri-pandemic COVID era with parallels to the 2021-22 NFL season. Knee Surg Sports Traumatol Arthrosc 2023; 31:2160-2165. [PMID: 36645466 PMCID: PMC9842209 DOI: 10.1007/s00167-023-07309-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 01/02/2023] [Indexed: 01/17/2023]
Abstract
PURPOSE Acute Achilles tendon ruptures (AATRs) are a common sporting injury, whether for recreational athletes or elite athletes. Prior research has shown returning to physical activity after extended periods of inactivity leads to increased rates of musculoskeletal injuries. The purpose of this study was to investigate rates of acute Achilles' tendon ruptures at a single academic institute in the peri-COVID era, with corollary to the recent NFL season. METHODS A retrospective search was conducted using current procedural terminology to identify the total number of Achilles acute primary repair surgeries performed from years 2017 to 2021. Non-operatively managed AATRs were identified from the same electronic medical record using ICD-10 codes. NFL data were obtained from publicly available sites according to previously validated studies. RESULTS A total of 588 patients who sustained AATRs and underwent primary surgical repair were identified, primarily men (75.7%, n = 445), with an average age of 43.22 ± 14.4 years. The number and corresponding incidence of AATR repairs per year was: 2017: n = 124 (21.1%), 2018: n = 110 (18.7%), 2019: n = 130 (22.1%), 2020: n = 86 (14.6%), 2021: n = 138 (23.5%), indicating a 7.5% decrease in rate of AATRs from 2019 to 2020, followed by an 8.9% increase in incidence from 2020 to 2021. Within the NFL, the number of AATRs resulting in an injured reserve stint increased every regular season from 2019 to 2020: n = 11 (21.2%), to 2020-2021: n = 17 (32.7%), to this past 2021-2022 season: n = 24 (46.2%). CONCLUSION AATR surgeries seem to have increased in 2021 following a 2020 COVID pandemic-induced quarantine for recreational athletes at a single academic institution and for professional athletes in the NFL, although these results are of questionable clinical significance. This provides prognostic information when counseling patients and athletes on return to activity or sport. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Andrew S. Bi
- grid.240324.30000 0001 2109 4251Department of Orthopedic Surgery, NYU Langone Health, 301 E 17th St, New York, NY 10003 USA
| | - Mohammad T. Azam
- grid.240324.30000 0001 2109 4251Department of Orthopedic Surgery, Division of Foot and Ankle Surgery, NYU Langone Health, 171 Delancey St. 2nd Floor, New York, NY 10002 USA
| | - James J. Butler
- grid.240324.30000 0001 2109 4251Department of Orthopedic Surgery, Division of Foot and Ankle Surgery, NYU Langone Health, 171 Delancey St. 2nd Floor, New York, NY 10002 USA
| | - Michael J. Alaia
- grid.240324.30000 0001 2109 4251Department of Orthopedic Surgery, Division of Sports Medicine, NYU Langone Health, 333 East 38th St, 4th Floor, New York, NY 10016 USA
| | - Laith M. Jazrawi
- grid.240324.30000 0001 2109 4251Department of Orthopedic Surgery, Division of Sports Medicine, NYU Langone Health, 333 East 38th St, 4th Floor, New York, NY 10016 USA
| | - Guillem Gonzalez-Lomas
- grid.240324.30000 0001 2109 4251Department of Orthopedic Surgery, Division of Sports Medicine, NYU Langone Health, 333 East 38th St, 4th Floor, New York, NY 10016 USA
| | - John G. Kennedy
- grid.240324.30000 0001 2109 4251Department of Orthopedic Surgery, Division of Foot and Ankle Surgery, NYU Langone Health, 171 Delancey St. 2nd Floor, New York, NY 10002 USA
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Burton I. Interventions for prevention and in-season management of patellar tendinopathy in athletes: A scoping review. Phys Ther Sport 2022; 55:80-89. [DOI: 10.1016/j.ptsp.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 10/18/2022]
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Ready LV, Li NY, Worobey S, Lemme NJ, Yang DS, Yang J, Krill M, Owens BD. Influence of Preseason Versus In-Season Play on Achilles Tendon Injuries in the National Football League. Orthop J Sports Med 2021; 9:23259671211056083. [PMID: 34901290 PMCID: PMC8655453 DOI: 10.1177/23259671211056083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/24/2021] [Indexed: 11/22/2022] Open
Abstract
Background: A ruptured Achilles tendon (AT) can sideline a player for 6 to 12 months and reduce their power rankings by more than 50%. Previous research has compared AT rupture rates in different game conditions. Purpose: To determine environmental and physiological risk factors for AT tears, given the minimal amount of research on AT ruptures in the National Football League (NFL). Study Design: Case series; Level of evidence, 4. Methods: NFL players with a diagnosed AT tear between 2009 and 2016 were selected as the study population for this retrospective analysis. Data on NFL injury were collected from an established database composed of publicly available information. Player profiles were employed to determine position, team, and game statistics at the time of injury. The proportion of NFL rookies was approximated by summing the number of draft picks and the number of signed, undrafted free agents and measured against the number of roster spots before the season. Results: Between 2009 and 2016, there were 101 documented AT tears. Of these, 64% (65/101) occurred before the official season, including preseason games. Of the 36 tears that occurred in-season, 34 were during games. Overall, 29% (19/65) of the preseason tears occurred in rookies and 100% (36/36) of the in-season tears affected nonrookies. Of the rookies with AT ruptures, 42.11% returned to play in the NFL, while 62.20% of the nonrookies came back to partake in future seasons. Despite an average age of 26.7 years, the tear distribution was bimodal with players aged 24 and 36 years exhibiting the highest rates of tear. Conclusion: In our review of AT tears in NFL athletes, a large percentage of the tears occurred in rookie players, especially during the preseason. We also found that tears during the season occurred in only nonrookies, suggesting that the preseason is when rookies experience the greatest risk for injury.
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Affiliation(s)
- Lauren V Ready
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Neill Y Li
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | | | - Nicholas J Lemme
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Daniel S Yang
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - JaeWon Yang
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Michael Krill
- Department of Family Medicine, University of Iowa Sports Medicine, Iowa City, Iowa, USA
| | - Brett D Owens
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Bittencourt NFN, Oliveira RRD, Vaz RDPM, Silva RS, Mendonça LDM. Preventive effect of tailored exercises on patellar tendinopathy in elite youth athletes: A cohort study. Phys Ther Sport 2021; 53:60-66. [PMID: 34837804 DOI: 10.1016/j.ptsp.2021.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To investigate the effects of an intervention with tailored exercises on the incidence of patellar tendinopathy (PT) in elite youth jumping athletes. DESIGN Prospective crossover cohort. SETTING One sport club facility. PARTICIPANTS 271 elite youth basketball and volleyball player were followed in the first year of the study (Observation year) and 270 athletes were followed in the second year (intervention year). MAIN OUTCOME MEASURE Incidence rates of PT per 1,000h of exposure. Cox survival analysis was used to verify the effects of the intervention (exercises implemented according to the findings of a preseason assessment) on PT incidence. RESULTS The exercise prevention program significantly reduced the number of cases of PT, with athletes submitted to the intervention showing 51% less risk of developing PT. The overall PT incidence in the Observation year (5.9 per 1,000h of exposure) was significantly higher than that in the intervention year (2.8 per 1,000h of exposure) (P = .037). Twenty-six athletes developed PT in the observation year, whereas 13 athletes developed PT in the intervention year. CONCLUSIONS A tailored preventive program may be able to reduce the incidence of patellar tendinopathy, especially in male youth volleyball athletes. Randomized controlled trials are encouraged to confirm these findings.
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Affiliation(s)
- Natália Franco Neto Bittencourt
- Sports Physical Department - Minas Tênis Club, Belo Horizonte, MG, Brazil; Centro Universitário Uni-BH, Belo Horizonte, MG, Brazil; Tendon Research Group - Brazil, Fortaleza, CE, Brazil
| | - Rodrigo Ribeiro de Oliveira
- Tendon Research Group - Brazil, Fortaleza, CE, Brazil; Master Program in Physiotherapy and Functioning - Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Rodrigo Scattone Silva
- Tendon Research Group - Brazil, Fortaleza, CE, Brazil; Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande Do Norte, Santa Cruz, RN, Brazil; Postgraduate Program in Physical Therapy, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
| | - Luciana De Michelis Mendonça
- Tendon Research Group - Brazil, Fortaleza, CE, Brazil; Physical Therapy Department - Universidade Federal Dos Vales Do Jequitinhonha e Mucuri, Brazil; Programa de Pós-Graduação Em Reabilitação e Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha e Mucuri, Diamantina, Brazil.
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11
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Is the Integration of Additional Eccentric, Balance and Core Muscles Exercises into a Typical Soccer Program Effective in Improving Strength and Postural Stability? Sports (Basel) 2021; 9:sports9110147. [PMID: 34822347 PMCID: PMC8622779 DOI: 10.3390/sports9110147] [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: 08/30/2021] [Revised: 10/06/2021] [Accepted: 10/18/2021] [Indexed: 11/21/2022] Open
Abstract
Soccer teams integrate specific exercises into their typical workout programs for injury prevention. The purpose of this study was to investigate whether the incorporation of a brief and supplementary training program that involves eccentric, balance, and core exercises into the weekly soccer schedule can cause positive neuromuscular adaptations. Twenty-one soccer players were randomly allocated to either a training (n = 11) or a control group (n = 10). All players followed their teams’ typical program, consisting of 4–5 soccer-specific sessions plus 1 match, weekly. Training group players additionally performed biweekly, hamstring eccentric, balance, and core stability exercises for 8 weeks. Isokinetic concentric and eccentric peak torque (PT) of the hamstrings and quadriceps, changes in the center of pressure (COP) during a 30 s single-leg stance, and a supine bridge (trunk stability) test were assessed before and after the intervention. After the intervention, a 27% increase in hamstring concentric PT and a 33% reduction in COP sway in the stance test, were observed for the training group only (p < 0.05). These improvements were significant only for the non-dominant leg. Furthermore, the control group displayed an increase in COP sway during the bridge test compared to baseline values (p < 0.05), which reflects a deterioration in postural balance over time. Consequently, incorporating small doses of hamstring eccentric, proprioception, and core stability exercises into a typical training program of youth soccer players improves strength and postural balance in the non-dominant leg, as well as core muscle performance.
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von Rickenbach KJ, Borgstrom H, Tenforde A, Borg-Stein J, McInnis KC. Achilles Tendinopathy: Evaluation, Rehabilitation, and Prevention. Curr Sports Med Rep 2021; 20:327-334. [PMID: 34099611 DOI: 10.1249/jsr.0000000000000855] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Achilles tendinopathy is a common overuse condition that is characterized by degenerative, cumulative tissue microtrauma. It is largely a clinical diagnosis in which the patient typically presents with localized pain that is worse with tendon-loading activities. Imaging modalities may be helpful with the diagnosis of difficult cases or in the planning of interventional procedures. Midportion (noninsertional) and insertional tendinopathy have distinct features and differences for therapeutic paradigms. Overall, Achilles tendinopathy has a good clinical prognosis with most patients improving with activity modification and rehabilitation, with a focus on progressive tendon-loading. Recalcitrant cases may require adjuvant treatment with procedures (e.g., injections, shockwave therapy) and rarely surgical intervention.
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Hamstring Strain Injury (HSI) Prevention in Professional and Semi-Professional Football Teams: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168272. [PMID: 34444026 PMCID: PMC8394329 DOI: 10.3390/ijerph18168272] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022]
Abstract
Hamstring Strain Injuries (HSIs) are the most common type of lesion in professional footballers and the leading cause of absence days from sports. However, recent studies have shown that high-level football teams apparently do not apply any HSI prevention protocol. The aim of the study was to determine the effect of preventive strategies and protocols in reducing the incidence of hamstring muscle injuries in professional and semi-professional football teams. A literature search of PubMed/MEDLINE, ISI/Web of Science and Scopus databases was conducted with the keywords “hamstring* and (injury* or strain) and prevent* and (soccer or football)”. Quality and bias assessment was completed through the Kennelly modified scale. The Injury Incidence Rate (IIR) and the Incidence Rate Ratio (IRR) were assessed in the statistical analysis. In the meta-analysis, data were extracted, pooled and analysed with “Comprehensive Meta-Analysis Version 3.3.070” software. In total, 8 of the 1017 original search studies met the inclusion criteria of this review. The total exposure of the studies was 170,221.8 h, while the number of HSIs recorded was 165 in the intervention groups and 224 in the control groups. The average score of the quality assessment was 23.6/34. The meta-analysis of six of the eight included studies provided strong evidence that interventions are effective in reducing hamstring injuries. The IRR of the effect size was 0.443, with p-value = 0.001. The studies analysed applied different preventive strategies: the Nordic hamstring exercise, the FIFA 11+ programme and exercises for core stability or balance training. All these interventions proved to have a successful effect on prevention of hamstring injuries.
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14
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Kollock R, Thomas J, Hale D, Sanders G, Long A, Dawes J, Peveler W. The Effects of Firefighter Equipment and Gear on the Static and Dynamic Postural Stability of Fire Cadets. Gait Posture 2021; 88:292-296. [PMID: 34153807 DOI: 10.1016/j.gaitpost.2021.05.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/28/2021] [Accepted: 05/11/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Slips, trips, falls, and jumps were the second leading cause of injuries at the fireground. RESEARCH QUESTION The purpose of this study was to explore the effects of firefighter equipment and gear (EQG) on postural stability and determine if load per kg of body mass (L/BM) is associated with postural stability. METHODS 26 male fire cadets (26.15 ± 4.16 yr., 178.92 ± 6.92 cm, 86.61 ± 9.09 kg) were included in the analyses. Participants performed 3 single-leg landings (SLL) with and without EQG. The first 3 seconds of ground reaction forces following initial ground contact were used to calculate dynamic postural stability index (DPSI). Participants completed 2 static balance tasks (normal stability and limits of stability (LoS)) with and without EQG. Main outcome measures were overall LoS score (LoSS), direction-specific LoSS, and LoS distance (cm) of COP excursion (LoSD) in the anterior, posterior, right, and left directions. Separate paired-samples t-tests were run to determine the differences between load conditions for DPSI, overall LoSS, direction-specific LoSS, and LoSD in all directions. Bivariate correlations were conducted to determine the relationship of L/BM to DPSI, overall LoSS, and LoSS and LoSD in the anterior, posterior, right and left directions. RESULTS Due to the use of multiple statistical tests, a Bonferroni correction was used, and the alpha level of .05 was adjusted to .005. DPSI was significantly higher loaded than unloaded, t(25) = -13.965, p < .001, d = 7.032, 95% CI, -0.133 to -0.099. No other comparisons were significant. A significant strong positive correlation (r(24) = .665, p < .001) was observed between L/BM and DPSI. No other correlations were significant. SIGNIFICANCE This study demonstrates that firefighter EQG may significantly impact a cadet's ability to maintain postural stability while performing their duties.
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Affiliation(s)
- Roger Kollock
- The University of Tulsa, 800 S Tucker Drive, Tulsa, OK, 74104, USA.
| | - Jacob Thomas
- The University of Tulsa, 800 S Tucker Drive, Tulsa, OK, 74104, USA.
| | - Davis Hale
- The University of Tulsa, 800 S Tucker Drive, Tulsa, OK, 74104, USA.
| | - Gabriel Sanders
- Northern Kentucky University, Louie B Nunn Dr, Highland Heights, KY, 41099, USA.
| | - Alex Long
- The University of Tulsa, 800 S Tucker Drive, Tulsa, OK, 74104, USA.
| | - Jay Dawes
- Oklahoma State University, CRC 183, Stillwater, OK, 74078, USA.
| | - Will Peveler
- Liberty University, 1971 University Blvd, Lynchburg, VA, 24515, USA.
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15
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Exercise-Based Strategies to Prevent Muscle Injury in Elite Footballers: A Systematic Review and Best Evidence Synthesis. Sports Med 2021; 50:1653-1666. [PMID: 32185630 DOI: 10.1007/s40279-020-01282-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Exercise-based strategies are used to prevent muscle injuries in football and studies on different competitive-level populations may provide different results. OBJECTIVES To evaluate the effectiveness of exercise-based muscle injury prevention strategies in adult elite football. METHODS A systematic search was conducted in PubMed (MEDLINE), Web of Science, Cochrane Library, and SPORTDiscuss (EBSCO). We considered only elite adult (> 16 year-old) football players with no distinction for gender; the intervention to be any exercise/s performed with the target to prevent lower-limb muscle injuries; the comparison to be no injury prevention exercise undertaken; the outcome to be the number of injuries, injury incidence, and severity. We searched systematic reviews, randomized-controlled trials (RCTs), and non-randomized-controlled trials (NRCTs), limited for English language. Risk of bias was assessed using the Risk of Bias in Systematic Reviews tool, the Cochrane Collaboration's Tool for assessing risk of bias in RCTs, and the Risk of Bias in NRCTs of Interventions tool. RESULTS 15 studies were included. Three systematic reviews showed inconsistent results, with one supporting (high risk of bias) and two showing insufficient evidence (low risk of bias) to support exercise-based strategies to prevent muscle injuries in elite players. Five RCTs and seven NRCTs support eccentric exercise, proprioception exercises, and a multi-dimensional component to an injury prevention program; however, all were deemed to be at high/critical risk of bias. Only one RCT was found at low risk of bias and supported eccentric exercise for preventing groin problems. CONCLUSION We found limited scientific evidence to support exercise-based strategies to prevent muscle injury in elite footballers. TRIAL REGISTRATION NUMBER PROSPERO CRD42017077705.
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16
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Raya-Gonzalez J, Castillo D, Clemente FM. Injury prevention of hamstring injuries through exercise interventions. J Sports Med Phys Fitness 2021; 61:1242-1251. [PMID: 33480508 DOI: 10.23736/s0022-4707.21.11670-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Hamstring injuries are the most prevalent time-loss injuries in sport, mainly in those modalities characterized by high-intensity and short-term actions, especially accelerations and decelerations during high-speed running. Expanding the knowledge about this type of injury and its preventive programs could be a key strategy to reduce the hamstring injury incidence. Thus, this review aimed to study the effectiveness of different preventive programs based on exercise interventions on reducing the hamstring injury incidence in athletes. EVIDENCE ACQUISITION An umbrella review was conducted through of PubMed/MEDLINE, Scopus, SPORTDiscus, Web of Science, Cochrane Library and Physiotherapy Evidence Database databases. The methodological quality of the included systematic reviews was assessed through the Assessing the Methodological Quality of Systematic Reviews 2 and the quality of the evidence was evaluated using the modified Grading of Recommendations Assessment, Development and Evaluation principles. EVIDENCE SYNTHESIS Eight systematic reviews and meta-analysis (40 primary studies) met the inclusion criteria, which included interventions based on eccentric strength, Nordic hamstring, proprioceptive training, stretching, FIFA11 and combined programs. From the qualitative synthesizes, three studies showed that eccentric-based training programs were effective; seventeen studies reported that Nordic hamstring-based programs were effective; three studies observed that stability training-based interventions were effective; two studies indicated that flexibility were effective; three studies claimed that FIFA11+based programs were effective; and two studies reported that combined programs were effective. CONCLUSIONS Exercise is a key strategy to reduce the hamstring injury incidence, being programs based on eccentric strength mainly by means of Nordic hamstring exercise, and on stability training, those programs which reported greater effectiveness.
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Affiliation(s)
| | | | - Filipe M Clemente
- School of Sport and Leisure, Polytechnic Institute of Viana do Castelo, Viana do Castelo, Portugal
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17
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Güler Ö, Aras D, Akça F, Bianco A, Lavanco G, Paoli A, Şahin FN. Effects of Aerobic and Anaerobic Fatigue Exercises on Postural Control and Recovery Time in Female Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176273. [PMID: 32872251 PMCID: PMC7503876 DOI: 10.3390/ijerph17176273] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 12/20/2022]
Abstract
Sixteen female soccer players (age = 20.19 ± 1.52 years; body mass = 56.52 ± 4.95 kg; body height = 164.81 ± 4.21 cm) with no history of lower extremity injury participated in the study. The Biodex SD Balance system was used to determine the non-dominant single-leg stability. In anaerobic exercise, each subject performed four maximal cycling efforts against a resistance equivalent to 0.075 kg/body mass for 30 s with three-minute rest intervals. In aerobic exercise, subjects performed the Bruce protocol on a motorized treadmill. After each exercise, subjects subsequently performed a single-leg stability test and then repeated the same test for four times with five-minute passive rest periods. In accordance with the results, it was found that the impairment observed right after the aerobic loading was higher (p < 0.001) compared to the anaerobic one. However, the time-related deterioration in both aerobic and anaerobic loadings was similar. The B-pre value was lower than Bpost and B5 (p < 0.01) and B10 (p < 0.05) in both conditions. Subjects could reach the initial balance level at B15 after aerobic and anaerobic loadings. The lactate level did not reach resting value even after 20 min of both fatigue protocols. Although the fatigue after aerobic and aerobic exercise negatively affects a single-leg dynamic balance level, single leg balance ability returns to the baseline status after 10 min of passive recovery duration.
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Affiliation(s)
- Özkan Güler
- Faculty of Sports Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (Ö.G.); (D.A.); (F.A.); (F.N.Ş.)
| | - Dicle Aras
- Faculty of Sports Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (Ö.G.); (D.A.); (F.A.); (F.N.Ş.)
| | - Fırat Akça
- Faculty of Sports Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (Ö.G.); (D.A.); (F.A.); (F.N.Ş.)
| | - Antonino Bianco
- Department of Psychological, Pedagogical, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy;
- Correspondence: ; Tel.: +39-091-23896910
| | - Gioacchino Lavanco
- Department of Psychological, Pedagogical, Educational Science and Human Movement, University of Palermo, 90144 Palermo, Italy;
| | - Antonio Paoli
- Department of Biomedical Science, University of Padova, 35122 Padova, Italy;
| | - Fatma Neşe Şahin
- Faculty of Sports Sciences, Ankara University, Gölbaşı, Ankara 06830, Turkey; (Ö.G.); (D.A.); (F.A.); (F.N.Ş.)
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18
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Ishøi L, Krommes K, Husted RS, Juhl CB, Thorborg K. Diagnosis, prevention and treatment of common lower extremity muscle injuries in sport - grading the evidence: a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). Br J Sports Med 2020; 54:528-537. [PMID: 31937579 PMCID: PMC7212929 DOI: 10.1136/bjsports-2019-101228] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2019] [Indexed: 01/09/2023]
Abstract
This statement summarises and appraises the evidence on diagnosis, prevention and treatment of the most common lower extremity muscle injuries in sport. We systematically searched electronic databases, and included studies based on the highest available evidence. Subsequently, we evaluated the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework, grading the quality of evidence from high to very low. Most clinical tests showed very low to low diagnostic effectiveness. For hamstring injury prevention, programmes that included the Nordic hamstring exercise resulted in a hamstring injury risk reduction when compared with usual care (medium to large effect size; moderate to high quality of evidence). For prevention of groin injuries, both the FIFA 11+programme and the Copenhagen adductor strengthening programme resulted in a groin injury risk reduction compared with usual care (medium effect size; low to moderate quality of evidence). For the treatment of hamstring injuries, lengthening hamstring exercises showed the fastest return to play with a lower reinjury rate compared with conventional hamstring exercises (large effect size; very low to low quality of evidence). Platelet-rich plasma had no effect on time to return-to-play and reinjury risk (trivial effect size; moderate quality of evidence) after a hamstring injury compared with placebo or rehabilitation. At this point, most outcomes for diagnosis, prevention and treatment were graded as very low to moderate quality of evidence, indicating that further high-quality research is likely to have an important impact on the confidence in the effect estimates.
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Affiliation(s)
- Lasse Ishøi
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Sports Orthopedic Research Center - Copenhagen (SORC-C), Hvidovre, Denmark
| | - Kasper Krommes
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Sports Orthopedic Research Center - Copenhagen (SORC-C), Hvidovre, Denmark
| | - Rasmus Skov Husted
- Department of Orthopedic Surgery and Physical Therapy, Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Copenhagen University Hospital, Hvidovre, Denmark
- Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Carsten B Juhl
- Research Unit of Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kristian Thorborg
- Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Sports Orthopedic Research Center - Copenhagen (SORC-C), Hvidovre, Denmark
- Department of Orthopedic Surgery and Physical Therapy, Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Copenhagen University Hospital, Hvidovre, Denmark
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19
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Vatovec R, Kozinc Ž, Šarabon N. Exercise interventions to prevent hamstring injuries in athletes: A systematic review and meta-analysis. Eur J Sport Sci 2019; 20:992-1004. [PMID: 31680644 DOI: 10.1080/17461391.2019.1689300] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this meta-analysis was to assess the effectiveness of exercise-based interventions for prevention of hamstring injuries in sport. PubMed, Cochrane Central Register of Controlled Trials, Web of Science, ResearchGate, CINAHL, PEDro, ScienceDirect and Google Scholar databases were searched for randomized controlled trials and prospective cohort studies exploring the effects of exercise interventions on hamstring injury incidence. Subgroup analyses were performed to determine effects of several independent variables related to the interventions. Altogether, 17 studies were included. Exercise interventions decreased hamstring injury risk (RR = 0.49; 95%CI = 0.40-0.59; p < 0.001). There were similar effects found for interventions performed ≤2 times per week (RR = 0.35; 95%CI = 0.15-0.82) and the interventions performed >2 times per week (RR = 0.44; 95%CI = 0.31-0.61). Similarly, there were similar effects found for the interventions with progressive increase in load (RR = 0.53; 95%CI = 0.37-0.74) and the interventions with constant loads (RR = 0.46; 95%CI = 0.36-0.58). Other subgroup analyses (intervention supervision, sport type, inclusion of Nordic hamstring exercise and type of the trial) also showed no indications on specific characteristics of the interventions, that increase the preventive effects. Our findings showed that hamstring injury incidence can be decreased with exercise-based interventions, and that weekly frequency and load progression are not among the most important variables to consider in prevention programmes design.
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Affiliation(s)
- Rok Vatovec
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia.,Laboratory for Motor Control and Motor Behaviour, S2P, Science to practice, Ltd., Ljubljana, Slovenia
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20
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Andersson SH, Bahr R, Olsen MJ, Myklebust G. Attitudes, beliefs, and behavior toward shoulder injury prevention in elite handball: Fertile ground for implementation. Scand J Med Sci Sports 2019; 29:1996-2009. [DOI: 10.1111/sms.13522] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 05/01/2019] [Accepted: 07/21/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Stig Haugsboe Andersson
- Oslo Sports Trauma Research Center, Department of Sports Medicine Norwegian School of Sport Sciences Oslo Norway
| | - Roald Bahr
- Oslo Sports Trauma Research Center, Department of Sports Medicine Norwegian School of Sport Sciences Oslo Norway
| | - Magnus Johnsen Olsen
- Oslo Sports Trauma Research Center, Department of Sports Medicine Norwegian School of Sport Sciences Oslo Norway
| | - Grethe Myklebust
- Oslo Sports Trauma Research Center, Department of Sports Medicine Norwegian School of Sport Sciences Oslo Norway
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21
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22
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Heer ST, Callander JW, Kraeutler MJ, Mei-Dan O, Mulcahey MK. Hamstring Injuries: Risk Factors, Treatment, and Rehabilitation. J Bone Joint Surg Am 2019; 101:843-853. [PMID: 31045674 DOI: 10.2106/jbjs.18.00261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Steven T Heer
- Tulane University School of Medicine, New Orleans, Louisiana
| | | | | | - Omer Mei-Dan
- University of Colorado School of Medicine, Aurora, Colorado
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana
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23
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Abstract
Adolescent cricket pace bowlers are prone to non-contact shoulder, low back and lower-limb injuries. Exercise-based injury prevention programmes (IPPs) are effective for reducing non-contact injuries in athletes; however, a specific programme for adolescent pace bowlers has not been published. This paper therefore seeks to provide a rationale for the development of an exercise-based IPP specific for adolescent pace bowlers. It also outlines design principles and provides an example exercise programme that can be implemented at the community level. In addition, the paper addresses other injury prevention techniques concerned with the prescription of appropriate bowling loads and the modification of poor bowling biomechanics. Performing an exercise-based IPP before cricket training could reduce injury rates in adolescent pace bowlers. Eccentric strengthening exercises can be employed to target injuries to the posterior shoulder muscles, hip adductors and hamstring muscles. The risk of low back, knee and ankle injury could also be reduced with the inclusion of dynamic neuromuscular control exercises and trunk extensor endurance exercises. Other prevention strategies that need to be considered include the modification of poor bowling biomechanics, such as shoulder counter-rotation and lateral trunk flexion. Coaches and players should also aim to quantify bowling load accurately and coaches should use this information to prescribe appropriate individualised bowling loads. Specifically, players would benefit from avoiding both long periods of low load and acute periods when load is excessively high. Future evidence is needed to determine the effectiveness of the example programme outlined in this paper. It would also be beneficial to investigate whether the modification of bowling biomechanics is achievable at the non-elite level and if bowling load can be accurately measured and manipulated within a community-level population.
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24
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Vriend I, Gouttebarge V, Finch CF, van Mechelen W, Verhagen EALM. Intervention Strategies Used in Sport Injury Prevention Studies: A Systematic Review Identifying Studies Applying the Haddon Matrix. Sports Med 2018; 47:2027-2043. [PMID: 28303544 PMCID: PMC5603636 DOI: 10.1007/s40279-017-0718-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. OBJECTIVE Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. METHODS Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. RESULTS A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the 'pre-event' phase (n = 73) and the use of equipment to avoid injury in the 'event phase' (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). CONCLUSIONS Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention.
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Affiliation(s)
- Ingrid Vriend
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands.,Consumer Safety Institute VeiligheidNL, Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands.,Consumer Safety Institute VeiligheidNL, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Caroline F Finch
- Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia
| | - Willem van Mechelen
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands.,School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia.,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Evert A L M Verhagen
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,Amsterdam Collaboration on Health and Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands. .,Division of Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. .,Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia.
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25
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Gheidi N, Kernozek TW, Willson JD, Revak A, Diers K. Achilles tendon loading during weight bearing exercises. Phys Ther Sport 2018; 32:260-268. [DOI: 10.1016/j.ptsp.2018.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 04/18/2018] [Accepted: 05/08/2018] [Indexed: 01/18/2023]
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26
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Valle X, Alentorn-Geli E, Tol JL, Hamilton B, Garrett WE, Pruna R, Til L, Gutierrez JA, Alomar X, Balius R, Malliaropoulos N, Monllau JC, Whiteley R, Witvrouw E, Samuelsson K, Rodas G. Muscle Injuries in Sports: A New Evidence-Informed and Expert Consensus-Based Classification with Clinical Application. Sports Med 2018; 47:1241-1253. [PMID: 27878524 DOI: 10.1007/s40279-016-0647-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Muscle injuries are among the most common injuries in sport and continue to be a major concern because of training and competition time loss, challenging decision making regarding treatment and return to sport, and a relatively high recurrence rate. An adequate classification of muscle injury is essential for a full understanding of the injury and to optimize its management and return-to-play process. The ongoing failure to establish a classification system with broad acceptance has resulted from factors such as limited clinical applicability, and the inclusion of subjective findings and ambiguous terminology. The purpose of this article was to describe a classification system for muscle injuries with easy clinical application, adequate grouping of injuries with similar functional impairment, and potential prognostic value. This evidence-informed and expert consensus-based classification system for muscle injuries is based on a four-letter initialism system: MLG-R, respectively referring to the mechanism of injury (M), location of injury (L), grading of severity (G), and number of muscle re-injuries (R). The goal of the classification is to enhance communication between healthcare and sports-related professionals and facilitate rehabilitation and return-to-play decision making.
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Affiliation(s)
- Xavier Valle
- Medical Department, FC Barcelona, Ciutat Esportiva Joan Gamper, Av. Onze de Setembre, s/n, Sant Joan Despí, 08970, Barcelona, Spain. .,Sports Medicine School, Universitat de Barcelona, Barcelona, Spain. .,Mapfre Centre for Tennis Medicine, Barcelona, Spain. .,Department de Cirurgia de la Facultat de Medicina, 'Universitat Autònoma de Barcelona', Barcelona, Spain.
| | - Eduard Alentorn-Geli
- Department of Orthopaedic Surgery, Duke Sports Sciences Institute, Duke University, Durham, NC, USA
| | - Johannes L Tol
- Department of Sports Medicine, Aspetar, Doha, Qatar.,Department of Sports Medicine, The Sports Physician Group, OLVG-West, Amsterdam, The Netherlands.,Academic Center for Evidence Based Sports Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Bruce Hamilton
- Department of Sports Medicine, Aspetar, Doha, Qatar.,High Performance Sport NZ, Millenium Institute of Sport and Health, Auckland, New Zealand
| | - William E Garrett
- Department of Orthopaedic Surgery, Duke Sports Sciences Institute, Duke University, Durham, NC, USA
| | - Ricard Pruna
- Medical Department, FC Barcelona, Ciutat Esportiva Joan Gamper, Av. Onze de Setembre, s/n, Sant Joan Despí, 08970, Barcelona, Spain
| | - Lluís Til
- Medical Department, FC Barcelona, Ciutat Esportiva Joan Gamper, Av. Onze de Setembre, s/n, Sant Joan Despí, 08970, Barcelona, Spain.,High Performance Centre, Health Consortium of Terrassa, Barcelona, Spain
| | - Josep Antoni Gutierrez
- Medical Department, FC Barcelona, Ciutat Esportiva Joan Gamper, Av. Onze de Setembre, s/n, Sant Joan Despí, 08970, Barcelona, Spain.,Sport Catalan Council, Generalitat de Catalunya, Barcelona, Spain
| | | | - Ramón Balius
- Mapfre Centre for Tennis Medicine, Barcelona, Spain.,Sport Catalan Council, Generalitat de Catalunya, Barcelona, Spain
| | - Nikos Malliaropoulos
- Musculoskeletal Department, Thessaloniki Sports Medicine Clinic, Thessaloníki, Greece.,Department of Rheumatology, Sports Clinic, Mile End Hospital, Barts Health NHS Trust, London, UK
| | - Joan Carles Monllau
- Department of Orthopaedic Surgery, Parc de Salut Mar-Hospital del Mar and Hospital de l'Esperança, Universitat Autònoma de Barcelona, Barcelona, Spain.,Hospital Universitari Dexeus (ICATME), Barcelona, Spain
| | - Rodney Whiteley
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Erik Witvrouw
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Kristian Samuelsson
- Department of Orthopaedic Surgery, Sahlgrenska Academy, University of Gothenburg, Göteburg, Sweden
| | - Gil Rodas
- Medical Department, FC Barcelona, Ciutat Esportiva Joan Gamper, Av. Onze de Setembre, s/n, Sant Joan Despí, 08970, Barcelona, Spain
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Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2018. J Orthop Sports Phys Ther 2018; 48:A1-A38. [PMID: 29712543 DOI: 10.2519/jospt.2018.0302] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to midportion Achilles tendinopathy. J Orthop Sports Phys Ther 2018;48(5):A1-A38. doi:10.2519/jospt.2018.0302.
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Sussman WI, Mautner K, Malanga G. The role of rehabilitation after regenerative and orthobiologic procedures for the treatment of tendinopathy: a systematic review. Regen Med 2018. [DOI: 10.2217/rme-2017-0110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: Significant variability exists in the literature, with no clear consensus to the optimal protocol after a regenerative procedure. Given this uncertainty, the authors systematically reviewed the literature cataloging the different variables that may influence outcomes. Methods: Search was limited to randomized clinical trials and prospective cohort studies of regenerative procedures for the treatment of tendinopathy. Variables were predetermined, and included: cyrotherapy, pre- and post-procedure nonsteroidal anti-inflammatory drugs use, recommendations for alternative pain medications, immobilization and duration of rest. Variables were categorized based on the influence of the intervention on the three phases of healing. Results: 749 studies were assessed for eligibility, and 60 studies were included. Significant variability existed in the literature. Conclusion: Despite the importance of rehabilitation after regenerative procedures, there is a paucity of evidence available to guide clinicians and highlights the need for additional validation.
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Affiliation(s)
- Walter I Sussman
- Department of Physical Medicine & Rehabilitation, Tufts University, Boston, MA 02111, USA
- Orthopedic Care Physician Network, N Easton, MA 02356, USA
| | - Ken Mautner
- Department of Physical Medicine & Rehabilitation & Department of Orthopedics, Emory University, Atlanta, GA 30329, USA
| | - Gerard Malanga
- Department of Physical Medicine & Rehabilitation, Rutgers School of Medicine University of Medicine & Density, Newark, NJ 07101, USA
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Ghareeb DM, McLaine AJ, Wojcik JR, Boyd JM. Effects of Two Warm-up Programs on Balance and Isokinetic Strength in Male High School Soccer Players. J Strength Cond Res 2017; 31:372-379. [PMID: 27243911 DOI: 10.1519/jsc.0000000000001509] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ghareeb, DM, McLaine, AJ, Wojcik, JR, and Boyd, JM. Effects of two warm-up programs on balance and isokinetic strength in male high school soccer players. J Strength Cond Res 31(2): 372-379, 2017-One of the most common warm-up programs used to prevent injury in soccer, FIFA11+, integrates aerobic, strength, and balance. The purpose of this study was to compare FIFA11+ to a new warm-up program (NWP) on balance and isokinetic strength of the quadriceps and hamstrings at 60, 180, and 300°·s in male high school soccer players. Participants at one school (n = 17) performed the NWP before practice for 6 weeks during one soccer season, whereas participants at another school (n = 17) performed FIFA11+. There were no differences at baseline. At posttest, players in NWP significantly improved (p < 0.01) in Overall Stability Index Balance, Anterior/Posterior Index Balance, and Medial Lateral Index with large effect sizes (ES) > 1.3. No changes were seen in FIFA11+. Isokinetic strength peak torque increased at 60°·s in the quadriceps and hamstrings in dominant and nondominant legs in NWP (p < 0.01, ES, 0.59-1.02) and in hamstrings in FIFA11+ (p ≤ 0.05, ES, 0.32-0.40). At 180°·s, NWP improved peak torque (p < 0.01, ES, 0.74-0.90) except hamstrings in the nondominant leg, whereas FIFA11+ showed improvements across all muscle groups (p < 0.01), but with smaller ES, 0.25-0.84. Both programs improved isokinetic peak torque at 300°·s except hamstrings in the nondominant leg in NWP, although ES were higher in NWP (ES, 0.60-1.03) than FIFA11+ (ES, 0.31-0.42). The NWP seems to be effective for soccer conditioning by improving balance and isokinetic strength.
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Affiliation(s)
- Dana M Ghareeb
- Department of Physical Education, Sport, & Human Performance, Winthrop University, Rock Hill, South Carolina
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Injury Prevention Exercise Programs for Professional Soccer: Understanding the Perceptions of the End-Users. Clin J Sport Med 2017; 27:1-9. [PMID: 26829608 DOI: 10.1097/jsm.0000000000000291] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the perceptions of professional soccer players and staff members toward injury prevention exercise programs (IPEPs). DESIGN Self-report survey. SETTING Four professional soccer teams in 4 different countries. PARTICIPANTS 126 players, coaches, physiotherapists, and fitness coaches were invited to participate, with 72 respondents. MAIN OUTCOME MEASURES Web-based survey detailing perceptions of lower limb (LL) injury susceptibility and seriousness, the value of IPEPs in general, and more specifically the International Federation of Association Football (FIFA) 11+. RESULTS The vast majority of the respondents believed that professional soccer players are at high risk of LL injuries (93%) and that players should perform evidence-based injury prevention exercises (98%). They also agreed that LL injuries can shorten a player's career (85%), cause physical problems later in life (82%), and negatively impact on team performance (77%). However, perceptions varied across teams regarding which types of injury prevention exercises are effective, who holds responsibility for injury prevention, and when IPEPs should be performed. Specific knowledge of the FIFA 11+ was very low and 47% of respondents believed the program would need modification for use in their team. CONCLUSIONS Players and staff members in professional soccer teams strongly support the use of evidence-based IPEPs. However, perceptions vary considerably between teams regarding which exercises can prevent injuries, who holds the responsibility for injury prevention, and when preventive exercises should be performed. Enhancing the ultimate impact of IPEPs in professional soccer requires a detailed understanding of each team's specific implementation context.
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The Accuracy of the VISA-P Questionnaire, Single-Leg Decline Squat, and Tendon Pain History to Identify Patellar Tendon Abnormalities in Adult Athletes. J Orthop Sports Phys Ther 2016; 46:673-80. [PMID: 27374017 DOI: 10.2519/jospt.2016.6192] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Cross-sectional clinical assessment. Background Patellar tendinopathy is not always accompanied by patellar tendon abnormalities (PTAs). Thus, clinical screening tools to help identify patients with patellar tendon pain who have PTAs could enhance clinical decision making and patient prognosis. Objectives To test the diagnostic accuracy of the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire, a single-leg decline squat (SLDS), tendon pain history, age, and years of sports participation to identify athletes with symptomatic patellar tendons who have PTAs confirmed on imaging. Methods Data provided by ultrasound examination, the VISA-P questionnaire, the SLDS, tendon pain history, age, and years of sport participation were collected in 43 athletes. A classification and regression tree (CART) model was developed to verify variables associated with PTA occurrence. Likelihood ratios (LRs) were computed for positive and negative tests. Results The SLDS, VISA-P questionnaire, and tendon pain history were associated with PTA occurrence. Athletes with negative results on all 3 tests (CART model) had a lower likelihood of having PTAs (negative LR = 0.3; 95% confidence interval [CI]: 0.2, 0.5). The isolated use of the SLDS or tendon pain history (positive LR = 4.2; 95% CI: 2.3, 7.14 and 4.5; 95% CI: 1.8, 11.1, respectively) had similar influence on probability of PTA presence compared to the CART model (positive LR = 4.1; 95% CI: 2.5, 6.3). Conclusion Although the objective was to investigate a clinical test to identify PTAs, the combined use of the tests had greater accuracy to identify individuals without PTAs. Level of Evidence Diagnosis, level 3b. J Orthop Sports Phys Ther 2016;46(8):673-680. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6192.
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Moral-Muñoz JA, Esteban-Moreno B, Arroyo-Morales M, Cobo MJ, Herrera-Viedma E. Agreement Between Face-to-Face and Free Software Video Analysis for Assessing Hamstring Flexibility in Adolescents. J Strength Cond Res 2016; 29:2661-5. [PMID: 26313580 DOI: 10.1519/jsc.0000000000000896] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The objective of this study was to determine the level of agreement between face-to-face hamstring flexibility measurements and free software video analysis in adolescents. Reduced hamstring flexibility is common in adolescents (75% of boys and 35% of girls aged 10). The length of the hamstring muscle has an important role in both the effectiveness and the efficiency of basic human movements, and reduced hamstring flexibility is related to various musculoskeletal conditions. There are various approaches to measuring hamstring flexibility with high reliability; the most commonly used approaches in the scientific literature are the sit-and-reach test, hip joint angle (HJA), and active knee extension. The assessment of hamstring flexibility using video analysis could help with adolescent flexibility follow-up. Fifty-four adolescents from a local school participated in a descriptive study of repeated measures using a crossover design. Active knee extension and HJA were measured with an inclinometer and were simultaneously recorded with a video camera. Each video was downloaded to a computer and subsequently analyzed using Kinovea 0.8.15, a free software application for movement analysis. All outcome measures showed reliability estimates with α > 0.90. The lowest reliability was obtained for HJA (α = 0.91). The preliminary findings support the use of a free software tool for assessing hamstring flexibility, offering health professionals a useful tool for adolescent flexibility follow-up.
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Affiliation(s)
- José A Moral-Muñoz
- Departments of 1Library Science; and 2Physical Therapy, University of Granada, Granada, Spain; 3Department of Physical Therapy, University of Granada, Granada, Spain; 4Department of Computer Science, University of Cádiz, Cádiz, Spain; and 5Department of Computer Science and Artificial Intelligence, CITIC-UGR (Research Center on Information and Communications Technology), University of Granada, Granada, Spain
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Di Trani Lobacz A, Glutting J, Kaminski TW. Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries. J Athl Train 2016; 51:162-74. [PMID: 26942659 DOI: 10.4085/1062-6050-51.3.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Hamstrings strain injuries (HSIs) are among the most commonly occurring injuries in sport and are top causes of missed playing time. Lingering symptoms, prolonged recovery, and a high reinjury rate (12%-34%) make HSI management a frustrating and challenging process for the athletic trainer (AT). The clinical practice patterns and opinions of ATs regarding HSI treatment and rehabilitation are unknown. OBJECTIVE To examine the frequency of method use and opinions about current HSI management among ATs. DESIGN Cross-sectional study. SETTING Survey administered to registrants at the 2013 National Athletic Trainers' Association Clinical Symposia and AT Expo. PATIENTS OR OTHER PARTICIPANTS A total of 1356 certified ATs (691 men, 665 women; age = 35.4 ± 10.5 years, time certified = 11.92 ± 9.75 years). DATA COLLECTION AND ANALYSIS A survey was distributed electronically to 7272 registrants and on paper to another 700 attendees. Validity and reliability were established before distribution. Participants reported demographic information and rated their frequency of treatment and rehabilitation method use and agreement with questions assessing confidence, satisfaction, and desire for better clinical practice guidelines. Exploratory factor analysis and principal axis factor analysis were used. We also calculated descriptive statistics and χ(2) tests to assess practice patterns. RESULTS The response rate was 17% (n = 1356). A 2-factor solution was accepted for factor analysis (r = 0.76, r = 0.70), indicating that ATs follow either a contemporary or traditional management style. Various practice patterns were evident across employment settings and years of clinical experience. Satisfaction with the current HSI management plan was high (73.6%), whereas confidence in returning an athlete to play was lower (62.0%). Rates of use were associated with belief in effectiveness for all methods assessed (P < .001). Higher confidence levels were associated with high use of several methods; we observed increased satisfaction (χ(2)2 = 22.5, P = .002) but not increased confidence levels in more experienced ATs. CONCLUSIONS Our study demonstrated the lack of consensus in HSI treatment and rehabilitation and the ATs' desire for better clinical practice guidelines. Future research in which multimodal strategies, including both traditional and contemporary methods, are studied is warranted for effective management of HSI.
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Peters JA, Zwerver J, Diercks RL, Elferink-Gemser MT, van den Akker-Scheek I. Preventive interventions for tendinopathy: A systematic review. J Sci Med Sport 2016; 19:205-211. [DOI: 10.1016/j.jsams.2015.03.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 03/04/2015] [Accepted: 03/23/2015] [Indexed: 01/03/2023]
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Groot HE, van der Worp H, Nijenbanning L, Diercks RL, Zwerver J, van den Akker-Scheek I. Is proprioception diminished in patients with patellar tendinopathy? Gait Posture 2016; 45:224-8. [PMID: 26979910 DOI: 10.1016/j.gaitpost.2016.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 01/25/2016] [Accepted: 02/09/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE Patellar tendinopathy is a highly prevalent overuse injury, and most treatments are only effective to some extent. This persistence of complaints could be linked to changed proprioception. One study showed diminished proprioception in athletes with lateral epicondylitis. Aim of this study was to determine differences in proprioception, by measuring threshold to detect passive motion (TTDPM) between recreational athletes diagnosed with patellar tendinopathy and healthy controls. METHOD The TTDPM as measure of proprioception was determined in 22 recreational athletes with patellar tendinopathy and 22 healthy recreational athletes using a validated instrument. Amount of knee flexion and extension before the movement was noticed by the subject was determined. 80 measurements per athlete (left and right leg, towards extension and flexion and with two starting angles of 20° and 40° flexion) were performed. Mean TTDPM was compared between groups and among the injured recreational athletes between the affected and unaffected knee. RESULTS No significant difference in TTDPM was found between recreational athletes with patellar tendinopathy and healthy controls. We did find a significant difference between the injured and non-injured knee in recreational athletes with patellar tendinopathy; mean TTDPM was 0.02° higher in the injured knee (p=0.044). CONCLUSION No difference was found in proprioception between recreational athletes with patellar tendinopathy and healthy recreational athletes. It is unclear whether such a small difference in TTDPM between affected and unaffected knee is important in clinical setting.
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Affiliation(s)
- H E Groot
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - H van der Worp
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - L Nijenbanning
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - R L Diercks
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - J Zwerver
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
| | - I van den Akker-Scheek
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, The Netherlands.
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Ksibi I, Mrabet A, Mathlouthi H, Maaoui R, Bejaoui A, Rahali Khachlouf H. Évaluation instrumentale du profil postural chez des handballeurs. Étude pilote à propos de 24 handballeurs. Sci Sports 2016. [DOI: 10.1016/j.scispo.2015.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Valle X, L.Tol J, Hamilton B, Rodas G, Malliaras P, Malliaropoulos N, Rizo V, Moreno M, Jardi J. Hamstring Muscle Injuries, a Rehabilitation Protocol Purpose. Asian J Sports Med 2015; 6:e25411. [PMID: 26715969 PMCID: PMC4691307 DOI: 10.5812/asjsm.25411] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/28/2015] [Accepted: 02/06/2015] [Indexed: 11/22/2022] Open
Abstract
Context: Hamstring acute muscle injuries are prevalent in several sports including AFL football (Australian Football League), sprinting and soccer, and are often associated with prolonged time away from sport. Evidence Acquisition: In response to this, research into prevention and management of hamstring injury has increased, but epidemiological data shows no decline in injury and re-injury rates, suggesting that rehabilitation programs and return to play (RTP) criteria have to be improved. There continues to be a lack of consensus regarding how to assess performance, recovery and readiness to RTP, following hamstring strain injury. Results: The aim of this paper was to propose rehabilitation protocol for hamstring muscle injuries based on current basic science and research knowledge regarding injury demographics and management options. Conclusions: Criteria-based (subjective and objective) progression through the rehabilitation program will be outlined along with exercises for each phase, from initial injury to RTP.
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Affiliation(s)
- Xavier Valle
- Football Club Barcelona, Medical Department, Barcelona, Spain
- Corresponding author: Xavier Valle, Football Club Barcelona, Medical Department, Barcelona, Spain. Tel: +34-699416359, Fax: +34-934963664, E-mail:
| | | | - Bruce Hamilton
- Sports Medicine Department, Millenium Institute of Sport and Health, Auckland, New Zealand
| | - Gil Rodas
- Football Club Barcelona, Medical Department, Barcelona, Spain
| | - Peter Malliaras
- Sports Medicine Department, Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Nikos Malliaropoulos
- Sports Medicine Department, Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
- Musculoskeletal Department, Thessaloniki Sports Medicine Clinic, Thessaloniki, Greece
| | - Vicenc Rizo
- Football Club Barcelona, Medical Department, Barcelona, Spain
| | - Marcel Moreno
- Football Club Barcelona, Medical Department, Barcelona, Spain
| | - Jaume Jardi
- Football Club Barcelona, Medical Department, Barcelona, Spain
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Clinical principles in the management of hamstring injuries. Knee Surg Sports Traumatol Arthrosc 2015; 23:2449-2456. [PMID: 24556933 DOI: 10.1007/s00167-014-2912-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 02/09/2014] [Indexed: 01/12/2023]
Abstract
PURPOSE Hamstring injuries are among the most common muscle injuries seen in sports clinical practice. This narrative review covers essential knowledge of hamstring injuries, ranging from strains to total proximal three-tendon ruptures. The primary aim is to provide basic information for clinicians and sports medicine therapists dealing with hamstring problems. METHODS In this review, existing literature of hamstring injuries was taken together. Emphasis was given to subjects less well covered in previous reviews, such as preventive measures, as well as the most relevant information needed in the treatment of these injuries. RESULTS Occasionally, symptoms remain after hamstring injuries which can be successfully treated with surgery. Knowledge of the effectiveness of preventive measures and nonsurgical and surgical treatment is limited by small studies of low evidence level. CONCLUSIONS Evidence-based treatment algorithms are not available. Larger studies of better quality with more concrete grading of hamstring tears are needed to improve knowledge in prevention and treatment of hamstring injuries. LEVEL OF EVIDENCE IV.
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Alzahrani MM, Aldebeyan S, Abduljabbar F, Martineau PA. Hamstring Injuries in Athletes: Diagnosis and Treatment. JBJS Rev 2015; 3:01874474-201506000-00005. [PMID: 27490012 DOI: 10.2106/jbjs.rvw.n.00108] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Mohammad M Alzahrani
- Division of Orthopaedic Surgery, McGill University Health Center, 1650 Cedar Avenue, A5-175, Montreal, Quebec H3G 1A4, Canada
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Goossens L, Cardon G, Witvrouw E, Steyaert A, De Clercq D. A multifactorial injury prevention intervention reduces injury incidence in Physical Education Teacher Education students. Eur J Sport Sci 2015; 16:365-73. [PMID: 25768808 DOI: 10.1080/17461391.2015.1015619] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Physical Education Teacher Education (PETE) students are at considerable risk for non-contact sports injuries of the lower extremities. Multifactorial injury prevention interventions including exercises have been successful in sports populations, but no such study has ever been performed in PETE students. This study investigated the efficacy of a multifactorial injury prevention intervention on injury incidence reduction in PETE students. PETE students in the intervention group (n = 154) and in the control group (n = 189) registered sports injuries prospectively. The intervention lasted one academic year and consisted of an injury awareness programme and preventive strategies, implemented by the PETE sports lecturers. Differences in injury incidence between the intervention and control group were tested by Poisson regression Wald tests. There was a trend towards significantly lower incidence rate (2.18 vs. 2.73; p = 0.061) in the intervention group compared with the control group. Students in the intervention group had significantly less acute, first-time and extracurricular injuries. The largest reduction was observed for injuries during unsupervised practice sessions. A multifactorial injury prevention intervention embedded into a regular PETE programme is a promising and feasible strategy to prevent injuries in PETE students. Further research is needed to investigate whether the results may be generalised to other PETE programmes.
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Affiliation(s)
- L Goossens
- a Department for Movement and Sports Sciences , Ghent University , Ghent , Belgium
| | - G Cardon
- a Department for Movement and Sports Sciences , Ghent University , Ghent , Belgium
| | - E Witvrouw
- b Department of Rehabilitation and Physiotherapy , Ghent University , Ghent , Belgium.,c Aspetar Orthopaedic and Sports Medicine Hospital , Doha , Qatar
| | - A Steyaert
- d Department of Physical Medicine and Orthopaedic Surgery , Ghent University , Ghent , Belgium
| | - D De Clercq
- a Department for Movement and Sports Sciences , Ghent University , Ghent , Belgium
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Baltich J, Emery CA, Stefanyshyn D, Nigg BM. The effects of isolated ankle strengthening and functional balance training on strength, running mechanics, postural control and injury prevention in novice runners: design of a randomized controlled trial. BMC Musculoskelet Disord 2014; 15:407. [PMID: 25471989 PMCID: PMC4295291 DOI: 10.1186/1471-2474-15-407] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 11/24/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Risk factors have been proposed for running injuries including (a) reduced muscular strength, (b) excessive joint movements and (c) excessive joint moments in the frontal and transverse planes. To date, many running injury prevention programs have focused on a "top down" approach to strengthen the hip musculature in the attempt to reduce movements and moments at the hip, knee, and/or ankle joints. However, running mechanics did not change when hip muscle strength increased. It could be speculated that emphasis should be placed on increasing the strength of the ankle joint for a "ground up" approach. Strengthening of the large and small muscles crossing the ankle joint is assumed to change the force distribution for these muscles and to increase the use of smaller muscles. This would be associated with a reduction of joint and insertion forces, which could have a beneficial effect on injury prevention. However, training of the ankle joint as an injury prevention strategy has not been studied. Ankle strengthening techniques include isolated strengthening or movement-related strengthening such as functional balance training. There is little knowledge about the efficacy of such training programs on strength alteration, gait or injury reduction. METHODS/DESIGN Novice runners will be randomly assigned to one of three groups: an isolated ankle strengthening group (strength, n = 40), a functional balance training group (balance, n = 40) or an activity-matched control group (control, n = 40). Isokinetic strength will be measured using a Biodex System 3 dynamometer. Running kinematics and kinetics will be assessed using 3D motion analysis and a force platform. Postural control will be assessed by quantifying the magnitude and temporal structure of the center of pressure trace during single leg stance on a force platform. The change pre- and post-training in isokinetic strength, running mechanics, and postural control variables will be compared following the interventions. Injuries rates will be compared between groups over 6 months. DISCUSSION Avoiding injury will allow individuals to enjoy the benefits of participating in aerobic activities and reduce the healthcare costs associated with running injuries. TRIAL REGISTRATION Current Controlled Trial NCT01900262.
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Affiliation(s)
- Jennifer Baltich
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
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The Implementation of Musculoskeletal Injury-Prevention Exercise Programmes in Team Ball Sports: A Systematic Review Employing the RE-AIM Framework. Sports Med 2014; 44:1305-18. [DOI: 10.1007/s40279-014-0208-4] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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44
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Andrew N, Gabbe BJ, Cook J, Lloyd DG, Donnelly CJ, Nash C, Finch CF. Could targeted exercise programmes prevent lower limb injury in community Australian football? Sports Med 2014; 43:751-63. [PMID: 23681448 DOI: 10.1007/s40279-013-0056-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. OBJECTIVE The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. METHODS The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. RESULTS Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most (n = 27 [57%]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. CONCLUSIONS Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football.
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Affiliation(s)
- Nadine Andrew
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Owen AL, Wong DP, Dellal A, Paul DJ, Orhant E, Collie S. Effect of an Injury Prevention Program on Muscle Injuries in Elite Professional Soccer. J Strength Cond Res 2013; 27:3275-85. [DOI: 10.1519/jsc.0b013e318290cb3a] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Grooms DR, Palmer T, Onate JA, Myer GD, Grindstaff T. Soccer-specific warm-up and lower extremity injury rates in collegiate male soccer players. J Athl Train 2013; 48:782-9. [PMID: 23848519 PMCID: PMC3867089 DOI: 10.4085/1062-6050-48.4.08] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effects but have had limited adoption across athletic settings. This may be due to program noncompliance, minimal exercise supervision, lack of exercise progression, and sport specificity. A soccer-specific program described as the F-MARC 11+ was developed by an expert group in association with the Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) to require minimal equipment and implementation as part of regular soccer training. The F-MARC 11+ has been shown to reduce injury risk in youth female soccer players but has not been evaluated in an American male collegiate population. OBJECTIVE To investigate the effects of a soccer-specific warm-up program (F-MARC 11+) on lower extremity injury incidence in male collegiate soccer players. DESIGN Cohort study. SETTING One American collegiate soccer team followed for 2 seasons. PATIENTS OR OTHER PARTICIPANTS Forty-one male collegiate athletes aged 18-25 years. INTERVENTION(S) The F-MARC 11+ program is a comprehensive warm-up program targeting muscular strength, body kinesthetic awareness, and neuromuscular control during static and dynamic movements. Training sessions and program progression were monitored by a certified athletic trainer. MAIN OUTCOME MEASURE(S) Lower extremity injury risk and time lost to lower extremity injury. RESULTS The injury rate in the referent season was 8.1 injuries per 1000 exposures with 291 days lost and 2.2 injuries per 1000 exposures and 52 days lost in the intervention season. The intervention season had reductions in the relative risk (RR) of lower extremity injury of 72% (RR = 0.28, 95% confidence interval = 0.09, 0.85) and time lost to lower extremity injury (P < .01). CONCLUSIONS This F-MARC 11+ program reduced overall risk and severity of lower extremity injury compared with controls in collegiate-aged male soccer athletes.
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Affiliation(s)
| | | | | | - Gregory D. Myer
- The Ohio State University, Columbus
- Cincinnati Children's Hospital Medical Center, Sports Medicine Biodynamics Center and Human Performance Laboratory, OH
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Ricotti L, Rigosa J, Niosi A, Menciassi A. Analysis of balance, rapidity, force and reaction times of soccer players at different levels of competition. PLoS One 2013; 8:e77264. [PMID: 24130870 PMCID: PMC3795057 DOI: 10.1371/journal.pone.0077264] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 08/30/2013] [Indexed: 11/25/2022] Open
Abstract
In the present study we analyzed 12 physical parameters, namely force, static and dynamic balance (both quantified by means of 4 parameters each), rapidity, visual reaction times and acoustic reaction times, over 185 subjects. 170 of them played soccer in teams enrolled in all the ten different Italian soccer leagues. Results show that 6 parameters (out of the 12 analyzed) permit to identify and discriminate top-level players, among those showing the same training frequency. The other parameters are strictly related to training frequency or do not discriminate among players or control subjects (non-athletes), such as visual and acoustic reaction times. Principal component analysis permits to identify 4 clusters of subjects with similar performances, thus representing a useful instrument to characterize the overall ability of players in terms of athletic characteristics, on the basis of their location on the principal component parameters plane.
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Affiliation(s)
- Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pontedera (Pisa), Italy
- * E-mail:
| | - Jacopo Rigosa
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pontedera (Pisa), Italy
| | - Alberto Niosi
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pontedera (Pisa), Italy
| | - Arianna Menciassi
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pontedera (Pisa), Italy
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Performance enhancement effects of Fédération Internationale de Football Association's "The 11+" injury prevention training program in youth futsal players. Clin J Sport Med 2013; 23:318-20. [PMID: 23528840 DOI: 10.1097/jsm.0b013e318285630e] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate if Fédération Internationale de Football Association's "The 11+" injury prevention program improves physical fitness and technical performance in youth futsal players. DESIGN Randomized cohort study. SETTING Futsal club. PARTICIPANTS Thirty-six futsal players (17.3 ± 0.7 years). INTERVENTION Players were randomized to an intervention group (n = 18) or a control group (n = 18). Intervention group performed "The 11+" twice per week for 12 weeks. MAIN OUTCOME MEASURES Isokinetic testing to access maximal quadriceps (Q) and hamstring (H) strength, vertical jump (squat jump, SJ; countermovement jump, CMJ), 5-m and 30-m sprint, agility, slalom, and balance performances were also measured. RESULTS Intervention group increased (P < 0.05) quadriceps concentric (14.7%-27.3%) and hamstrings concentric (9.3%-13.3%) and eccentric (12.7%) peak torque. Intervention group improved functional H:Q ratio by 1.8% to 8.5% (P < 0.05). Intervention group improved (P < 0.05) SJ (13.8%) and CMJ (9.9%) and 5-m and 30-m sprint (8.9% and 3.3%, respectively), agility (4.7%), and slalom (4.8%) performances. Intervention group also improved balance, by decreasing the number of falls by 30% in the nondominant limb. No changes were observed in control group. CONCLUSIONS The results suggest that 'The 11+' can be used as an effective conditioning means for improving physical fitness and technical performance of youth futsal players.
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Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: a randomized clinical trial. J Orthop Sports Phys Ther 2013; 43:284-99. [PMID: 23485730 PMCID: PMC3751188 DOI: 10.2519/jospt.2013.4452] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Randomized, double-blind, parallel-group clinical trial. OBJECTIVES To assess differences between a progressive agility and trunk stabilization rehabilitation program and a progressive running and eccentric strengthening rehabilitation program in recovery characteristics following an acute hamstring injury, as measured via physical examination and magnetic resonance imaging (MRI). BACKGROUND Determining the type of rehabilitation program that most effectively promotes muscle and functional recovery is essential to minimize reinjury risk and to optimize athlete performance. METHODS Individuals who sustained a recent hamstring strain injury were randomly assigned to 1 of 2 rehabilitation programs: (1) progressive agility and trunk stabilization or (2) progressive running and eccentric strengthening. MRI and physical examinations were conducted before and after completion of rehabilitation. RESULTS Thirty-one subjects were enrolled, 29 began rehabilitation, and 25 completed rehabilitation. There were few differences in clinical or morphological outcome measures between rehabilitation groups across time, and reinjury rates were low for both rehabilitation groups after return to sport (4 of 29 subjects had reinjuries). Greater craniocaudal length of injury, as measured on MRI before the start of rehabilitation, was positively correlated with longer return-to-sport time. At the time of return to sport, although all subjects showed a near-complete resolution of pain and return of muscle strength, no subject showed complete resolution of injury as assessed on MRI. CONCLUSION The 2 rehabilitation programs employed in this study yielded similar results with respect to hamstring muscle recovery and function at the time of return to sport. Evidence of continuing muscular healing is present after completion of rehabilitation, despite the appearance of normal physical strength and function on clinical examination. LEVEL OF EVIDENCE Therapy, level 1b-.
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Scott A, Docking S, Vicenzino B, Alfredson H, Murphy RJ, Carr AJ, Zwerver J, Lundgreen K, Finlay O, Pollock N, Cook JL, Fearon A, Purdam CR, Hoens A, Rees JD, Goetz TJ, Danielson P. Sports and exercise-related tendinopathies: a review of selected topical issues by participants of the second International Scientific Tendinopathy Symposium (ISTS) Vancouver 2012. Br J Sports Med 2013; 47:536-44. [PMID: 23584762 PMCID: PMC3664390 DOI: 10.1136/bjsports-2013-092329] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In September 2010, the first International Scientific Tendinopathy Symposium (ISTS) was held in Umeå, Sweden, to establish a forum for original scientific and clinical insights in this growing field of clinical research and practice. The second ISTS was organised by the same group and held in Vancouver, Canada, in September 2012. This symposium was preceded by a round-table meeting in which the participants engaged in focused discussions, resulting in the following overview of tendinopathy clinical and research issues. This paper is a narrative review and summary developed during and after the second ISTS. The document is designed to highlight some key issues raised at ISTS 2012, and to integrate them into a shared conceptual framework. It should be considered an update and a signposting document rather than a comprehensive review. The document is developed for use by physiotherapists, physicians, athletic trainers, massage therapists and other health professionals as well as team coaches and strength/conditioning managers involved in care of sportspeople or workers with tendinopathy.
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Affiliation(s)
- Alex Scott
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
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