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Hameed I, Farooq N, Haq A, Aimen I, Shanley J. Role of strengthening exercises in management and prevention of overuse sports injuries of lower extremity: a systematic review. J Sports Med Phys Fitness 2024; 64:807-815. [PMID: 38470015 DOI: 10.23736/s0022-4707.23.15470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Overuse injuries are common in sports involving jumping, running, and landing, due to the repetitive nature of these activities and the strain they place on the lower extremity. The objective of the study was to determine the role of strengthening exercises in the management of overuse sports injuries of lower extremity and its effects on prevention of injury recurrence. EVIDENCE ACQUISITION This study employed a systematic review design. The author extracted and reviewed the papers for this study in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, and then used the PEDro scale to rate the articles' quality. For the most recent and well-developed primary data, several electronic databases including Google Scholar, PubMed Central, MEDLINE, Cochrane Library, and PEDro were exhaustively searched. Inclusion criteria were based on PICO (T) model and included study population, intervention nature, outcome measures, time period, methodological quality, and linguistic extent. EVIDENCE SYNTHESIS The data synthesis involved analyzing randomized control/clinical trials on strengthening exercises for lower extremity overuse sports injuries in athletes, considering outcomes including muscle strength, pain scores, return to sports, and injury prevention. CONCLUSIONS The methodological quality of the recruited articles ranged from excellent to fair on PEDro scale. Three included studies investigated the effects of strengthening exercises on management of lower extremity injuries of athletes. Four studies evaluated its role on prevention from recurrence of injuries. This study has concluded that strength training plays a fundamental role in management and prevention of overuse injuries. It not only improves the muscle performance, fitness level, speed and agility in sports but also decreases the pain, and aids in early recovery from an injury.
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Affiliation(s)
- Iqra Hameed
- Postgraduate Course in Advancing Physiotherapy Practice, Coventry University, Coventry, UK -
| | - Nawal Farooq
- Department of Physical Therapy, Riphah International University, Lahore, Pakistan
| | - Ayesha Haq
- Department of Physical Therapy, Riphah International University, Lahore, Pakistan
| | - Ifra Aimen
- Department of Physical Therapy, Riphah International University, Lahore, Pakistan
| | - Jackie Shanley
- Postgraduate Course in Advancing Physiotherapy Practice, Coventry University, Coventry, UK
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Sanchis GJB, Nascimento JASD, Santana RDC, Santos VMD, Cunha VLD, Assis SJCD, Cavalcanti RL, Guedes TSR, Oliveira AGRDC, Guedes MBOG. Biomechanical factors associated with patellofemoral pain in children and adolescents. Sci Rep 2024; 14:15490. [PMID: 38969665 PMCID: PMC11226601 DOI: 10.1038/s41598-024-64394-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/07/2024] [Indexed: 07/07/2024] Open
Abstract
To investigate the biomechanical factors associated with patellofemoral pain in children and adolescents. A cross-sectional, population-based study conducted in Brazil from 2019 to 2023, involving students from public schools. Adjusted prevalence ratios and their respective 95% confidence intervals for the outcome in relation to independent variables were calculated for association analysis, adopting a significance level of 5%. Out of the total of 283 students, 152 were female and 182 were aged between 16 and 18 years old. A positive association was observed between the presence of patellofemoral pain and a poor movement quality in both lower limbs (right side: p = 0.04 and left side: p = 0.04) as well as with dynamic valgus of the left lower limb (p < 0.01). Patellofemoral pain in children and adolescents is associated with poor movement quality in the lower limbs and dynamic valgus of the left lower limb. Actions targeting these biomechanical factors may be crucial for early diagnosis and clinical treatment of this disfunction.
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Affiliation(s)
- Gerônimo J B Sanchis
- Brazil Federal University of Minas Gerais, Belo Horizonte, Brazil
- Universidad de Valencia, Valencia, Spain
| | | | - Rebeca de C Santana
- Federal University of Rio Grande Do Norte, Lagoa Nova, University Campus, Natal, RN, 59078-900, Brazil
| | - Vagner M Dos Santos
- Federal University of Rio Grande Do Norte, Lagoa Nova, University Campus, Natal, RN, 59078-900, Brazil
| | - Vitor L da Cunha
- Federal University of Rio Grande Do Norte, Lagoa Nova, University Campus, Natal, RN, 59078-900, Brazil
| | - Sanderson J C de Assis
- Federal University of Rio Grande Do Norte, Lagoa Nova, University Campus, Natal, RN, 59078-900, Brazil
| | - Rafael L Cavalcanti
- Federal University of Rio Grande Do Norte, Lagoa Nova, University Campus, Natal, RN, 59078-900, Brazil
| | - Thaís S R Guedes
- Federal University of Rio Grande Do Norte, Lagoa Nova, University Campus, Natal, RN, 59078-900, Brazil
| | - Angelo G R da C Oliveira
- Federal University of Rio Grande Do Norte, Lagoa Nova, University Campus, Natal, RN, 59078-900, Brazil
| | - Marcello B O G Guedes
- Federal University of Rio Grande Do Norte, Lagoa Nova, University Campus, Natal, RN, 59078-900, Brazil
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Muckelt PE, Power CNT, Patterson J, Stevens L, Powell C, Warner MB, Stokes MJ, Fallowfield JL. Efficacy of neuromuscular exercises to promote movement quality and reduce musculoskeletal injury during initial military training in Royal Navy recruits. BMJ Mil Health 2024:e002674. [PMID: 38782491 DOI: 10.1136/military-2024-002674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Musculoskeletal injuries (MSKIs) are a significant problem in the Royal Navy, contributing to 48% of all medical discharges from service between 2019 and 2020. The objective of the study was to assess efficacy of implementing a neuromuscular training intervention to improve movement quality and reduce MSKIs in Royal Navy recruits undertaking initial military training. METHODS Neuromuscular training (pre-activation exercises, focusing on hip control) was integrated into the warm-up exercise regimen preceding physical training during the 10-week initial naval training (recruits) programme (January-March 2020) at HMS Raleigh (intervention group; n=162). A control group comprised (n=90) of recruits entering training from January 2019, who completed the standard warm-up programme prior to physical training. Movement control of the intervention group (intervention) was assessed before and after the 10-week programme using the Hip and Lower-Limb Movement Screen (HLLMS). Injury incidence proportion for both groups was determined retrospectively by review of medical notes. RESULTS The control group's MSKI incidence proportion was 31%, which was higher (p<0.05) than the 8% reported in the intervention group. The majority of MSKIs were of the lower limb, and were reported in weeks 1, 2 and 5 of the 10-week training programme. Movement control, as assessed by the HLLMS score, improved (pretraining (week 1) and post-training (week 10) HLLMS score (mean (SD) pre: 11.2 (5.6); post: 8.4 (3.9); t=5.829, p<0.001) following the neuromuscular training in the intervention group but was not assessed in the control group. CONCLUSION A neuromuscular control intervention was successfully implemented during the initial military training in the Royal Navy. The cohort undertaking the intervention demonstrated lower injury incidence compared with an equivalent cohort of recruits who undertook standard training. Movement control improved following the intervention, indicating better movement quality. Continued use of the programme may reduce military training attrition in the Royal Navy.
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Affiliation(s)
- Paul E Muckelt
- School of Health Sciences, University of Southampton-Highfield Campus, Southampton, UK
- Centre for Sports, Exercise and Osteoarthritis Research Versus Arthritis, University of Southampton, Southampton, UK
| | - C N T Power
- School of Health Sciences, University of Southampton-Highfield Campus, Southampton, UK
| | | | - L Stevens
- Headquarters Defence Medical Services Group, Lichfield, UK
| | - C Powell
- Primary Care Rehabilitation Facility, Defence Primary Healthcare, Britannia Royal Naval College, Dartmouth, UK
| | - M B Warner
- School of Health Sciences, University of Southampton-Highfield Campus, Southampton, UK
- Centre for Sports, Exercise and Osteoarthritis Research Versus Arthritis, University of Southampton, Southampton, UK
| | - M J Stokes
- School of Health Sciences, University of Southampton-Highfield Campus, Southampton, UK
- NIHR Southampton Biomedical Research Centre, Southampton, UK
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Mozafaripour E, Shirvani H, Alikhani S, Bayattork M, Yaghoubitajani Z, Andersen LL. The effect of a suspension training on physical fitness, lower extremity biomechanical factors, and occupational health in Navy personnel: a randomized controlled trial. Sci Rep 2024; 14:11192. [PMID: 38755263 PMCID: PMC11099111 DOI: 10.1038/s41598-024-61933-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/11/2024] [Indexed: 05/18/2024] Open
Abstract
Optimal physical fitness is essential for military personnel to effectively meet their rigorous physical demands. This study aimed to investigate the effectiveness of a suspension training program on physical fitness, biomechanical risk factors for lower extremity injury, mental health, and work-related factors in Navy personnel. A total of 50 young men participated in a randomized controlled trial. The participants were randomly assigned to two groups (n = 25): the intervention group and the control group. The intervention group performed an eight-week suspension training session three times per week, while the control group maintained their daily duties. The primary outcome was physical performance. The secondary outcomes were determined biomechanical risk factors for lower extremity injuries, mental health, and work-related factors. The data were analyzed using the analysis of covariance (ANCOVA). Compared with the control group, the intervention group showed significant improvements in physical performance, biomechanical risk for lower extremity injuries, and work-related factors from baseline to follow-up (p ≤ 0.05). However, there was no improvement in mental health. Based on these findings, suspension training positively impacted physical fitness, reduced injury risk, and enhanced the work-related factors of Navy personnel. This study provides new insights for various related experts and military coaches because it is an easy-to-use and feasible method with minimal facilities.
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Affiliation(s)
- Esmaeil Mozafaripour
- Health and Sports Medicine Department, Faculty of Physical Education and Sport Sciences, University of Tehran, between 15th and 16th St., North Kargar st., Tehran, Iran.
| | - Hossein Shirvani
- Exercise Physiology Research Center Research Institute for Life Style Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Sobhan Alikhani
- Faculty of Sport Sciences, Shahid Rajaee Teacher Training University, Tehran, Iran
| | - Mohammad Bayattork
- Sport Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran
| | - Zohreh Yaghoubitajani
- Department of Health and Sport Rehabilitation, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark
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Wu H, Brooke-Wavell K, Fong DTP, Paquette MR, Blagrove RC. Do Exercise-Based Prevention Programs Reduce Injury in Endurance Runners? A Systematic Review and Meta-Analysis. Sports Med 2024; 54:1249-1267. [PMID: 38261240 PMCID: PMC11127851 DOI: 10.1007/s40279-024-01993-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Endurance running is a popular sport and recreational activity yet is associated with a high prevalence of injury. Running related injuries (RRIs) are a leading cause of drop-out and represent a substantial financial burden to runners and healthcare services. There is clear evidence for the use of exercise-based injury prevention programs in games-based and youth sport settings, yet the research investigating the use of exercise to reduce injury risk in endurance runners has not been adequately reviewed recently. OBJECTIVES The aim of this review and meta-analysis was to systematically summarize the current research that has investigated the effect of exercise-based prevention programs and their state of supervision on the risk of RRIs in endurance runners. METHODS Three databases were searched for relevant studies. Selection and review were completed by two independent reviewers using the following inclusion criteria: (1) study population used endurance running training for health, occupational, or performance outcome(s); (2) participants performed running as their main form of exercise (> 50% of their total training time); (3) study was a randomized controlled trial; (4) a non-running-based exercise intervention was used; (5) a running-only or placebo exercise control group was included; (6) injury rate or incidence was reported; (7) injuries were recorded prospectively alongside the exercise training. Two meta-analyses were conducted using random-effects models, one based on log risk ratio and one based on log incidence rate ratio. The Cochrane Risk of Bias Assessment Tool 2 was used to evaluate the quality of studies and the Grading of Recommendations Assessment, Development and Evaluations approach was employed to grade the certainty of evidence. RESULTS A total of nine articles containing 1904 participants were included in analysis. Overall pooled results showed no significant differences between intervention and control groups in injury risk (z = - 1.60; p = 0.110) and injury rate (z = - 0.98; p = 0.329), while a post hoc analysis evaluating supervised interventions only showed that injury risk was significantly lower in the intervention group compared to the control group (z = - 3.75, p < 0.001). Risk of bias assessment revealed that seven studies included in the analysis were of low quality. CONCLUSIONS Exercise-based interventions do not appear to reduce the risk and rate of running-related injuries. Supervision may be essential for exercise-based intervention programs to reduce risk of RRIs, possibly due to increased compliance. Studies with more robust designs that include supervised exercise interventions should be prioritized in the future. TRIAL REGISTRY Clinical Trial Registration: PROSPERO CRD42021211274.
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Affiliation(s)
- Han Wu
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Katherine Brooke-Wavell
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Max R Paquette
- College of Health Sciences, University of Memphis, Memphis, TN, USA
| | - Richard C Blagrove
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
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Xu J, Cai Z, Chen M, Wang X, Luo X, Wang Y. Global research trends and hotspots in patellofemoral pain syndrome from 2000 to 2023: a bibliometric and visualization study. Front Med (Lausanne) 2024; 11:1370258. [PMID: 38566926 PMCID: PMC10985266 DOI: 10.3389/fmed.2024.1370258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
Background Patellofemoral pain syndrome (PFPS) is a prevalent condition in sports medicine, and as sports competitions become more popular, the incidence of sports injuries is on the rise. Despite the increasing research on PFPS, there remains a lack of bibliometric analyses on this topic. The aim of this study was to identify the research hotspots and trends in the field of PFPS by reviewing 23 years of literature in this field. Methods By analyzing the literature on PFPS research from 2000 to 2023 in the core dataset of the Web of Science database and utilizing bibliometric tools like CiteSpace 6.1, VOSviewer 1.6.18, R-bibliometrix 4.6.1, Pajek 5.16, and Scimago Graphica 1.0.26, our aim was to gain insights into the current status and key areas of PFPS research. The study examined various aspects including the number of publications, countries, institutions, journals, authors, collaborative networks, keywords, and more. Through the visualization of relevant data, we also attempted to forecast future trends in the field. Results There were 2,444 publications were included in this visualization study, published in 322 journals by 1,247 authors from 818 institutions in 67 countries. The Journal of Orthopaedic and Sports Physical Therapy had the highest number of publications, with the USA leading in article count. La Trobe University contributed the most articles, while Rathleff MS and Barton CJ emerged as the most prolific authors. Hip and knee strength and core strength, lower extremity kinematics and biomechanics, females (runners), muscle activation, risk factors, gait retraining, clinical practice guidelines, and rehabilitation were research hotspot keywords. Conclusion Current research suggests that there is still significant potential for the development of PFPS research. Key areas of focus include the clinical effectiveness of combined hip and knee strengthening to address PFPS, characterization of lower limb kinematics and biomechanics, gait retraining, risk factors, and clinical practice guidelines. Future research could explore the effectiveness of innovative exercise therapies such as blood flow restricting training, gait retraining, and neuromuscular control training for PFPS improvement. Further investigation into gait retraining for runners, particularly females, and clinical efficacy study of a novel PRP formulation for the treatment of PFPS.
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Affiliation(s)
- Jie Xu
- Department of Sports Medicine, Sichuan Provincial Orthopedics Hospital, Chengdu, China
| | - Zijuan Cai
- College of Physical Education and Health, Geely University of China, Chengdu, China
| | - Meng Chen
- Department of Emergency Medicine, Nanchong Hospital of Traditional Chinese Medicine, Nanchong, China
| | - Xin Wang
- Health Science Center, Peking University, Beijing, China
| | - Xiaobing Luo
- Department of Sports Medicine, Sichuan Provincial Orthopedics Hospital, Chengdu, China
| | - Yanjie Wang
- Department of Sports Medicine, Sichuan Provincial Orthopedics Hospital, Chengdu, China
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Bullock GS, Dartt CE, Ricker EA, Fallowfield JL, Arden N, Clifton D, Danelson K, Fraser JJ, Gomez C, Greenlee TA, Gregory A, Gribbin T, Losciale J, Molloy JM, Nicholson KF, Polich JG, Räisänen A, Shah K, Smuda M, Teyhen DS, Allard RJ, Collins GS, de la Motte SJ, Rhon DI. Barriers and facilitators to implementation of musculoskeletal injury mitigation programmes for military service members around the world: a scoping review. Inj Prev 2023; 29:461-473. [PMID: 37620010 DOI: 10.1136/ip-2023-044905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023]
Abstract
INTRODUCTION Musculoskeletal injury (MSK-I) mitigation and prevention programmes (MSK-IMPPs) have been developed and implemented across militaries worldwide. Although programme efficacy is often reported, development and implementation details are often overlooked, limiting their scalability, sustainability and effectiveness. This scoping review aimed to identify the following in military populations: (1) barriers and facilitators to implementing and scaling MSK-IMPPs; (2) gaps in MSK-IMPP research and (3) future research priorities. METHODS A scoping review assessed literature from inception to April 2022 that included studies on MSK-IMPP implementation and/or effectiveness in military populations. Barriers and facilitators to implementing these programmes were identified. RESULTS From 132 articles, most were primary research studies (90; 68.2%); the remainder were review papers (42; 31.8%). Among primary studies, 3 (3.3%) investigated only women, 62 (69%) only men and 25 (27.8%) both. Barriers included limited resources, lack of stakeholder engagement, competing military priorities and equipment-related factors. Facilitators included strong stakeholder engagement, targeted programme design, involvement/proximity of MSK-I experts, providing MSK-I mitigation education, low burden on resources and emphasising end-user acceptability. Research gaps included variability in reported MSK-I outcomes and no consensus on relevant surveillance metrics and definitions. CONCLUSION Despite a robust body of literature, there is a dearth of information about programme implementation; specifically, barriers or facilitators to success. Additionally, variability in outcomes and lack of consensus on MSK-I definitions may affect the development, implementation evaluation and comparison of MSK-IMPPs. There is a need for international consensus on definitions and optimal data reporting elements when conducting injury risk mitigation research in the military.
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Affiliation(s)
- Garrett S Bullock
- Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Centre for Sport, Exercise, and Osteoarthritis, University of Oxford Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford, UK
| | - Carolyn E Dartt
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences F Edward Hebert School of Medicine, Bethesda, Maryland, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine Inc, Bethesda, Maryland, USA
| | - Emily A Ricker
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences F Edward Hebert School of Medicine, Bethesda, Maryland, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine Inc, Bethesda, Maryland, USA
| | - Joanne L Fallowfield
- Environmental Medicine and Sciences Division, Institute of Naval Medicine, Gosport, UK
| | - Nigel Arden
- Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford Nuffield, Oxford, UK
- University of Southampton MRC Lifecourse Epidemiology Centre, Southampton, UK
| | - Daniel Clifton
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences F Edward Hebert School of Medicine, Bethesda, Maryland, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine Inc, Bethesda, Maryland, USA
| | - Kerry Danelson
- Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - John J Fraser
- Directorate for Operational Readiness & Health, Naval Health Research Center, San Diego, California, USA
| | - Christina Gomez
- College of Health Sciences, Western University of Health Sciences, Pomona, California, USA
| | - Tina A Greenlee
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas, USA
| | - Alexandria Gregory
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences F Edward Hebert School of Medicine, Bethesda, Maryland, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine Inc, Bethesda, Maryland, USA
| | - Timothy Gribbin
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences F Edward Hebert School of Medicine, Bethesda, Maryland, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine Inc, Bethesda, Maryland, USA
| | - Justin Losciale
- Department of Rehabilitation, The University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Joseph M Molloy
- Office of the Army Surgeon General, Falls Church, Virginia, USA
| | - Kristen F Nicholson
- Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Julia-Grace Polich
- Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Anu Räisänen
- Department of Physical Therapy Education, Oregon, College of Health Sciences, Western University of Health Sciences, Lebanon, Oregon, USA
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Karishma Shah
- Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford Nuffield, Oxford, UK
| | - Michael Smuda
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences F Edward Hebert School of Medicine, Bethesda, Maryland, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine Inc, Bethesda, Maryland, USA
| | - Deydre S Teyhen
- Army Medical Specialist Corps Chief, Office of the Army Surgeon General, Falls Church, Virginia, USA
| | - Rhonda J Allard
- Learning Resource Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Gary S Collins
- Centre for Statistics in Medicine, University of Oxford Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford, UK
| | - Sarah J de la Motte
- Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Daniel I Rhon
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas, USA
- Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences F Edward Hebert School of Medicine, Bethesda, Maryland, USA
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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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Lloyd DG, Saxby DJ, Pizzolato C, Worsey M, Diamond LE, Palipana D, Bourne M, de Sousa AC, Mannan MMN, Nasseri A, Perevoshchikova N, Maharaj J, Crossley C, Quinn A, Mulholland K, Collings T, Xia Z, Cornish B, Devaprakash D, Lenton G, Barrett RS. Maintaining soldier musculoskeletal health using personalised digital humans, wearables and/or computer vision. J Sci Med Sport 2023:S1440-2440(23)00070-1. [PMID: 37149408 DOI: 10.1016/j.jsams.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 03/27/2023] [Accepted: 04/05/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES The physical demands of military service place soldiers at risk of musculoskeletal injuries and are major concerns for military capability. This paper outlines the development new training technologies to prevent and manage these injuries. DESIGN Narrative review. METHODS Technologies suitable for integration into next-generation training devices were examined. We considered the capability of technologies to target tissue level mechanics, provide appropriate real-time feedback, and their useability in-the-field. RESULTS Musculoskeletal tissues' health depends on their functional mechanical environment experienced in military activities, training and rehabilitation. These environments result from the interactions between tissue motion, loading, biology, and morphology. Maintaining health of and/or repairing joint tissues requires targeting the "ideal" in vivo tissue mechanics (i.e., loading and strain), which may be enabled by real-time biofeedback. Recent research has shown that these biofeedback technologies are possible by integrating a patient's personalised digital twin and wireless wearable devices. Personalised digital twins are personalised neuromusculoskeletal rigid body and finite element models that work in real-time by code optimisation and artificial intelligence. Model personalisation is crucial in obtaining physically and physiologically valid predictions. CONCLUSIONS Recent work has shown that laboratory-quality biomechanical measurements and modelling can be performed outside the laboratory with a small number of wearable sensors or computer vision methods. The next stage is to combine these technologies into well-designed easy to use products.
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Affiliation(s)
- David G Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia.
| | - David J Saxby
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Claudio Pizzolato
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Matthew Worsey
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia
| | - Laura E Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Dinesh Palipana
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Medicine, Dentistry and Health, Griffith University, Australia
| | - Matthew Bourne
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Ana Cardoso de Sousa
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia
| | - Malik Muhammad Naeem Mannan
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia
| | - Azadeh Nasseri
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia
| | - Nataliya Perevoshchikova
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia
| | - Jayishni Maharaj
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Claire Crossley
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Alastair Quinn
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Kyle Mulholland
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia
| | - Tyler Collings
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Zhengliang Xia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia
| | - Bradley Cornish
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Daniel Devaprakash
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; VALD Performance, Australia
| | | | - Rodney S Barrett
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, Australia; School of Health Sciences and Social Work, Griffith University, Australia
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Musculoskeletal Injury Risk in a Military Cadet Population Participating in an Injury-Prevention Program. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020356. [PMID: 36837558 PMCID: PMC9961050 DOI: 10.3390/medicina59020356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
Background and Objectives: Musculoskeletal injuries are a major health hazard among military personnel. Previous research has proposed several exercise-based strategies for prevention. The purpose of this study was to investigate the effect of an exercise-based injury-prevention program on the incidence of musculoskeletal injury, motor performance and psychosocial status. Materials and Methods: Thirty-six Estonian Military Academy cadets were randomly assigned into either an intervention or control group. The intervention group followed a neuromuscular exercise-based injury-prevention warm-up program, three times per week for 6 months. The control group continued with the usual warm-up. The main outcome measure was injury incidence during the study period. Additionally, evaluation of isokinetic lower-extremity strength, postural sway, physical fitness and psychosocial status was included pre- and post-intervention. Results: During the 6-month study period, the musculoskeletal injury incidence was 43% in the intervention group and 54% in the control group (RR = 0.8; 95% CI = 0.41 to 1.99). The noted 20% risk reduction was not statistically significant (p = 0.59). Furthermore, there were no statistically significant differences between the intervention and control group in motor performance or psychosocial status measures. Conclusions: In conclusion, no effect of the exercise-based injury-prevention program on injury risk, motor performance or psychosocial status could be detected.
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Mozafaripour E, Seidi F, Minoonejad H, Bayattork M, Khoshroo F. The effectiveness of the comprehensive corrective exercise program on kinematics and strength of lower extremities in males with dynamic knee valgus: a parallel-group randomized wait-list controlled trial. BMC Musculoskelet Disord 2022; 23:700. [PMID: 35869467 PMCID: PMC9306108 DOI: 10.1186/s12891-022-05652-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Dynamic knee valgus (DKV) is a prevalent movement impairment widely regarded as a risk factor for lower extremity disorders such as patellofemoral pain syndrome. The present study aimed to investigate the effectiveness of the comprehensive corrective exercise program (CCEP) on kinematics and strength of lower extremities in males with DKV.
Methods
Thirty asymptomatic young men with DKV between the ages of 18 and 28 years participated in this study. They were randomly assigned to the intervention (n = 15) and control groups (n = 15). The intervention group performed the CCEP for three sessions per week for eight weeks, while the control group only did activities of daily living. Hip external rotator and abductor muscle strength and three-dimensional lower extremity kinematics consisting of knee varus/valgus, femur adduction/abduction, femur medial/lateral rotation, and tibial medial/lateral rotation were measured at the baseline and post-test. The data were analyzed using the analysis of covariance (ANCOVA).
Results
There were significant improvements in all kinematics variables in the intervention group after the 8-week CCEP. Moreover, the strength of abductor and external rotator muscle improved in the intervention group (P < 0.05).
Conclusions
The CCEP led to substantial improvements in the selected variables of lower extremity kinematics and muscle strength in participants with DKV during a single-leg squat. These results imply that practitioners should adopt a comprehensive approach to pay simultaneous attention to both proximal and distal segments for improving DKV.
Trial registration
The protocol has been approved in the Registry of Clinical Trials (Registration N: IRCT20180821040843N1) on 2018-12-30.
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Minnig MC, Hawkinson L, Root HJ, Driban J, DiStefano LJ, Callahan L, Ambrose KR, Spang JT, Golightly YM. Barriers and facilitators to the adoption and implementation of evidence-based injury prevention training programmes: a narrative review. BMJ Open Sport Exerc Med 2022; 8:e001374. [PMID: 36187085 PMCID: PMC9516217 DOI: 10.1136/bmjsem-2022-001374] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/21/2022] Open
Abstract
While there is a multitude of evidence supporting the efficacy of injury prevention training programmes, the literature investigating the implementation of these programmes is, in contrast, rather limited. This narrative review sought to describe the commonly reported barriers and facilitators of the implementation of injury prevention training programmes among athletes in organised sport. We also aimed to identify necessary steps to promote the uptake and sustainable use of these programmes in non-elite athletic communities. We identified 24 publications that discussed implementing evidence-based injury prevention training programmes. Frequently reported barriers to implementation include the perceived time and financial cost of the programme, coaches lacking confidence in their ability to implement it, and the programme including exercises that were difficult or confusing to follow. Frequently reported facilitators to implementation include the coach being aware of programme efficacy, shared motivation to complete the programme from both coaches and athletes, and the ability to easily integrate the programme into practice schedules. The current literature is focused on high-income, high-resource settings. We recommend that future studies focus on understanding the best practices of programme dissemination in culturally and economically diverse regions. Programmes ought to be of no financial burden to the user, be simply adaptable to different sports and individual athletes and be available for use in easily accessible forms, such as in a mobile smartphone application.
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Affiliation(s)
- Mary Catherine Minnig
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lauren Hawkinson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill College of Arts and Sciences, Chapel Hill, North Carolina, USA
| | - Hayley J Root
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona, USA
| | - Jeffrey Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Lindsay J DiStefano
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA.,Institute of Sports Medicine, University of Connecticut, Storrs, Connecticut, USA
| | - Leigh Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.,Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Kirsten R Ambrose
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Jeffrey T Spang
- Department of Orthopaedics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.,College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska, USA
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13
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Pereira PM, Baptista JS, Conceição F, Duarte J, Ferraz J, Costa JT. Patellofemoral Pain Syndrome Risk Associated with Squats: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159241. [PMID: 35954598 PMCID: PMC9367913 DOI: 10.3390/ijerph19159241] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022]
Abstract
Patellofemoral pain syndrome (PFPS) is highly prevalent; it can cause severe pain and evolve into progressive functional loss, leading to difficulties performing daily tasks such as climbing and descending stairs and squatting. This systematic review aimed to find evidence, in the literature, of squat movements that can cause or worsen PFPS. This work was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and its protocol was registered in PROSPERO (CRD42019128711). From the 6570 collected records, 37 were included. From these 37 articles, 27 present a causal relationship between knee flexion and PFPS, 8 describe a relationship, considering the greater existence of muscle contractions, and one article did not describe this relationship in its results. The main limitations stem from the fact that different studies used different evaluation parameters to compare the force exerted on the patellofemoral joint. Furthermore, most studies are focused on sports populations. After analysing the included works, it was concluded that all squat exercises can cause tension overload in the knee, especially with a knee flexion between 60° and 90° degrees. The main causal/worsening factors of PFPS symptoms are the knee translocation forward the toes (on the same body side) when flexing the knee, and the muscle imbalance between the thigh muscles.
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Affiliation(s)
- Pablo Monteiro Pereira
- Associated Laboratory for Energy, Transports and Aeronautics (PROA/LAETA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (P.M.P.); (J.D.); (J.F.)
| | - João Santos Baptista
- Associated Laboratory for Energy, Transports and Aeronautics (PROA/LAETA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (P.M.P.); (J.D.); (J.F.)
- Correspondence:
| | - Filipe Conceição
- Center for Research, Education, Innovation and Intervention in Sport (CIFI2D/LABIOMEP), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal;
| | - Joana Duarte
- Associated Laboratory for Energy, Transports and Aeronautics (PROA/LAETA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (P.M.P.); (J.D.); (J.F.)
| | - João Ferraz
- Associated Laboratory for Energy, Transports and Aeronautics (PROA/LAETA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (P.M.P.); (J.D.); (J.F.)
| | - José Torres Costa
- Associated Laboratory for Energy, Transports and Aeronautics (PROA/LAETA), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
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Bunn PDS, Sodré RDS, Matos MI, Saliba GF, Silva GDP, Caldas R, Esteves JDS, Silva EB. Effects of prevention programmes on injury risk in military personnel: a systematic review with meta-analysis. BMJ Mil Health 2022:e002098. [PMID: 35732343 DOI: 10.1136/bmjmilitary-2022-002098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/04/2022] [Indexed: 12/04/2022]
Abstract
INTRODUCTION Exercise programmes have been used to prevent injuries in military personnel, as they can reduce modifiable risk factors for injuries. Our aim was to review the literature to evaluate the effects of different exercise protocols on the prevention of injuries in military personnel. METHODS A systematic literature review examined the effects of different exercise protocols on the prevention of musculoskeletal injuries in the military. Several databases were explored to find experimental studies that investigated the effects of prevention programmes on the risk of injury. We have extracted from the studies: profile of participants, sample size, study design and characteristics of the control group (CG), the type of intervention and the relative risk (RR) in the experimental group and CG, with their significance levels. For data analysis, we used the RevMan V.5.3 software. The measure of RR was investigated. The risk of publication bias was analysed with Begg's test. RESULTS A total of 13 694 titles and studies were recovered from the databases and by manual search. After the removal of duplicate titles and studies that did not meet the eligibility criteria, 17 studies were selected. The protocols were composed of neuromuscular training, stretching, agility training or combined exercises. The meta-analysis showed that injury prevention exercise programmes reduced the risk of musculoskeletal injuries in military personnel by 14% (RR=0.86; 95% CI=0.76 to 0.98). CONCLUSION Injury prevention exercise programmes promoted a slight reduction in the risk of musculoskeletal injuries in military personnel. LEVEL OF EVIDENCE Very low. TRIAL REGISTRATION NUMBER CRD 42017077946.
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Affiliation(s)
- Priscila Dos Santos Bunn
- Laboratório de Pesquisa em Ciências do Exercício (LABOCE), Centro de Educação Física Almirante Adalberto Nunes (CEFAN), Rio de Janeiro, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Ciências do Exercício e do Esporte (PPGCEE), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - R D S Sodré
- Programa de Pós-Graduação em Ciências do Exercício e do Esporte (PPGCEE), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - M I Matos
- Programa de Pós-Graduação em Ciências do Exercício e do Esporte (PPGCEE), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - G F Saliba
- Programa de Pós-Graduação em Ciências da Reabilitação, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Rio de Janeiro, Brazil
| | - G D P Silva
- Programa de Pós-Graduação em Ciências do Exercício e do Esporte (PPGCEE), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - R Caldas
- Programa de Pós-Graduação em Ciências do Exercício e do Esporte (PPGCEE), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - J D S Esteves
- Laboratório de Pesquisa em Ciências do Exercício (LABOCE), Centro de Educação Física Almirante Adalberto Nunes (CEFAN), Rio de Janeiro, Rio de Janeiro, Brazil
| | - E B Silva
- Programa de Pós-Graduação em Ciências do Exercício e do Esporte (PPGCEE), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
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Lotfi H, Moghadam AN, Shati M. Electromyography Activity of Vastus Medialis Obliquus and Vastus Lateralis Muscles During Lower Limb Proprioceptive Neuromuscular Facilitation Patterns in Individuals with and without Patellofemoral Pain Syndrome. Phys Ther Res 2022; 24:218-224. [PMID: 35036255 DOI: 10.1298/ptr.e10094] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/24/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Exercise therapy to strengthen quadriceps muscle is recommended in rehabilitation program for people with patellofemoral pain syndrome (PFPS). This study aimed to investigate the electromyography (EMG) activity of vastus medialis obliquus (VMO), vastus lateralis (VL) and VMO/VL ratio during PNF in individuals with and without PFPS. METHODS 26 persons with PFPS and 26 healthy subjects participated to study. All subjects performed PNF patterns (Flexion-Adduction-External Rotation (D1FL), Extension-Adduction-External Rotation (D2EX), D1FL+ load, D2EX+ load) and straight leg raise (SLR). The normalized EMG activity of VMO, VL and VMO/VL ratio were measured and analyzed using repeated measure ANOVA. RESULTS There were significant main effects of group and exercises for the both VMO and VL (p<0.05). It was found that except SLR and D2EX, in the other motions PFPS group had lower VMO activity compared to healthy group (p<0.05). For VL except SLR, in the other motions PFPS group had lower VL activity too (p<0.05). The PNF patterns activated VMO more than SLR, however it was not significant (p>0.05). Also; there weren't any significant difference between the two groups in VMO/VL activation ratios. Also, performing the PNF patterns with load increased VMO and VL muscles activity significantly (p<0.05). It also found that in PFPS group the VMO/VL ratio values in PNF patterns were significantly more than SLR and the highest VMO/VL ratio value (0.96) was found during D2EX. CONCLUSION The PNF patterns due to provide optimal VMO/VL ratio value than SLR and proper balance between these two muscles can be recommended in rehabilitation of individuals with PFPS.
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Affiliation(s)
- Hiva Lotfi
- MSc of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Iran
| | - Afsun Nodehi Moghadam
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Iran
| | - Mohsen Shati
- Department of aging, University of Social Welfare and Rehabilitation Sciences, Iran
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16
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Stephenson SD, Kocan JW, Vinod AV, Kluczynski MA, Bisson LJ. A Comprehensive Summary of Systematic Reviews on Sports Injury Prevention Strategies. Orthop J Sports Med 2021; 9:23259671211035776. [PMID: 34734094 PMCID: PMC8558815 DOI: 10.1177/23259671211035776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/03/2021] [Indexed: 12/26/2022] Open
Abstract
Background A large volume of systematic reviews and meta-analyses has been published on the effectiveness of sports injury prevention programs. Purpose To provide a qualitative summary of published systematic reviews and meta-analyses that have examined the effectiveness of sports injury prevention programs on reducing musculoskeletal injuries. Study Design Systematic review; Level of evidence, 4. Methods We searched the PubMed, CINAHL, EMBASE, and the Cochrane databases for systematic reviews and meta-analyses that evaluated the effectiveness of sports injury prevention programs. We excluded published abstracts, narrative reviews, articles not published in English, commentaries, studies that described sports injury prevention strategies but did not assess their effectiveness, studies that did not assess musculoskeletal injuries, and studies that did not assess sports-related injuries. The most relevant results were extracted and summarized. Levels of evidence were determined per the Oxford Centre for Evidence-Based Medicine, and methodological quality was assessed using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews, revised version). Results A total of 507 articles were retrieved, and 129 were included. Articles pertaining to all injuries were divided into 9 topics: sports and exercise in general (n = 20), soccer (n = 13), ice hockey (n = 1), dance (n = 1), volleyball (n = 1), basketball (n = 1), tackle collision sports (n = 1), climbing (n = 1), and youth athletes (n = 4). Articles on injuries by anatomic site were divided into 11 topics: general knee (n = 8), anterior cruciate ligament (n = 34), ankle (n = 14), hamstring (n = 11), lower extremity (n = 10), foot (n = 6), groin (n = 2), shoulder (n = 1), wrist (n = 2), and elbow (n = 1). Of the 129 studies, 45.7% were ranked as evidence level 1, and 55.0% were evidence level 2. Based on the AMSTAR-2, 58.9% of the reviews reported a priori review methods, 96.1% performed a comprehensive literature search, 47.3% thoroughly described excluded articles, 79.1% assessed risk of bias for individual studies, 48.8% reported a valid method for statistical combination of data (ie, meta-analysis), 45.0% examined the effect of risk of bias on pooled study results, and 19.4% examined the risk for publication bias. Conclusion This comprehensive review provides sports medicine providers with a single source of the most up-to-date publications in the literature on sports injury prevention.
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Affiliation(s)
- Samuel D Stephenson
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Joseph W Kocan
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Amrit V Vinod
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Melissa A Kluczynski
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
| | - Leslie J Bisson
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, The State University of New York at Buffalo, New York, USA
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17
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Kozin S. Biomechanical technology of injury prevention in the training of specialists in physical education and sports. HEALTH, SPORT, REHABILITATION 2021. [DOI: 10.34142/hsr.2021.07.02.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Purpose: to develop and experimentally test the biomechanical technology of injury prevention of future specialists in physical education and sports in the process of professional training (rock climbing for example).
Material and Methods. The participants of this study were 84 male students engaged in amateur climbing aged 18-19 years. All athletes were also students of physical education faculties of Ukrainian universities; 40 athletes were in the experimental group and 44 athletes were in the control group. The biomechanical technology for injury prevention in the training of specialists in physical education and sports has been developed on rock climbing for example. Developed biomechanical technology for injury prevention contains 3 areas: 1 - theoretical; 2 - analytical; 3 - practical. Injury risk (incidence) was defined as the number of injuries to the total number of athletes in the analyzed group. Relative risk (incidence rate ratio) was determined by the ratio of risk in the control group to the risk in the experimental group. The chance of injury was defined as the ratio of the number of injuries to the number of uninjured athletes in the analyzed group. The relative chance (Odds Ratio) was defined as the chances of injury in the control group to the chances of injury in the experimental group. These indicators were determined separately for low, medium and severe finger injuries.
Results. The applied technology of injury prevention significantly influences the reduction of the number of injuries of athletes – future specialists on the physical education and sports (on rock climbing for example). It is established that the application of the developed technology of injury prevention reduces the risk of finger injuries: low complexity – in 2.364 times (95% CI = 0.925-6.041, P> 0,05) times; medium complexity – in 3.333 times (95% CI = 1.001-11.096, P (Fisher) = 0.030); high complexity – in 8.182 times (95% CI = 1.084-61.749, P (Fisher) = 0.011).
Conclusions. The application of the developed biomechanical technology of injury prevention in the process of training specialists in physical education and sports significantly reduces the risk of injury to students.
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Mazzone B, Yoder A, Condon R, Farrokhi S. Clinical application of foot strike run retraining for military service members with chronic knee pain. BMJ Mil Health 2021; 168:303-307. [PMID: 34035158 DOI: 10.1136/bmjmilitary-2021-001789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/14/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Military training is associated with a high incidence of knee pain. Conversion from a rearfoot to non-rearfoot strike during running is effective at reducing knee pain in research environments. The purpose of this report was to demonstrate run retraining as a clinical intervention for service members with knee pain. METHODS Sixteen service members with running-related chronic knee pain underwent run retraining that converted foot strike from a rearfoot to a non-rearfoot strike using real-time visual feedback. The Lower Extremity Functional Scale (LEFS) and Numerical Pain Rating Scale (NPRS) for knee pain during running were assessed pretraining, at the final training session and at a 1-month follow-up. During running, foot inclination angle and vertical ground reaction force (VGRF) average loading rate were measured pretraining and at 1 month of follow-up. RESULTS Service members underwent 7.4±1.0 training sessions over the course of 15.8±4.6 days. LEFS improved by 8±6 points immediately after retraining, with an overall improvement of 10±6 points from pretraining to 1-month follow-up (p<0.01). NPRS improved by 2.0±0.4 points immediately after retraining, with an overall improvement of 2.0±0.4 points from pretraining to 1-month follow-up (p<0.01). Conversion to a non-rearfoot strike pattern was apparent at follow-up for all but two patients. VGRF average loading rate decreased by 56%±17% (p<0.01) from pretraining to 1-month follow-up. CONCLUSIONS Knee pain and function improved as a result of non-rearfoot strike run retraining, which supports the clinical use of this evidence-based intervention.
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Affiliation(s)
- Brittney Mazzone
- Research and Surveillance Division, Extremity Trauma and Amputation Center of Excellence, San Diego, California, USA .,Department of Physical and Occupational Therapy, Naval Medical Center San Diego, San Diego, California, USA
| | - A Yoder
- Research and Surveillance Division, Extremity Trauma and Amputation Center of Excellence, San Diego, California, USA
| | - R Condon
- Department of Physical and Occupational Therapy, Naval Medical Center San Diego, San Diego, California, USA
| | - S Farrokhi
- Research and Surveillance Division, Extremity Trauma and Amputation Center of Excellence, San Diego, California, USA
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Glaviano NR, Boling MC, Fraser JJ. Anterior Knee Pain Risk Differs Between Sex and Occupation in Military Tactical Athletes. J Athl Train 2021; 56:1180-1187. [PMID: 33787888 DOI: 10.4085/1062-6050-0578.20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Anterior knee pain (AKP) is ubiquitous in early-career military members and exacerbated during functional tasks required during military duties. Therefore, it is important to understand risk of this condition in male and female tactical athletes in diverse military occupations. OBJECTIVE To assess sex and occupation on AKP risk in military members. DESIGN Descriptive Epidemiology Study. SETTING United States Armed Forces. Patients All military members diagnosed with anterior or retro-patellar pain, patellar instability, knee tendinopathy on their initial encounter from 2006 to 2015. OUTCOME MEASURES The Defense Medical Epidemiology Database was queried for the number of individuals with AKP. Relative risk (RR) and chi-square statistics were calculated in the assessment of sex and occupational category. Regressions were calculated to determine association between service branch, sex, and AKP across time. RESULTS From 2006-2015, a total of 151,263 enlisted and 14,335 officer services members were diagnosed with AKP. Enlisted females had an incidence rate of 16.7 per 1000 person-years compared to the enlisted male service members with an incidence rate of 12.7 per 1000 person-years (RR: 1.32, 95%CI: 1.30-1.34, p<0.001) across all AKP diagnoses. Female officers had an incidence rate of 10.7 per 1,000 person-years compared to male officers at an incidence rate of 5.3 per 1000 person-years (RR: 2.01, 95%CI: 1.94-2.09). Differences in risk were also noted across military occupation for both enlisted and officer service members (p<.05). CONCLUSION Sex and military occupation were salient factors for AKP risk. Evaluation of training requirements and developing interventions programs across military occupation could serve as a focus for future research aiming to mitigate associated risk factors of AKP.
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Affiliation(s)
- Neal R Glaviano
- 1Department of Kinesiology, University of Connecticut, Storrs, CT. . Twitter: @NealGlaviano
| | - Michelle C Boling
- 2Brooks College of Health, University of North Florida, Jacksonville, FL. . Twitter: @mcboling23
| | - John J Fraser
- 1Department of Kinesiology, University of Connecticut, Storrs, CT. . Twitter: @NealGlaviano
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Rhode C, Louw QA, Leibbrandt DC, Williams L. Joint position sense in individuals with anterior knee pain. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1497. [PMID: 33824918 PMCID: PMC8008049 DOI: 10.4102/sajp.v77i1.1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 11/17/2020] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Anterior knee pain (AKP) commonly affects both physically active and sedentary individuals and the aetiology is unknown. Altered joint position sense (JPS) impacts accurate motor action and knee joint stability. It is unclear whether people with AKP have altered JPS. OBJECTIVE The aim of our study was to investigate JPS in the knees of individuals with AKP. METHOD A descriptive cross-sectional study measured JPS in 25 participants with unilateral or bilateral AKP. JPS was measured using active JPS testing during single leg squat (SLS) and active knee extension (AKE) in sitting. Target angles (TA) were self-determined based on each participant's capabilities. The absolute error (AE) was the main outcome measure. Impaired JPS was classified as an AE equal to or greater than five degrees. RESULTS There were no significant differences in JPS when comparing the affected and unaffected knees in participants with AKP (p > 0.05). However, a subgroup of participants with altered knee JPS was identified. There was a tendency towards greater knee flexion in the TAs of knees without AKP. CONCLUSION Our results showed that JPS is not significantly more impaired in knees with AKP compared with knees without AKP in a group of individuals with AKP. A subgroup with altered JPS in knees with and without AKP was identified. This finding could be because of compensatory gait patterns and the precision of the Vicon 3D motion analysis system. CLINICAL IMPLICATIONS Joint position sense should be assessed bilaterally in individuals with AKP.
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Affiliation(s)
- Carlyn Rhode
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Quinette A Louw
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dominique C Leibbrandt
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leone Williams
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
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21
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J H, K P, M L, K S, P K, A H, Vm M, J P. Association between lower extremity muscle strength and acute ankle injury in youth team-sports athletes. Phys Ther Sport 2021; 48:188-195. [PMID: 33508694 DOI: 10.1016/j.ptsp.2021.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/12/2021] [Accepted: 01/16/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To investigate lower extremity muscle strength as risk factor for an acute ankle injury in youth athletes. DESIGN Cohort study. SETTING Basketball and floorball clubs. PARTICIPANTS 188 youth (≤21) male and 174 female athletes. MAIN OUTCOME MEASURES 1RM leg press, maximal concentric isokinetic quadriceps and hamstrings as well as maximal isometric hip abductor strength were measured and athletes were followed for an acute ankle injury up to three years. Cox regression models were used in statistical analyses. RESULTS In males, greater 1RM leg press and maximal quadriceps strength increased the risk of any type of acute ankle injury (Hazard ratio [HR] for 1 SD increase, 1.63 [95% CI, 1.12-2.39] and 1.43 [95% CI, 1.01-2.01], respectively). In females, greater 1RM leg press and difference between legs in hip abduction strength increased the risk of acute non-contact ankle injury (HR for 1 SD increase, 1.44 [95% CI, 1.03-2.02] and 1.44 [95% CI, 1.03-2.00], respectively). However, ROC curve analyses showed AUC:s of 0.57-0.64 indicating "fail" to "poor" combined sensitivity and specifity of these tests. CONCLUSION Greater strength in both sexes along with asymmetry in hip abductor strength in females increased the risk of acute ankle injury.
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Affiliation(s)
- Hietamo J
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland; KHKS, Hämeenlinna, Finland.
| | - Pasanen K
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland; Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Leppänen M
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Steffen K
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kannus P
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland; Departement of Orthopedics and Traumatology, Tampere University Hospital, and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Heinonen A
- University of Jyväskylä, Jyväskylä, Finland
| | - Mattila Vm
- Departement of Orthopedics and Traumatology, Tampere University Hospital, and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Parkkari J
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland; Departement of Orthopedics and Traumatology, Tampere University Hospital, and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
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Relationship Between Training Factors and Injuries in Stand-Up Paddleboarding Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030880. [PMID: 33498553 PMCID: PMC7908629 DOI: 10.3390/ijerph18030880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 01/10/2023]
Abstract
Stand-up paddleboarding (SUP) is an increasingly popular sport but, as in other sports, there is an injury ratio associated with practicing it. In other types of sport, some factors have been linked to the likelihood of suffering an injury, among which stretching, core training and resistance training may be considered the most significant. Therefore, the main aim of this study was to identify the training factors that could influence injuries suffered by participants in international SUP competitions. Ninety-seven questionnaires were collected from paddlers who participated in an international SUP circuit, with epidemiological data being gathered about injuries and different questions related to the training undertaken. A multi-factor ANOVA test was used to identify the factors which influence the state of injury. Results showed that almost 60% of injuries occurred in the arms or in the upper thoracic region, around 65% of which were in tendons or muscles and, in almost half of cases, were related to overuse. Likewise, the results showed that athletes with injury performed fewer resistance training sessions per week (p = 0.028), over fewer months per year (p = 0.001), more weekly training sessions (p = 0.004) and, lastly, a greater volume of weekly training (p = 0.003) than athletes without injury. Moreover, the most important training factors that reduce the likelihood of suffering an injury were taken into account-in. particular, resistance training alone (p = 0.011) or together with CORE training (p = 0.006) or stretching (p = 0.012), and the dominant side of paddling (p = 0.032). In conclusion, resistance training would seem to reduce the likelihood of injury among SUP practitioners, and such benefits could be obtained by resistance training alone or in combination with CORE training or stretching.
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Zeng J, Zhang R, Ke J, Wu X, Chen L, Wang Y, Xiao J. Reliability evaluation of functional movement screen for prevention of military training injury: A prospective study in China. J Occup Health 2021; 63:e12270. [PMID: 34423506 PMCID: PMC8381230 DOI: 10.1002/1348-9585.12270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 07/29/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the effectiveness and feasibility of functional movement screen (FMS) evaluation system and individualized intervention measures in preventing military training injuries. METHODS A total of 420 recruits from a unit of the People's Liberation Army of China were included as the research object. According to random grouping method, they were divided into observation group (Group A) and control group (Group B), with 210 patients in each group. Before recruit training, individual FMS was performed, and functional correction training was performed in the observation group according to the test scores, while no intervention measures were applied in the control group. After 3 months of training, the tests were repeated. Age, body mass index (BMI), and incidence of military training injuries were recorded during the training period. RESULTS There was no statistical difference between the two groups in age, BMI, FMS score before the training (P > .05). After receiving functional correction training, the FMS score of the Group A was higher than that of the Group B, and the difference was statistically significant (P < .05). The incidence of military training injury in Group A and Group B was 20.95% and 44.02%, respectively (P < .05), and the difference was statistically significant. CONCLUSION The evaluation system of FMS and individualized intervention measures are feasible and effective in predicting and reducing the occurrence of military training injuries.
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Affiliation(s)
- Jing Zeng
- Department of Special Service Physiological TrainingGuangzhou Special Service Recuperation Center of PLA Rocket ForceGuangzhouPeople’s Republic of China
| | - Rong‐Bing Zhang
- Department of Special Service Physiological TrainingGuangzhou Special Service Recuperation Center of PLA Rocket ForceGuangzhouPeople’s Republic of China
| | - Jing‐Jiu Ke
- Department of Special Service Physiological TrainingGuangzhou Special Service Recuperation Center of PLA Rocket ForceGuangzhouPeople’s Republic of China
| | - Xiang Wu
- Department of Special Service Physiological TrainingGuangzhou Special Service Recuperation Center of PLA Rocket ForceGuangzhouPeople’s Republic of China
| | - Li‐Hua Chen
- Department of Special Service Physiological TrainingGuangzhou Special Service Recuperation Center of PLA Rocket ForceGuangzhouPeople’s Republic of China
| | - Yan‐Yan Wang
- Hainan Hospital of PLA General HospitalSanyaPeople’s Republic of China
| | - Jun Xiao
- Department of Special Service Physiological TrainingGuangzhou Special Service Recuperation Center of PLA Rocket ForceGuangzhouPeople’s Republic of China
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24
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McGuine TA, Post E, Biese K, Kliethermes S, Bell D, Watson A, Brooks A, Lang P. The Incidence and Risk Factors for Injuries in Girls Volleyball: A Prospective Study of 2072 Players. J Athl Train 2020; 58:446976. [PMID: 33150377 PMCID: PMC10072088 DOI: 10.4085/182-20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Girls high school volleyball is very popular across the United States. There is limited prospective data regarding the incidence and risk factors of time loss (TL) and non-time loss (NTL) injuries sustained in this population. OBJECTIVES To estimate the incidence and describe the characteristics of injuries (TL and NTL) sustained in a girls' high school volleyball season. DESIGN Descriptive epidemiology study. SETTING Convenience sample of 78 high school interscholastic volleyball programs. PATIENTS OR OTHER PARTICIPANTS High school volleyball players participating during the 2018 interscholastic season. MAIN OUTCOME MEASURES TL and NTL injury rates, proportions, rate ratios, and with 95%CI. RESULTS A total of 2,072 girls enrolled in the study with 468 subjects (22.5%) sustaining 549 injuries (NTL=28.4%, TL=71.6%) for an overall injury rate of 5.31 [4.89, 5.79] per 1000 AEs. The competition injury rate was greater than the practice injury rate for all injuries (IRR: 1.19, [1.00, 1.41]) and TL injuries (IRR: 1.31, [1.07, 1.60]). Players with a previous musculoskeletal injury had a higher rate of TL than NTL injuries (IRR; 1.36 [1.12, 1.65]). Ankle injuries accounted for the greatest proportion of TL injuries (n=110, 28%), while the greatest proportion of NTL injuries occurred in the hand/fingers (n=34, 22%). Moreover, ligament sprains accounted for 40% of TL injuries (n=156), whereas muscle/tendon strains (n=79, 51%) accounted for over half of all NTL injuries. CONCLUSIONS While the majority of injuries sustained by adolescent girls' volleyball athletes were TL in nature, nearly a third of all injuries were NTL injuries. Injury characteristics differed widely between TL and NTL injuries. Understanding the most common types and characteristics of injury among high school volleyball players is critical for the development of effective injury prevention programs.
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25
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Culvenor AG, van Middelkoop M, Macri EM, Crossley KM. Is patellofemoral pain preventable? A systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2020; 55:bjsports-2020-102973. [PMID: 33115705 DOI: 10.1136/bjsports-2020-102973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of interventions to reduce the risk of incident patellofemoral pain. DESIGN Systematic review and meta-analysis, with strength of evidence evaluated separately for each intervention type. DATA SOURCES MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials evaluating the effectiveness of interventions to reduce patellofemoral pain risk compared with a control/non-exposed group. RESULTS Thirteen trials of mostly military recruits and young athletes analysed six different interventions. There was low certainty evidence from two trials (227 participants) that patellofemoral braces worn during physical activity (compared with no brace) effectively reduced the risk of patellofemoral pain (risk ratio (RR) 0.40, 95% CI 0.22 to 0.73; I2=24.0%). There was low certainty evidence from one trial (320 participants) that running technique retraining to (run softer) reduced patellofemoral pain risk (RR 0.21, 95% CI 0.07 to 0.60). There was low certainty evidence from four trials (3364 participants) that multicomponent (strengthening/neuromuscular) exercise programmes did not significantly reduce the risk of patellofemoral pain (RR 0.49, 95% CI 0.18 to 1.36; I2=64.9%), although broad CIs may reflect exercise dose variations among studies. There was very low certainty evidence from four trials (2314 participants) that foot orthoses (compared with flat inserts/no orthosis) did not significantly reduce the risk of patellofemoral pain (RR 0.63, 95% CI 0.35 to 1.13; I2=0.0%). Static stretching and a running programme that progressed intensity (compared with volume) did not significantly influence patellofemoral pain risk (single studies). CONCLUSION There is low-level evidence that patellofemoral braces and running technique retraining can reduce the risk of patellofemoral pain by 60%-79%.
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Affiliation(s)
- Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Erin M Macri
- Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Kay M Crossley
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia
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26
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Ladlow P, Conway D, Hayhurst D, Suffield C, Cassidy RP, Coppack RJ. Integration of strength training into UK Defence Rehabilitation practice: current trends and future challenges. BMJ Mil Health 2020; 168:314-319. [PMID: 33087537 PMCID: PMC9340023 DOI: 10.1136/bmjmilitary-2020-001590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/19/2020] [Accepted: 08/28/2020] [Indexed: 11/19/2022]
Abstract
The use of strength and conditioning (S&C) in musculoskeletal rehabilitation has gained wide acceptance among the rehabilitation community. However, there is an absence of evidence demonstrating how to best integrate the principles of S&C into rehabilitation practice. This article discusses four broad themes: (1) an overview of the UK Defence Rehabilitation care pathway, (2) the historical and current approaches to physical training to support operational readiness of the British Armed Forces, (3) the current and future challenges of integrating S&C into Defence Rehabilitation practice and (4) research priorities relating to the use of S&C in Defence Rehabilitation. We detail the importance of strength/power-based physical attributes within our military population. We recommend that consideration be given to the benefits of an alternative education/coaching-based model to be used during the current 3-week residential care pathway, which aims to ensure effective implementation of therapeutic S&C over a longer period of care.
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Affiliation(s)
- Peter Ladlow
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
- Department for Health, University of Bath, Bath, UK
| | - D Conway
- Complex Trauma Department, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
| | - D Hayhurst
- Primary Care Rehabilitation Facility (PCRF) Credenhill, Credinhill, UK
| | - C Suffield
- Physical and Recreational Training Centre, Army Training Centre Pirbright, Pirbright, UK
| | - R P Cassidy
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
- Centre for Lower Limb Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
| | - R J Coppack
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Stanford Hall, Loughborough, UK
- Versus Arthritis Centre for Sport, Exercise and Osteoarthritis Research, Department for Health, University of Bath, Bath, UK
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Stokes KA, Jones B, Bennett M, Close GL, Gill N, Hull JH, Kasper AM, Kemp SP, Mellalieu SD, Peirce N, Stewart B, Wall BT, West SW, Cross M. Returning to Play after Prolonged Training Restrictions in Professional Collision Sports. Int J Sports Med 2020; 41:895-911. [PMID: 32483768 PMCID: PMC7799169 DOI: 10.1055/a-1180-3692] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic in 2020 has resulted in widespread training disruption in many sports. Some athletes have access to facilities and equipment, while others have limited or no access, severely limiting their training practices. A primary concern is that the maintenance of key physical qualities (e. g. strength, power, high-speed running ability, acceleration, deceleration and change of direction), game-specific contact skills (e. g. tackling) and decision-making ability, are challenged, impacting performance and injury risk on resumption of training and competition. In extended periods of reduced training, without targeted intervention, changes in body composition and function can be profound. However, there are strategies that can dramatically mitigate potential losses, including resistance training to failure with lighter loads, plyometric training, exposure to high-speed running to ensure appropriate hamstring conditioning, and nutritional intervention. Athletes may require psychological support given the challenges associated with isolation and a change in regular training routine. While training restrictions may result in a decrease in some physical and psychological qualities, athletes can return in a positive state following an enforced period of rest and recovery. On return to training, the focus should be on progression of all aspects of training, taking into account the status of individual athletes.
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Affiliation(s)
- Keith A. Stokes
- Department for Health, University of Bath, Bath, United Kingdom of Great
Britain and Northern Ireland
- Medical Services, Rugby Football Union, Twickenham, United Kingdom of Great
Britain and Northern Ireland
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University
Carnegie Faculty, Leeds, United Kingdom of Great Britain and Northern
Ireland
- Leeds Rhinos Rugby League Club, Leeds, United Kingdom of Great Britain and
Northern Ireland
- England Performance Unit, Rugby Football League Ltd, Leeds, United Kingdom
of Great Britain and Northern Ireland
- Division of Exercise Science and Sports Medicine, University of Cape Town,
Faculty of Health Sciences, Cape Town, South Africa
| | - Mark Bennett
- Rugby Union of Russia, Moscow, Russian Federation
- Applied Sport Technology Exercise and Medicine Research Centre (A-STEM),
Swansea University College of Engineering, Swansea, United Kingdom of Great Britain
and Northern Ireland
| | - Graeme L. Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, United Kingdom of Great Britain and Northern
Irelan
- Professional Rugby Department, Rugby Football Union, Twickenham, United
Kingdom of Great Britain and Northern Ireland
| | - Nicholas Gill
- New Zealand Rugby Union, Wellington, New Zealand
- Te HuatakiWaiora School of Health, University of Waikato, Hamilton, New
Zealand
| | - James H. Hull
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United
Kingdom of Great Britain and Northern Ireland
| | - Andreas M. Kasper
- Professional Rugby Department, Rugby Football Union, Twickenham, United
Kingdom of Great Britain and Northern Ireland
| | - Simon P.T. Kemp
- Medical Services, Rugby Football Union, Twickenham, United Kingdom of Great
Britain and Northern Ireland
| | - Stephen D. Mellalieu
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan
University, Cardiff, United Kingdom of Great Britain and Northern
Ireland
| | - Nicholas Peirce
- Sport Science & Medicine, England and Wales Cricket Board,
Loughborough, United Kingdom of Great Britain and Northern Ireland
| | - Bob Stewart
- Medical Services, Rugby Football Union, Twickenham, United Kingdom of Great
Britain and Northern Ireland
| | - Benjamin T. Wall
- School of Sport and Health Sciences, University of Exeter, Exeter, United
Kingdom of Great Britain and Northern Ireland
| | - Stephen W. West
- Department for Health, University of Bath, Bath, United Kingdom of Great
Britain and Northern Ireland
| | - Matthew Cross
- Department for Health, University of Bath, Bath, United Kingdom of Great
Britain and Northern Ireland
- Professional Rugby Department, Rugby Football Union, Twickenham, United
Kingdom of Great Britain and Northern Ireland
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Hietamo J, Parkkari J, Leppänen M, Steffen K, Kannus P, Vasankari T, Heinonen A, Mattila VM, Pasanen K. Association between lower extremity muscular strength and acute knee injuries in young team‐sport athletes. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Jussi Hietamo
- Tampere Research Center of Sport Medicine UKK Institute for Health Promotion Research Tampere Finland
- KHKS Hämeenlinna Finland
| | - Jari Parkkari
- Tampere Research Center of Sport Medicine UKK Institute for Health Promotion Research Tampere Finland
- Department of Orthopedics and Traumatology Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology University of Tampere Tampere Finland
| | - Mari Leppänen
- Tampere Research Center of Sport Medicine UKK Institute for Health Promotion Research Tampere Finland
| | - Kathrin Steffen
- Oslo Sports Trauma Research Center Department of Sports Medicine Norwegian School of Sport Sciences Oslo Norway
| | - Pekka Kannus
- UKK Institute for Health Promotion Research Tampere Finland
| | | | | | - Ville M. Mattila
- Department of Orthopedics and Traumatology Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology University of Tampere Tampere Finland
| | - Kati Pasanen
- Tampere Research Center of Sport Medicine UKK Institute for Health Promotion Research Tampere Finland
- Sport Injury Prevention Research Centre Faculty of Kinesiology University of Calgary Calgary AB Canada
- Alberta Children’s Hospital Research Institute University of Calgary Calgary AB Canada
- McCaig Institute for Bone and Joint Health Cumming School of Medicine University of Calgary Calgary AB Canada
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29
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Dijksma I, Arslan IG, van Etten-Jamaludin FS, Elbers RG, Lucas C, Stuiver MM. Exercise Programs to Reduce the Risk of Musculoskeletal Injuries in Military Personnel: A Systematic Review and Meta-Analysis. PM R 2020; 12:1028-1037. [PMID: 32162467 PMCID: PMC7586796 DOI: 10.1002/pmrj.12360] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/17/2020] [Accepted: 03/03/2020] [Indexed: 12/13/2022]
Abstract
Objective To evaluate the effect of exercise programs on reduction of musculoskeletal injury (MSI) risk in military populations. Design Systematic review and meta‐analysis. Literature Survey A database search was conducted in PubMed/MEDLINE, EMBASE, Cochrane Library, CINAHL, SPORTdiscus, WHO International Clinical Trials Registry Platform Search Portal, Open Gray, National Technical Reports Library, and reference lists of included articles up to July 2019. Randomized and cluster‐randomized controlled trials evaluating exercise programs as preventive interventions for MSIs in armed forces compared to other exercise programs or to usual practice were eligible for inclusion. Methodology Two authors independently assessed risk of bias and extracted data. Data were adjusted for clustering if necessary and pooled using the random‐effects model when appropriate. Synthesis We included 15 trials in this review, with a total number of 14 370 participants. None of the included trials appeared to be free of any risk of bias. Meta‐analysis and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment could be performed for static stretching compared to no stretching (3532 participants), showing low quality of evidence indicating no favorable effect of stretching. Gait retraining, an anterior knee‐pain targeted program, and resistance exercises showed cautious favorable effects on reducing injury risk in military personnel. Conclusion The current evidence base for exercise‐based MSI prevention strategies in the military is of low quality. Areas worthy of further exploration include the effects of gait retraining, anterior knee‐pain targeted programs, agility training, and resistance training programs, on medial tibial stress syndrome incidence, anterior knee pain incidence, attrition due to injuries and any type of MSI, respectively.
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Affiliation(s)
- Iris Dijksma
- Clinical Epidemiology, Biostatistics and Bioinformatics, Master Evidence Based Practice in Health Care, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Defence Healthcare Organisation, Ministry of Defence, Utrecht, The Netherlands
| | - Ilgin G Arslan
- Clinical Epidemiology, Biostatistics and Bioinformatics, Master Evidence Based Practice in Health Care, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Roy G Elbers
- Clinical Epidemiology, Biostatistics and Bioinformatics, Master Evidence Based Practice in Health Care, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Cees Lucas
- Clinical Epidemiology, Biostatistics and Bioinformatics, Master Evidence Based Practice in Health Care, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Martijn M Stuiver
- Clinical Epidemiology, Biostatistics and Bioinformatics, Master Evidence Based Practice in Health Care, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Almaawi A, Awwad W, Bamugaddam A, Alasheikh M, Muaddi M, Almutair O, Alomar AZ. Prevalence of knee injuries among male college students in Riyadh, Kingdom of Saudi Arabia. J Orthop Surg Res 2020; 15:126. [PMID: 32238180 PMCID: PMC7110648 DOI: 10.1186/s13018-020-01638-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 03/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The knee is considered the most common injured joint between young sport participants. However, there is lack of proper prevalence estimation in our population. The purpose of this study was to identify the prevalence of knee injuries among male college students and to observe the demographic data associated with it. Our secondary objective was to evaluate the awareness and knowledge about these injuries. METHODS This is a cross-sectional study. A survey was distributed to collect the data among male college students, King Saud University, Riyadh, Saudi Arabia. Out of 688 students who participated and completed the questionnaire, a total of 482 were considered valid and met the inclusion criteria. Data were analyzed using Statistical Package for Social Sciences (SPSS). RESULTS The overall prevalence of knee injury was 23.2% (n = 112). Most of them injured during sport activities especially soccer and 68.7% involved in a non-contact mechanism of injury. Among those who went to a hospital mostly were diagnosed as contusion (31.4%) then as meniscus tear, ACL, and collateral ligament injury, respectively. Majority was treated conservatively and only 10.7% needed surgery surprisingly. There was no statistically significant difference between those who are injured and whether they were warmed up and stretched or not (P = 0.619). Low level of knowledge about knee injuries was noticed among the participants 57.7%. CONCLUSION Our study has highlighted the high prevalence of knee injuries and the need to raise the level of awareness and knowledge about these injuries in our population. Soccer was the most common sport associated with knee injuries; most of these injuries were treated conservatively.
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Affiliation(s)
- Abdulaziz Almaawi
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Waleed Awwad
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Azzam Bamugaddam
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Muath Alasheikh
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Omar Almutair
- Orthopedic Surgery Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulaziz Z Alomar
- Orthopedic Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Nielsen TG, Miller LL, Mygind-Klavsen B, Lind M. A simple rehabilitation regime improves functional outcome in patients with patellafemoral pain after 12 month. J Exp Orthop 2020; 7:5. [PMID: 32034562 PMCID: PMC7007455 DOI: 10.1186/s40634-020-00223-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/03/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The purpose of the present study was to investigate the effects of a 3-month multimodal intervention including patient education, a simple hip exercise program, footwear adjustment, and foot orthoses to reduce symptoms in patients with patellafemoral pain (PFP). METHODS Patients were diagnosed based on a physical examination, patient symptoms and ruled out intra-articular knee pathologies by MRI. Patients were educated on PFP and participated in a 3-month exercise program; shoes with solid heel-caps were recommended, and custom made orthoses with arch support were recommended to patients with foot pronation. The Anterior Knee Pain Scale (AKPS) and the pain numeric rating scale (NRS) were used to evaluate the outcomes of the intervention and collected at baseline, 3 and 12-months follow-ups. RESULTS Sixty-five patients (age 18 years (9-32)) were included in a consecutive prospective cohort. The AKPS score improved from 71 ± 24 to 89 ± 9 (p < 0.01) at 12 months follow up. The NRS-rest and NRS-activity improved from 3 to 0 (p < 0.01) and 7 to 3 (p < 0.01) respectively. 78% of the patients clinically improved (i.e., demonstrated a > 10-point improvement (minimal clinically important difference (MCID))) considering the AKPS; and 76% and 73% clinically improved (i.e., demonstrated (MCID) a ≥ 2-point improvement) in their NRS-rest and NRS-activity, respectively. No patients experienced a decrease in their AKPS score or an increase in their NRS-rest and NRS-activity scores at 12-months. CONCLUSION A 3-month PFP multimodal treatment strategy focusing on patient education, footwear adjustment, orthoses, and simple hip muscle exercises significantly improved functional outcomes and reduced pain at a 12 month follow-up.
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Affiliation(s)
- Torsten Grønbech Nielsen
- Orthopedic Department, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Lene Lindberg Miller
- Orthopedic Department, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Bjarne Mygind-Klavsen
- Orthopedic Department, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Martin Lind
- Orthopedic Department, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
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Lima KMME, Flôr JDS, Barbosa RI, Marcolino AM, Almeida MGD, Silva DCD, Kuriki HU. Effects of a 12-week hip abduction exercise program on the electromyographic activity of hip and knee muscles of women with patellofemoral pain: A pilot study. MOTRIZ: REVISTA DE EDUCACAO FISICA 2020. [DOI: 10.1590/s1980-6574201900040103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Juliane da Silva Flôr
- Universidade Federal de Santa Catarina, Brasil; Universidade Federal de Santa Catarina, Brasil
| | - Rafael Inácio Barbosa
- Universidade Federal de Santa Catarina, Brasil; Universidade Federal de Santa Catarina, Brasil
| | | | | | | | - Heloyse Uliam Kuriki
- Universidade Federal de Santa Catarina, Brasil; Universidade Federal de Santa Catarina, Brasil
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Wills JA, Saxby DJ, Lenton GK, Doyle TL. Ankle and knee moment and power adaptations are elicited through load carriage conditioning in males. J Biomech 2019; 97:109341. [DOI: 10.1016/j.jbiomech.2019.109341] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 09/08/2019] [Accepted: 09/11/2019] [Indexed: 11/30/2022]
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Astur DC, Angelini FB, Santos MA, Arliani GG, Belangero PS, Cohen M. Use of Exogenous Hyaluronic Acid for the Treatment of Patellar Chondropathy- A Six-Month Randomized Controlled Trial. Rev Bras Ortop 2019; 54:549-555. [PMID: 31686712 PMCID: PMC6819163 DOI: 10.1055/s-0039-1697974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/18/2019] [Indexed: 12/13/2022] Open
Abstract
Objective To evaluate the clinical and radiological benefits of intra-articular exogenous hyaluronic acid for the treatment of chondral patellar injury. Method Randomized clinical trial with 70 patients divided into 2 groups: those submitted to physical therapy for 3 months, and those submitted to physical therapy associated with the intra-articular administration of 2 mL of hyaluronic acid for the same period, who had anterior knee pain and patellar cartilage injury of grades II or III with no significant bone abnormalities. The functional scores and the characteristics of the physical and imaging exams were evaluated before and 3 and 6 months after the treatment. Result The average age of the patients was 32 ± 7.6 years. Patients from the hyaluronic acid group had better Kujala et al and Lysholm scores, and lower pain scores after 3 and 6 months of treatment when compared to the control group. The incidence of positive Clarke maneuver was lower in the treated group, but there was no difference in the magnetic resonance imaging classification. Conclusion Patients with patellar chondropathy of grades II or III treated with hyaluronic acid and physical therapy had less pain (visual analogue scale, VAS), and better functional results in the Lysholm and Kujala et al questionnaires after 3 and 6 months of treatment compared to patients undergoing physical therapy alone. In addition, the number of cases with a negative Clarke maneuver was larger in the treated group after 6 months of treatment.
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Affiliation(s)
- Diego Costa Astur
- Grupo do Joelho, Centro de Traumatologia do Esporte, Departamento de Ortopedia e Traumatologia da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Felipe Berteli Angelini
- Grupo do Joelho, Centro de Traumatologia do Esporte, Departamento de Ortopedia e Traumatologia da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Marcelo Abdulchlek Santos
- Grupo do Joelho, Centro de Traumatologia do Esporte, Departamento de Ortopedia e Traumatologia da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Gustavo Gonçalves Arliani
- Grupo do Joelho, Centro de Traumatologia do Esporte, Departamento de Ortopedia e Traumatologia da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Paulo Santoro Belangero
- Grupo do Joelho, Centro de Traumatologia do Esporte, Departamento de Ortopedia e Traumatologia da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Moisés Cohen
- Grupo do Joelho, Centro de Traumatologia do Esporte, Departamento de Ortopedia e Traumatologia da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
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Rethinking patellofemoral pain: Prevention, management and long-term consequences. Best Pract Res Clin Rheumatol 2019; 33:48-65. [DOI: 10.1016/j.berh.2019.02.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Bolgla LA, Boling MC, Mace KL, DiStefano MJ, Fithian DC, Powers CM. National Athletic Trainers' Association Position Statement: Management of Individuals With Patellofemoral Pain. J Athl Train 2018; 53:820-836. [PMID: 30372640 DOI: 10.4085/1062-6050-231-15] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE: To present recommendations for athletic trainers and other health care providers regarding the identification of risk factors for and management of individuals with patellofemoral pain (PFP). BACKGROUND: Patellofemoral pain is one of the most common knee diagnoses; however, this condition continues to be one of the most challenging to manage. Recent evidence has suggested that certain risk factors may contribute to the development of PFP. Early identification of risk factors may allow clinicians to develop and implement programs aimed at reducing the incidence of this condition. To date, clinicians have used various treatment strategies that have not necessarily benefitted all patients. Suboptimal outcomes may reflect the need to integrate clinical practice with scientific evidence to facilitate clinical decision making. RECOMMENDATIONS: The recommendations are based on the best available evidence. They are intended to give athletic trainers and other health care professionals a framework for identifying risk factors for and managing patients with PFP.
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Affiliation(s)
- Lori A Bolgla
- Department of Physical Therapy, Augusta University, GA
| | - Michelle C Boling
- Department of Clinical and Applied Movement Sciences, University of North Florida, Jacksonville
| | | | | | | | - Christopher M Powers
- Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles
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Neal BS, Lack SD, Lankhorst NE, Raye A, Morrissey D, van Middelkoop M. Risk factors for patellofemoral pain: a systematic review and meta-analysis. Br J Sports Med 2018; 53:270-281. [PMID: 30242107 DOI: 10.1136/bjsports-2017-098890] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Patellofemoral pain (PFP) is a prevalent condition commencing at various points throughout life. We aimed to provide an evidence synthesis concerning predictive variables for PFP, to aid development of preventative interventions. METHODS We searched Medline, Web of Science and SCOPUS until February 2017 for prospective studies investigating at least one potential risk factor for future PFP. Two independent reviewers appraised methodological quality using the Newcastle-Ottawa Scale. We conducted meta-analysis where appropriate, with standardised mean differences (SMD) and risk ratios calculated for continuous and nominal scaled data. RESULTS This review included 18 studies involving 4818 participants, of whom 483 developed PFP (heterogeneous incidence 10%). Three distinct subgroups (military recruits, adolescents and recreational runners) were identified. Strong to moderate evidence indicated that age, height, weight, body mass index (BMI), body fat and Q angle were not risk factors for future PFP. Moderate evidence indicated that quadriceps weakness was a risk factor for future PFP in the military, especially when normalised by BMI (SMD -0.69, CI -1.02, -0.35). Moderate evidence indicated that hip weakness was not a risk factor for future PFP (multiple pooled SMDs, range -0.09 to -0.20), but in adolescents, moderate evidence indicated that increased hip abduction strength was a risk factor for future PFP (SMD 0.71, CI 0.39, 1.04). CONCLUSIONS This review identified multiple variables that did not predict future PFP, but quadriceps weakness in military recruits and higher hip strength in adolescents were risk factors for PFP. Identifying modifiable risk factors is an urgent priority to improve prevention and treatment outcomes.
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Affiliation(s)
- Bradley S Neal
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Pure Sports Medicine, London, UK
| | - Simon D Lack
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Pure Sports Medicine, London, UK
| | | | - Andrew Raye
- Sports and Exercise Medicine, Queen Mary University of London, London, UK
| | - Dylan Morrissey
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Physiotherapy Department, Barts Health NHS Trust, London, UK
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Lauersen JB, Andersen TE, Andersen LB. Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis. Br J Sports Med 2018; 52:1557-1563. [DOI: 10.1136/bjsports-2018-099078] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2018] [Indexed: 12/24/2022]
Abstract
ObjectiveThis review aims to analyse strength training-based sports injury prevention randomised controlled trials (RCT) and present best evidence recommendations for athletes and future research. A priori PROSPERO registration; CRD42015006970.DesignSystematic review, qualitative analysis and meta-analysis. Sorting of studies and quality assessments were performed by two independent authors. Qualitative analyses, relative risk (RR) estimate with robustness and strength of evidence tests, formal tests of publication bias and post-hoc meta-regression were performed.Data sourcesPubMed, Embase, Web of Science and SPORTDiscus were searched to July 2017.Eligibility criteria for selecting studiesRCTs on strength training exercises as primary prevention of sports injuries.ResultsSix studies analysed five different interventions with four distinct outcomes. 7738 participants aged 12–40 years were included and sustained 177 acute or overuse injuries. Studies were published in 2003–2016, five from Europe and one from Africa. Cluster-adjusted intention-to-treat analysis established RR 0.338 (0.238–0.480). The result was consistent across robustness tests and strength of evidence was high. A 10% increase in strength training volume reduced the risk of injury by more than four percentage points. Formal tests found no publication bias.ConclusionThe included studies were generally well designed and executed, had high compliance rates, were safe, and attained consistently favourable results across four different acute and overuse injury outcomes despite considerable differences in populations and interventions. Increasing strength training volume and intensity were associated with sports injury risk reduction. Three characteristically different approaches to prevention mechanisms were identified and incorporated into contemporary strength training recommendations.
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de Andrade Gomes MZ, Pinfildi CE. Prevalence of musculoskeletal injuries and a proposal for neuromuscular training to prevent lower limb injuries in Brazilian Army soldiers: an observational study. Mil Med Res 2018; 5:23. [PMID: 30049289 PMCID: PMC6062882 DOI: 10.1186/s40779-018-0172-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 07/06/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries. METHODS This observational (cross-sectional) study recruited a sample of 103 soldiers who required medical attention, from a total 202 new battalion soldiers. The medical records (paper and online) had a form of running text. All data collected were recorded by the registered physicians of the battalion medical post. The records were analyzed by the following variables: medical diagnosis, injury site, mechanism, type of treatment, time loss, existence of previous injury, and recurring injury. RESULTS A total of 112 musculoskeletal injuries were diagnosed in 71 soldiers, and other types of diseases/injuries were diagnosed in the other soldiers. Joint pain accounted for 55.4% of the diagnoses. The knee was the most affected site, while trauma and overload were the most common mechanisms of injury. Drug treatment was used most frequently, accounting for 58% of the cases. The majority of the sample obtained a temporary leave of absence for 1 to 6 days or not at all. Previous injuries and recurrence were not presented as risk factors for injury. With the data received, a protocol for the prevention of injuries to the lower limbs was proposed. CONCLUSION This study indicated that the most frequent site of injury is the knee, and joint pain is the most common diagnosis. These results may support the necessity to develop a neuromuscular training protocol to prevent lower limb injuries, which we suggest to be applied in future studies.
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Affiliation(s)
- Michele Zukauskas de Andrade Gomes
- Department of Human Movement Science, Federal University of São Paulo (UNIFESP), Campus Baixada Santista, Rua Silva Jardim, 136, Vila Mathias, Santos, SP 11015-020 Brazil
| | - Carlos Eduardo Pinfildi
- Human Movement Science and Rehabilitation, Department of Human Movement Science, Federal University of São Paulo-Physical Therapy, Campus Baixada Santista, Rua Silva Jardim, 136, Vila Mathias, Santos, SP 11015-020 Brazil
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Smith BE, Selfe J, Thacker D, Hendrick P, Bateman M, Moffatt F, Rathleff MS, Smith TO, Logan P. Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PLoS One 2018; 13:e0190892. [PMID: 29324820 PMCID: PMC5764329 DOI: 10.1371/journal.pone.0190892] [Citation(s) in RCA: 249] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/21/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Patellofemoral pain is considered one of the most common forms of knee pain, affecting adults, adolescents, and physically active populations. Inconsistencies in reported incidence and prevalence exist and in relation to the allocation of healthcare and research funding, there is a clear need to accurately understand the epidemiology of patellofemoral pain. METHODS An electronic database search was conducted, as well as grey literature databases, from inception to June 2017. Two authors independently selected studies, extracted data and appraised methodological quality. If heterogeneous, data were analysed descriptively. Where studies were homogeneous, data were pooled through a meta-analysis. RESULTS 23 studies were included. Annual prevalence for patellofemoral pain in the general population was reported as 22.7%, and adolescents as 28.9%. Incidence rates in military recruits ranged from 9.7-571.4/1,000 person-years, amateur runners in the general population at 1080.5/1,000 person-years and adolescents amateur athletes 5.1%-14.9% over 1 season. One study reported point prevalence within military populations as 13.5%. The pooled estimate for point prevalence in adolescents was 7.2% (95% Confidence Interval: 6.3%-8.3%), and in female only adolescent athletes was 22.7% (95% Confidence Interval 17.4%-28.0%). CONCLUSION This review demonstrates high incidence and prevalence levels for patellofemoral pain. Within the context of this, and poor long term prognosis and high disability levels, PFP should be an urgent research priority. PROSPERO REGISTRATION CRD42016038870.
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Affiliation(s)
- Benjamin E Smith
- Derby Teaching Hospitals NHS Foundation Trust, London Road Community Hospital, Derby, United Kingdom
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - James Selfe
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Damian Thacker
- PhysioWorks (Sheffield), Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Paul Hendrick
- Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences, University of Nottingham, Nottingham University Hospitals (City Campus), Nottingham, United Kingdom
| | - Marcus Bateman
- Derby Teaching Hospitals NHS Foundation Trust, London Road Community Hospital, Derby, United Kingdom
| | - Fiona Moffatt
- Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences, University of Nottingham, Nottingham University Hospitals (City Campus), Nottingham, United Kingdom
| | - Michael Skovdal Rathleff
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine at Aalborg University, Aalborg, Denmark
- Department of Occupational Therapy and Physiotherapy, Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Toby O Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Pip Logan
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Padua DA, DiStefano LJ, Hewett TE, Garrett WE, Marshall SW, Golden GM, Shultz SJ, Sigward SM. National Athletic Trainers' Association Position Statement: Prevention of Anterior Cruciate Ligament Injury. J Athl Train 2018; 53:5-19. [PMID: 29314903 DOI: 10.4085/1062-6050-99-16] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To provide certified athletic trainers, physicians, and other health care and fitness professionals with recommendations based on current evidence regarding the prevention of noncontact and indirect-contact anterior cruciate ligament (ACL) injuries in athletes and physically active individuals. BACKGROUND Preventing ACL injuries during sport and physical activity may dramatically decrease medical costs and long-term disability. Implementing ACL injury-prevention training programs may improve an individual's neuromuscular control and lower extremity biomechanics and thereby reduce the risk of injury. Recent evidence indicates that ACL injuries may be prevented through the use of multicomponent neuromuscular-training programs. RECOMMENDATIONS Multicomponent injury-prevention training programs are recommended for reducing noncontact and indirect-contact ACL injuries and strongly recommended for reducing noncontact and indirect-contact knee injuries during physical activity. These programs are advocated for improving balance, lower extremity biomechanics, muscle activation, functional performance, strength, and power, as well as decreasing landing impact forces. A multicomponent injury-prevention training program should, at minimum, provide feedback on movement technique in at least 3 of the following exercise categories: strength, plyometrics, agility, balance, and flexibility. Further guidance on training dosage, intensity, and implementation recommendations is offered in this statement.
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Bonato M, Benis R, La Torre A. Neuromuscular training reduces lower limb injuries in elite female basketball players. A cluster randomized controlled trial. Scand J Med Sci Sports 2018; 28:1451-1460. [PMID: 29239030 DOI: 10.1111/sms.13034] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 11/30/2022]
Abstract
The study was a two-armed, parallel group, cluster randomized controlled trial in which 15 teams (160 players) were assigned to either an experimental group (EG, 8 teams n = 86), which warmed-up with bodyweight neuromuscular exercises, or a control group (CG, 7 teams, n = 74) that performed standard tactical-technical exercises before training. All injuries during the 2015-2016 regular season were counted. Epidemiologic incidence proportion and incidence rate were also calculated. Countermovement jump (CMJ) and composite Y-Excursion Balance test (YBT) were used to assess lower limb strength and postural control. A total of 111 injuries were recorded. Chi-square test detected statistically significant differences between EG and CG (32 vs 79, P = .006). Significant differences in the injuries sustained in the EG (21 vs 11, P = .024) and CG (52 vs 27, P = .0001) during training and matches, respectively, were observed. Significant differences in post-intervention injuries were observed between in EG and CG during training (21 vs 52, P < .0001) and matches (11 vs 27, P = .006). Significant differences in epidemiologic incidence (0.37 vs 1.07, P = .023) and incidence rate (1.66 vs 4.69, P = .012) between the EG and the CG were found. Significant improvement in CMJ (+9.4%, P < .0001; d = 1.2) and composite YBT (right: +4.4%, P = .001, d = 1.0; left: +3.0%, P = .003; d = 0.8) for the EG was noted. Significant differences in post-intervention CMJ (+5.9%, P = .004) and composite YBT scores (right, +3.7%, P = .012; left, +2.3%, P = .007) between the EG and the CG were observed. Including bodyweight neuromuscular training into warm-up routines reduced the incidence of serious lower limb injuries in elite female basketball players.
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Affiliation(s)
- M Bonato
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - R Benis
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - A La Torre
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
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Wardle SL, Greeves JP. Mitigating the risk of musculoskeletal injury: A systematic review of the most effective injury prevention strategies for military personnel. J Sci Med Sport 2017; 20 Suppl 4:S3-S10. [PMID: 29103913 DOI: 10.1016/j.jsams.2017.09.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 09/11/2017] [Accepted: 09/19/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To update the current injury prevention strategy evidence base for making recommendations to prevent physical training-related musculoskeletal injury. DESIGN We conducted a systematic review to update the evidence base on injury prevention strategies for military personnel. METHODS Literature was systematically searched and extracted from five databases, and reported according to PRISMA guidelines. Sixty one articles meeting the inclusion criteria and published during the period 2008-2015 were selected for systematic review. RESULTS The retrieved articles were broadly categorised into six injury prevention strategies; (1) conditioning, (2) footwear modifications, (3) bracing, (4) physical activity volume, (5) physical fitness, and (6) leadership/supervision/awareness. The majority of retrieved articles (n=37 (of 61) evaluated or systematically reviewed a conditioning intervention of some nature. However, the most well-supported strategies were related to reducing physical activity volume and improving leadership/supervision/awareness of injuries and injury prevention efforts. CONCLUSIONS Several injury prevention strategies effectively reduce musculoskeletal injury rates in both sexes, and many show promise for utility with military personnel. However, further evaluation, ideally with prospective randomised trials, is required to establish the most effective injury prevention strategies, and to understand any sex-specific differences in the response to these strategies.
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Affiliation(s)
- Sophie L Wardle
- Division of Applied Human Physiology, Army Personnel Research Capability, Army Headquarters, Andover, UK.
| | - Julie P Greeves
- Division of Applied Human Physiology, Army Personnel Research Capability, Army Headquarters, Andover, UK
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van Reijen M, Vriend I, van Mechelen W, Finch CF, Verhagen EA. Compliance with Sport Injury Prevention Interventions in Randomised Controlled Trials: A Systematic Review. Sports Med 2017; 46:1125-39. [PMID: 26869058 PMCID: PMC4963451 DOI: 10.1007/s40279-016-0470-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Sport injury prevention studies vary in the way compliance with an intervention is defined, measured and adjusted for. OBJECTIVE The objective of this systematic review was to assess the extent to which sport injury prevention randomised controlled trials (RCTs) have defined, measured and adjusted results for compliance with an injury prevention intervention. METHODS An electronic search was performed in MEDLINE, PubMed, the Cochrane Center of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database) and SPORTDiscus. English RCTs, quasi-RCTs and cluster-RCTs were considered eligible. Trials that involved physically active individuals or examined the effects of an intervention aimed at the prevention of sport- or physical activity-related injuries were included. RESULTS Of the total of 100 studies included, 71.6 % mentioned compliance or a related term, 68.8 % provided details on compliance measurement and 51.4 % provided compliance data. Only 19.3 % analysed the effect of compliance rates on study outcomes. While studies used heterogeneous methods, pooled effects could not be presented. CONCLUSIONS Studies that account for compliance demonstrated that compliance significant affects study outcomes. The way compliance is dealt with in preventions studies is subject to a large degree of heterogeneity. Valid and reliable tools to measure and report compliance are needed and should be matched to a uniform definition of compliance.
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Affiliation(s)
- Miriam van Reijen
- Department of Public & Occupational Health, EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands
| | - Ingrid Vriend
- Department of Public & Occupational Health, EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands.,Consumer Safety Institute VeiligheidNL, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public & Occupational Health, EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & 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.,UCT/MRC Research Unit for 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 Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, VIC, Australia
| | - Evert A Verhagen
- Department of Public & Occupational Health, EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands. .,Amsterdam Collaboration on Health & 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. .,UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
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Althunyan AK, Darwish MA, Abdel Wahab MM. Knee problems and its associated factors among active cyclists in Eastern Province, Saudi Arabia. J Family Community Med 2017; 24:23-29. [PMID: 28163572 PMCID: PMC5248430 DOI: 10.4103/2230-8229.197178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Bicycling is one of the most enjoyable aerobic exercises recommended for the promotion of an individual's health. The Eastern Province of Saudi Arabia has seen a huge increase in the number of people who cycle. People have different goals for bicycling, but the injuries they sustain are common. Most of them relate to overuse, particularly of lower body joints. This study was conducted to determine the prevalence of knee problems and factors associated with knee pain in cyclists. MATERIALS AND METHODS A cross-sectional study was conducted in October 2015, using an online self-administered questionnaire. The questionnaire was based on pertinent literature, was piloted, and validated. A web link was sent to 513 cyclists (professional and amateur) using E-mail, WhatsApp application, or SMS. Three hundred and eleven responses were received, 283 of which were included in the analysis. RESULTS The overall prevalence of knee pain was 25.8%; 27.6% for amateur cyclists and 15.9% for professional cyclists. Only 17.2% knee pain was attributed to cycling, whereas in 32.8% it happened spontaneously and in 25% of cases it occurred while running. Majority of the cyclists reported pain as mild (61.6%) or moderate (28.7%); anterior knee pain accounted for 58.1% knee pain. Different goals of cycling and different bicycle types had statistically significant difference on the rate of knee pain. Of underweight cyclists, 62.2% reported knee pain. Cyclists who run more or participated in football had a higher rate of pain. CONCLUSION Knee injuries are common with cyclists. Factors such as the type of the bicycle, the goal of bicycling, club type, body mass index, and participation in other sports play a significant role in the rate of knee pain.
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Affiliation(s)
- Abdullatif K Althunyan
- Department of Family and Community Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - Magdy A Darwish
- Department of Family and Community Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - Moataza M Abdel Wahab
- Department of Family and Community Medicine, University of Dammam, Dammam, Kingdom of Saudi Arabia; Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Thomson C, Krouwel O, Kuisma R, Hebron C. The outcome of hip exercise in patellofemoral pain: A systematic review. ACTA ACUST UNITED AC 2016; 26:1-30. [DOI: 10.1016/j.math.2016.06.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 04/10/2016] [Accepted: 06/06/2016] [Indexed: 12/31/2022]
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Lehr ME, Kime D, Onks C, Silvis M, Streisel M. Development of a preliminary evidence-based neuromusculoskeletal exercise guideline to reduce injury risk in the lower limb. Phys Ther Sport 2016; 25:76-83. [PMID: 28188077 DOI: 10.1016/j.ptsp.2016.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 12/26/2022]
Abstract
Athletic participation growth has resulted in increased exposures and neuromusculoskeletal (NMSK) non-contact injuries. Based on current evidence, the primary objective of this literature review is to create a preliminary evidence-based NMSK exercise guideline, addressing these intrinsic modifiable risk factors. Systematic searches were conducted September 2014 prior to data extraction utilizing CINAHL Plus (1995 to September 2014), MEDLINE (1995 to September 2014), and Academic Search Premier (1995 to September 2014). A priori defined inclusion criteria were applied and included the following: (i) full text, (ii) published in English, (iii) peer-reviewed articles addressing injury risk of non-contact lower extremity injury, (iv) identified specific exercises aimed at reducing injury risk of non-contact lower extremity injury, were the key data extraction points of interest. 3163 potential articles were identified from the initial search, 3120 excluded with reason based on the exclusion criteria. Exclusion criteria was applied in the form of an eight item list summarized in table 2, 43 articles remained after search criteria were applied. Novel to the current body of knowledge, this review identified nine intrinsic modifiable risk factors of the NMSK system that were used as a foundation to create the exercise guideline consisting of 30 exercise techniques.
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Affiliation(s)
- Michael E Lehr
- Lebanon Valley College, Department of Physical Therapy, 101 North College Avenue, Annville, PA, 17003-1400, USA.
| | - Devin Kime
- Lebanon Valley College, Department of Physical Therapy, 101 North College Avenue, Annville, PA, 17003-1400, USA
| | - Cayce Onks
- Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| | - Matthew Silvis
- Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| | - Megan Streisel
- Lebanon Valley College, Athletic Training Department, 101 North College Avenue, Annville, PA, 17003-1400, USA
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Vercruysse S, Haerens L, Verhagen E, Goossens L, De Clercq D. Effects of a multifactorial injury prevention intervention in physical education teachers: A randomized controlled trial. Eur J Sport Sci 2016; 16:868-76. [PMID: 26848872 DOI: 10.1080/17461391.2016.1140812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Physical education (PE) teachers are at a high risk of musculoskeletal sports or work-related injuries because of the physical activity as inherent part of their profession. Such injuries have a negative impact on work and leisure time activities, and effective injury prevention interventions are needed. The present study aimed at testing the effectiveness of an injury prevention intervention that was developed and optimized according to PE teachers' wishes and values. Fifty-five PE teachers were randomly assigned to intervention or control group. Intervention group teachers engaged in two days of training during which they familiarized with eight injury prevention strategies (seven intrinsic and one extrinsic). A special feature of the intervention was that the way of delivery was based on the self-determination theory in order to stimulate participants' motivation to adhere to the proposed strategies. Prospective registrations during one school year were conducted concerning injuries and preventive behaviours. Results showed that the intervention group teachers had a lower number of injuries per 1000 h time of exposure (TOE) than the controls (INT: 0.49, CON: 1.14 injuries/1000 h TOE, OR: 2.32, 95% CI: 1.06-5.07), and applied a broader variety of strategies including dynamic and static stretching, core stability, balance and strength training, when compared to the controls who mainly engaged in warming-up. In conclusion, with the same amount of time, an injury reduction was found in PE teachers through a more balanced use of provided preventive strategies.
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Affiliation(s)
- Sien Vercruysse
- a Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium
| | - Leen Haerens
- a Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium
| | - Evert Verhagen
- b Amsterdam, Collaboration on Health & Safety in Sports, Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
| | - Lennert Goossens
- a Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium
| | - Dirk De Clercq
- a Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium
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Dawson SJ, Herrington L. Improving Single-Legged-Squat Performance: Comparing 2 Training Methods With Potential Implications for Injury Prevention. J Athl Train 2015; 50:921-9. [PMID: 26308498 DOI: 10.4085/1062-6050-50.9.03] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Poor dynamic limb alignment during loading tasks has links to the development of knee injuries, including patellofemoral pain and anterior cruciate ligament injury. Therefore, modalities to improve limb alignment during loading tasks are thought to reduce loading through these structures and potentially prevent injury. OBJECTIVE To compare hip-strengthening and skill-acquisition training to examine if they can improve lower limb biomechanics, potentially preventing injury, and to examine whether changes demonstrated can be maintained after 6 weeks of no practice. DESIGN Controlled laboratory study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 19 recreationally active individuals volunteered, and 17 (9 women: age = 27.9 ± 3.1 years, height = 165.4 ± 8.4 cm, mass = 60.5 ± 9.2 kg; 8 men: age = 30.4 ± 6.4 years, height = 181.4 ± 7.1 cm, mass = 69.8 ± 15.2 kg) completed the study. Nine participants were allocated to a hip-strengthening program; 8, to a skill-acquisition program. INTERVENTION(S) Participants performed a 6-week training program of either hip strengthening (n = 9) or skill acquisition (n = 8) 3 times per week. MAIN OUTCOME MEASURE(S) Measurements of clam-exercise strength, hip-abduction strength, frontal-plane projection angle, hip-adduction angle, and a qualitative score were taken at baseline, 6 weeks, and 12 weeks. RESULTS We observed improvements in frontal-plane projection angle (strength: t8 = 5.344, P = .001; skill: t7 = 4.393, P = .003), hip-adduction angle (strength: t8 = 3.597, P = .007; skill: t7 = 4.722, P = .002), and qualitative score (strength: t8 = 3.900, P = .005; skill: t7 = 8.283, P < .001) postintervention, which were retained at the 12-week retest in both groups. CONCLUSIONS A 6-week intervention of either hip-strengthening or skill-acquisition training improved lower limb biomechanics. The changes in biomechanics after skill training were retained at 12 weeks, suggesting a change in motor patterning that could be favorable to longer-term injury prevention.
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Affiliation(s)
- Samuel J Dawson
- Physiotherapy Department, Wrexham Maelor Hospital, United Kingdom
| | - Lee Herrington
- Directorate of Sport, University of Salford, Manchester, United Kingdom
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