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Hardaker NJ, Hume PA, Sims ST. Differences in Injury Profiles Between Female and Male Athletes Across the Participant Classification Framework: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:1595-1665. [PMID: 38536647 DOI: 10.1007/s40279-024-02010-7] [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: 02/23/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Female sex is a significant determinant of anterior cruciate ligament (ACL) injury. It is not understood if sex is a key determinant of other sports-related injuries. OBJECTIVE The aim of this systematic review was to identify where differences in injury profiles are most apparent between the sexes in all sports across the six-tiered participant classification framework. METHODS This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the 'implementing PRISMA in Exercise, Rehabilitation, Sport medicine and SporTs science'(PERSiST) guidance. The databases PubMed, CINAHL, Web of Science, SPORTDiscus, Medline, Scopus, Cochrane Library and EBSCO were searched from database inception to 24 April 2023. Longitudinal, prospective and retrospective cohort studies and cross-sectional and descriptive epidemiology studies that used standard injury data collection were included. Studies were excluded if injuries were not medically diagnosed and if injuries were not reported and/or analysed by sex. Two reviewers independently extracted data and assessed study quality using the Downs and Black checklist. RESULTS Overall, 180 studies were included (8 tier-5, 40 tier-4, 98 tier-3, 30 tier-2, 5 tier-1 studies; one study included data in two tiers). Of those, 174 studies were of moderate quality and six studies were of limited quality. In sex-comparable sports, there was moderate evidence that female athletes had greater risk of knee injury (relative risk (RR) 2.7; 95% CI 1.4-5.5), foot/ankle injuries (RR 1.25; 95% CI 1.17-1.34), bone stress injury (RR 3.4; 95% CI 2.1-5.4) and concussion (RR 8.46; 95% CI 1.04-68.77) than male athletes. Male athletes were at increased risk of hip/groin injuries (RR 2.26; 95% CI 1.31-3.88) and hamstring injuries (RR 2.4; 95% CI 1.8-3.2) compared with females, particularly in dynamic sports. Male athletes were 1.8 (1.37-2.7) to 2.8 (2.45-3.24) times more likely to sustain acute fractures than female athletes, with the highest risk in competition. DISCUSSION Most studies in all cohorts were of moderate quality (mean/range of scores tier-5: 17 ± 2.2 [14-20], tier-4: 16.9 ± 1.9 [11-21], tier-3: 16.9 ± 1.5 [11-20], tier-2: 16.3 ± 2.2 [11-20], tier-1 studies: 15.6 ± 1.3 [14-17] out of 28 on the Downs and Black checklist), with only six studies of limited quality. Female athletes' propensity for bone stress injuries highlights opportunities to reinforce development of optimal bone health during adolescence and to outline the effects of energy availability. Earlier strength development and exposure to neuromuscular training programmes and modification of skill development in female athletes may be effective strategies for reducing lower limb injury risk. Key components of neuromuscular training programmes could be beneficial for reducing hip/groin and hamstring injury risk in male athletes. There may be a need for sex-specific prevention and return-to-sport protocols for sports-related concussion in female athletes. CONCLUSIONS Female sex was a key determinant of sports-related injuries beyond ACL injury including foot/ankle injury, bone stress injury and sports-related concussion. Male sex was a key determinant of hip/groin, hamstring injury and upper limb injury. TRIAL REGISTRY PROSPERO registration number: CRD42017058806 (last updated on 7th June 2023).
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Affiliation(s)
- Natalie J Hardaker
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand.
- Accident Compensation Corporation, Wellington, New Zealand.
| | - Patria A Hume
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
- Tech & Policy Lab, Law School, The University of Western Australia, Perth, Australia
| | - Stacy T Sims
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
- Stanford Lifestyle Medicine, Stanford University, Palo Alto, CA, USA
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Reider B. Grappling With Injury. Am J Sports Med 2024; 52:583-585. [PMID: 38426230 DOI: 10.1177/03635465241230333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
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Gureck AE, Crockett Z, Barsky BW, Samuels S, Frank JS, Storer SK, Fazekas ML. Do Differences Exist in Impact Test Domains between Youth Athletes with and without an Anterior Cruciate Ligament Injury? Healthcare (Basel) 2023; 11:2764. [PMID: 37893838 PMCID: PMC10606848 DOI: 10.3390/healthcare11202764] [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: 09/13/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
Poor baseline reaction time, as measured via the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), has been associated with anterior cruciate ligament (ACL) injury risk in adult athletes. Our study sought to determine whether the reaction time and impulse control ImPACT test domains differed between ACL injured and uninjured pediatric athletes. A total of 140 high-school aged athletes comprising 70 athletes who went on to sustain an ACL injury between 2012 and 2018 and 70 age- and sex-matched uninjured controls were included in the study. Mean reaction times were similar for the injured (0.67 s) and uninjured (0.66 s) athletes (p = 0.432), and the impulse control scores were also similar for those with (5.67) and without (6.07) an ACL injury (p = 0.611). Therefore, neurocognitive risk factors for sustaining an ACL injury in adults cannot necessarily be extrapolated to adolescent athletes. Further research is needed to understand why differences exist between injury risk in youth and adult athletes.
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Affiliation(s)
- Ashley E. Gureck
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
| | - Zack Crockett
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
| | - Brandon W. Barsky
- Department of Sports Medicine, Kettering Health, Kettering, OH 45429, USA
| | - Shenae Samuels
- Memorial Healthcare System, Office of Human Research, Hollywood, FL 33021, USA
| | - Jeremy S. Frank
- Department of Orthopaedic Surgery and Sports Medicine, JoeDiMaggio Children’s Hospital, Hollywood, FL 33021, USA
| | - Stephen K. Storer
- Department of Orthopaedic Surgery and Sports Medicine, JoeDiMaggio Children’s Hospital, Hollywood, FL 33021, USA
| | - Matthew L. Fazekas
- Department of Orthopaedic Surgery and Sports Medicine, JoeDiMaggio Children’s Hospital, Hollywood, FL 33021, USA
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Rohde M, Ruhlemann A, Busch A, Grunwald U, Jaeger M, Mayer C. Evaluation of the Back-in-Action test Battery In Uninjured High School American Football Players. Int J Sports Phys Ther 2023; V18:746-757. [PMID: 37425120 PMCID: PMC10324321 DOI: 10.26603/001c.75367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/11/2023] [Indexed: 07/11/2023] Open
Abstract
Background Return to sport testing is an established routine, especially for athletes who have ruptured their anterior cruciate ligament (ACL). Various tests are performed, often combined in test batteries, such as the Back-in-action (BIA) test battery. Unfortunately, pre-injury performance is often unknown, and only few athletes pass the high demands of these test batteries. Purpose The aim of the study was to determine the performance of under 18 American football players on the BIA to establish pre-injury sport specific benchmarks for future RTS testing and to compare these values to data from an age-matched reference group. Methods Fifty-three healthy male American football players underwent a functional assessment using the "Back-in-action" test battery evaluating agility, speed (Parkour-Jumps and Quick-Feet test), balance (using a PC based balance board), and power (Counter-Movement-Jump [CMJ]) as objective measures. Their results were compared with a previously tested reference group (RP) and within the american football players (AF) through three subgroups according to field playing position. Results Overall, the American football (AF) athletes showed lower balance scores for both legs (AF: 3.71/3.57/3.61; RP: 3.4/3.2/3.2; p<0.002) compared to the reference population (RP). CMJ height and Quick-Feet results were not statistically different (p>0.05), Parkour-Jump times (AF: 8.18/ 8.13 sec.; RP: 5.9/5.9sec.; p<0.001) were significantly slower. Power output in all CMJ's (AF: 46.86/36.94/37.36 W/kg; RP: 43.2/29.5/29 W/kg; p<0.001) was significantly higher than the RP. Passing and running game involved players (G2 & G3) showed significantly better balance scores (G2+G3: 3.36/3.27/3.33; G1: 4.22/4.06/4.10; p<0.001), higher jump height (G2&G3: 38.87/24.02/24.96 cm; G1: 32.03/19.50/18.96 cm; p<0.001) and more watts/kg (G2&G3: 48.83/37.21/37.64 W/kg; G1: 43.95/36.88/36.53 W/kg; p<0.001) compared to blocking players like Linemen (G1) and to the age matched reference population (RP). Conclusion Only 53% of the healthy athletes would have been cleared for sport using the BIA test criteria, which highlights the challenging passing criteria. Despite significantly greater power measurements, scores of balance and agility were poorer compared to the reference group, especially for linemen. These data may serve as sport and position specific reference for high school American football players, instead of using the non-specific reference group data. Study design cross-sectional study. Level of evidence IIb.
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Affiliation(s)
- Marcel Rohde
- Orthopedics and Traumatology St. Marien Hospital Mulheim an der Ruhr
- Dean's office of the medical faculty University of Duisburg-Essen
- Orthopedics and Traumatology University of Duisburg-Essen
| | - Alina Ruhlemann
- Dean's office of the medical faculty university Duisburg Essen University of Duisburg-Essen
- Orthopedics and Traumatology University of Duisburg-Essen
| | - Andre Busch
- Orthopedics and Traumatology Katholisches Klinikum Philippusstift Essen
| | - Ulrich Grunwald
- Orthopedics and Traumatology Johannes Wesling Klinikum Minden
| | - Marcus Jaeger
- Head of the Chair of Orthopedics and Traumatology University of Duisburg-Essen
- Orthopedics and Traumatology St. Marien Hospital Mülheim an der Ruhr
| | - Constantin Mayer
- Orthopedics and Traumatology St. Marien Hospital Mülheim an der Ruhr
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Kennedy MA, Fortington LV, Penney M, Hart NH, d’Hemecourt PA, Sugimoto D. Running Marathons in High School: A 5-Year Review of Injury in a Structured Training Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4426. [PMID: 36901436 PMCID: PMC10001535 DOI: 10.3390/ijerph20054426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The aim in this study was to quantify the number, nature, and severity of injuries sustained by male and female high school students who took part in a running training program that culminated in the completion of a half or full marathon. DESIGN This study is a retrospective clinical audit. METHODS Injury reports from high school students (grades 9-12) who participated in a half or full marathon 30-week progressive training program comprising four training days per week (three running days and one cross-training day) were reviewed. The number of runners completing a marathon, together with the number, nature, severity of injuries, and treatment types, as reported to the program physiotherapist, were the main outcome measures. RESULTS Program completion was 96% (n = 448/469). Of all participants, 186 (39.6%) were injured, with 14 withdrawing from the program due to injury. For those who completed a marathon, 172 (38%) reported 205 musculoskeletal injuries (age of injured runners: 16.3 ± 1.1 years; 88 girls (51.2%) and 84 boys (48.8%)). More than half (n = 113, 55.1%) of the reported injuries were soft tissue injuries. Most injuries were localized to the lower leg (n = 88, 42.9%) and were of a minor nature (n = 181, 90%), requiring only 1-2 treatments. CONCLUSIONS There was a low number of relatively minor injuries for high school participants taking part in a graduated and supervised marathon training program. The injury definition was conservative (i.e., any attendance to physiotherapist) and the relative severity of injuries was minor (i.e., requiring 1-2 treatment sessions). Overall, these results do not support a need to restrict high school students from taking part in marathon running, though continued emphasis on graduated program development and close supervision of young participants is recommended.
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Affiliation(s)
- Mary A. Kennedy
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Lauren V. Fortington
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Matt Penney
- Advanced Sports Therapy, Wellesley, MA 02481, USA
- Sports Rehabilitation Unlimited, Middleton, MA 01949, USA
| | - Nicolas H. Hart
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5000, Australia
- Human Performance Research Centre, School of Sport, Exercise and Rehabilitation, University of Technology (UTS), Sydney, NSW 2021, Australia
- Institute for Health Research, University of Notre Dame Australia, Perth, WA 6027, Australia
| | - Pierre A. d’Hemecourt
- Division of Sports Medicine, Department of Orthopaedics, Boston Children’s Hospital, Waltham, MA 02115, USA
- Harvard Medical School, Harvard University, Boston, MA 02115, USA
- The Micheli Center for Sports Injury Prevention, Boston Children’s Hospital, Waltham, MA 02453, USA
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention, Boston Children’s Hospital, Waltham, MA 02453, USA
- Faculty of Sport Sciences, Waseda University, Tokyo 202-0021, Japan
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Tanaka MJ, LiBrizzi CL, Rivenburgh DW, Jones LC. Changes in U.S. girls' participation in high school sports: implications for injury awareness. PHYSICIAN SPORTSMED 2021; 49:450-454. [PMID: 33210569 DOI: 10.1080/00913847.2020.1852861] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONTEXT The number of female athletes has grown exponentially since Title IX. However, little data exists on the proportion of women and girls who play each sport. OBJECTIVE To quantify changes in female sports participation in high school sports from 1973 to 2018. DESIGN Retrospective analysis of data from the National Federation of State High School Associations Participation Survey. SETTING US high schools. PARTICIPANTS US high school athletes from 1973 to 2018. MAIN OUTCOME MEASURES Percentage of female participation for each high school sport in 5-year intervals; and changes in rates of participation by player gender and sport at designated intervals. RESULTS From 1973 to 2018, the percentage of high school sports played by girls increased from 24.2% to 42.9% ([95%CI, 18.6,18.8], p < 0.0001). In the 14 sports included in our study, all had an increase in the percentage of female participation between 1973 and 2018. >80% of the increases occurred between 1973 and 1998 for all sports except lacrosse, ice hockey, football, and wrestling. Between 1998 and 2018, the percentage of girls playing each sport increased by less than 5% in all sports, except for ice hockey (11.5%, 95% CI 11.0, 12.0, p < 0.001) and wrestling (7.1%, 95% CI 6.9, 7.1, p < 0.001). CONCLUSIONS Girls' participation in high school sports continues to grow not only in numbers but in the types of sports played. Between 1998 and 2018, the greatest increases were noted in ice hockey and wrestling, which had fewer than 1% female participation before 1998. Physicians providing care for female athletes should be aware of these changes and understand the potential injuries associated with these sports.
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Affiliation(s)
- Miho J Tanaka
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Christa L LiBrizzi
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Dennis W Rivenburgh
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Lynne C Jones
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
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Audlin J, Tipirneni K, Ryan J. Facial Trauma Patterns Among Young Athletes. Craniomaxillofac Trauma Reconstr 2021; 14:218-223. [PMID: 34567418 DOI: 10.1177/1943387520966424] [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] [Indexed: 11/17/2022] Open
Abstract
Study Design Retrospective case series review. Objective Participation in athletics is common in high school and college students and presents an increased risk of injury in this age-group. Previous studies have included National Collegiate Athletic Association athletes but not high school athletes. Here we report the trends of maxillofacial injuries in high school students. Methods Patients presenting to a level 1 trauma center with maxillofacial injuries were identified by chart query with associated International Classification of Diseases, 10th Revision codes for facial fractures between October 2015 and October 2017. Data collected included age, sport, fracture type, need for surgery, associated concussion, and time to return to play were measured. New York State Public High School Athletic Association regional high school sports participation data from 2016 to 2018 were used to calculate incidence. Results A total of 33 patients aged 13 to 19 years were identified. Baseball, basketball, and lacrosse were most frequently associated with maxillofacial trauma. Annual incidence rates for mandible fractures in high school athletes were 0.037%, 0.012%, and 0.01% for lacrosse, baseball, and basketball, respectively. Annual fracture incidence rates for midface fractures in high school athletes were 0.17%, 0.018%, and 0.01% for baseball, lacrosse, and basketball, respectively. Conclusion Maxillofacial fractures are uncommon injuries among athletes but present with serious implications including surgical correction. Baseball was strongly associated with midface fractures despite being considered a noncontact sport. Improved facial protection across all sports will be imperative at reducing the incidences of these injuries. Level of Evidence Level 4.
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Affiliation(s)
- Jason Audlin
- Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Kiranya Tipirneni
- Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jesse Ryan
- Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, NY, USA
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McSweeney SC, Grävare Silbernagel K, Gruber AH, Heiderscheit BC, Krabak BJ, Rauh MJ, Tenforde AS, Wearing SC, Zech A, Hollander K. Adolescent Running Biomechanics - Implications for Injury Prevention and Rehabilitation. Front Sports Act Living 2021; 3:689846. [PMID: 34514384 PMCID: PMC8432296 DOI: 10.3389/fspor.2021.689846] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/23/2021] [Indexed: 12/28/2022] Open
Abstract
Global participation in running continues to increase, especially amongst adolescents. Consequently, the number of running-related injuries (RRI) in adolescents is rising. Emerging evidence now suggests that overuse type injuries involving growing bone (e.g., bone stress injuries) and soft tissues (e.g., tendinopathies) predominate in adolescents that participate in running-related sports. Associations between running biomechanics and overuse injuries have been widely studied in adults, however, relatively little research has comparatively targeted running biomechanics in adolescents. Moreover, available literature on injury prevention and rehabilitation for adolescent runners is limited, and there is a tendency to generalize adult literature to adolescent populations despite pertinent considerations regarding growth-related changes unique to these athletes. This perspective article provides commentary and expert opinion surrounding the state of knowledge and future directions for research in adolescent running biomechanics, injury prevention and supplemental training.
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Affiliation(s)
- Simon C McSweeney
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Allison H Gruber
- Department of Kinesiology, School of Public Health - Bloomington, Indiana University, Bloomington, IN, United States
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, WI, United States
| | - Brian J Krabak
- Department of Rehabilitation, Orthopedics and Sports Medicine, University of Washington and Seattle Childrens Hospital, Seattle, WA, United States
| | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, United States
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Scott C Wearing
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Jena, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Faculty of Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Pike Lacy AM, Eason CM, Stearns RL, Casa DJ. Secondary School Administrators' Knowledge and Perceptions of the Athletic Training Profession, Part I: Specific Considerations for Athletic Directors. J Athl Train 2021; 56:1018-1028. [PMID: 33150440 DOI: 10.4085/54-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Athletic directors are charged with making impactful decisions for secondary school athletic programs that mitigate risks for stakeholders. This includes decision making regarding the provision of medical care for student-athletes. To date, few researchers have explored athletic directors' perceptions of the athletic training profession. OBJECTIVE To evaluate public school athletic directors' knowledge and perceptions of the athletic trainer (AT) role. DESIGN Concurrent mixed-methods study. SETTING Cross-sectional online questionnaire. PATIENTS OR OTHER PARTICIPANTS Athletic directors representing all 50 states and the District of Columbia (N = 954; 818 men, 133 women, 3 preferred not to answer; age = 47.8 ± 9.1 years; time in current role = 9.8 ± 8.3 years). MAIN OUTCOME MEASURE(S) The questionnaire was composed of demographics, quantitative measures that assessed athletic directors' knowledge and perceived value of ATs, and open-ended questions allowing for expansion on their perspectives. Descriptive statistics were reported, with key quantitative findings presented as count responses and overall percentages. Qualitative data were analyzed using the general inductive approach. RESULTS A majority of respondents recognized ATs' role in injury prevention (99.8%), first aid and wound care (98.8%), therapeutic interventions (93.8%), and emergency care (91.6%). Approximately 61% (n = 582) identified AT employment as a top sport safety measure, and 77% (n = 736) considered an AT to be extremely valuable to student-athlete health and safety. Athletic directors appeared to recognize the value of ATs as they provided "peace of mind" and relieved coaches and administration of the responsibility for making medical decisions. CONCLUSIONS Athletic directors seemed to recognize the value ATs brought to the secondary school setting and demonstrated adequate knowledge regarding ATs' roles and responsibilities. Educational efforts for this population should focus on ATs' tasks that add to their perceived value but are not frequently in the public eye, which may influence hiring decisions.
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Affiliation(s)
- Alicia M Pike Lacy
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
| | - Christianne M Eason
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs
| | - Rebecca L Stearns
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs
| | - Douglas J Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs
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Lower extremity energy absorption strategies at different phases during single and double-leg landings with knee valgus in pubertal female athletes. Sci Rep 2021; 11:17516. [PMID: 34471189 PMCID: PMC8410826 DOI: 10.1038/s41598-021-96919-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/19/2021] [Indexed: 02/07/2023] Open
Abstract
Dynamic knee valgus (DKV) malalignment affects the biomechanical characteristic during sports activities. This cross-sectional study was conducted to evaluate mechanical energy absorption (MEA) strategies at initial contact (IC) and total landing (TL) phases during single-leg landing (SLL), and double-leg landing (DLL). Twenty-eight female athletes with DKV (age 10-14) were invited. MEA analysis of lower extremity joints was done in sagittal and frontal motion planes employing 8 Vicon motion capture cameras and 2 Kistler force plates. Statistical analysis was done using IBM Statistics (version24) by Bivariate Pearson Correlation Coefficient test. Knee extensors MEA during SLL (IC: P = 0.008, R = 0.522/TL: P < 0.001, R = 0.642) and DLL (IC: P < 0.001, R = 0.611/TL: P = 0.011, R = 0.525), and knee abductors during SLL (IC: P = 0.021, R = 0.474) were positively correlated with increased DKV angle. Ankle plantar flexors during SLL (TL: P = 0.017, R = - 0.477) and DLL (TL: P = 0.028, R = - 0.404), and hip extensors during SLL (TL: P = 0.006, R = - 0.5120) were negatively correlated with increased DKV angle. Compensated MEA in knee extensors was correlated with less ankle plantar flexion MEA during SLL (IC: P = 0.027, R = - 0.514/TL: P = 0.007, R = - 0.637) and DLL (IC: P = 0.033, R = - 00.412/TL: P = 0.025, R = - 0.485). These outcomes indicated a knee-reliant MEA strategy in female athletes with DKV during puberty, putting them at higher risks of ACL injuries during landing.
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Injury Reduction Programs for Reducing the Incidence of Sport-Related Head and Neck Injuries Including Concussion: A Systematic Review. Sports Med 2021; 51:2373-2388. [PMID: 34143411 DOI: 10.1007/s40279-021-01501-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sport-related head and neck injuries, including concussion, are a growing global public health concern with a need to explore injury risk reduction strategies such as neck exercises. OBJECTIVES To systematically review the literature to investigate: (1) the relationship between neck strength and sport-related head and neck injuries (including sport-related concussion (SRC); and (2) whether neck exercise programs can reduce the incidence of (a) sport-related head and neck injuries; and (b) SRC. METHODS Five databases (Ovid MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science) and research lists of included studies were searched using a combination of medical subject headings and keywords to locate original studies which reported the association between incidence of head and/or neck injury and neck strength data, or included a neck exercise intervention either in isolation or as part of a more comprehensive exercise program. RESULTS From an initial search of 593 studies, six were included in this review. A narrative synthesis was performed due to the heterogeneity of the included studies. The results of two observational studies reported that higher neck strength, but not deep neck flexor endurance, is associated with a lower risk of sustaining a SRC. Four intervention studies demonstrated that injury reduction programs that included neck exercises can reduce the incidence of sport-related head and neck injuries including SRC. CONCLUSION Consideration should be given towards incorporating neck exercises into injury reduction exercise programs to reduce the incidence of sport-related head and neck injuries, including SRC. SYSTEMATIC REVIEW REGISTRATION PROSPERO (registration number: 194217).
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12
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Rinaldo N, Gualdi-Russo E, Zaccagni L. Influence of Size and Maturity on Injury in Young Elite Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063120. [PMID: 33803535 PMCID: PMC8003020 DOI: 10.3390/ijerph18063120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023]
Abstract
The involvement of pre-adolescents in soccer is becoming more and more frequent, and this growing participation generates some concerns about the potential factors for sports injuries. The purpose of this study was to investigate sports injuries in younger (U9–U11) and older (U12–U13) children playing soccer at an elite level, analyzing potential anthropometric and maturity risk factors. A total of 88 elite soccer players aged 9–13 years were investigated. Weight, stature, and sitting height were measured at the start and at the end of the competitive season, computing the relative growth velocities. Additional body composition parameters were taken during a second survey. Maturity offset was calculated using predictive equations based on anthropometric traits such as years from age at peak height velocity (YPHV). Injuries suffered during the competitive season were recorded. Maturity and some anthropometric characteristics were significantly different according to the presence or absence of injuries among the players. Multiple logistic regression revealed that YPHV, body mass index (BMI), and calf muscle area were the factors most significantly correlated with injuries. Players with increased BMI, with decreased calf muscle area, and who were closer to their peak height velocity, were at a higher risk of injury. Findings showed that a monitoring program of anthropometric characteristics taking into account the maturational stage needs to be developed to prevent injuries.
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13
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Scheer V, Costa RJS, Doutreleau S, Knechtle B, Nikolaidis PT, Roberts WO, Stoll O, S Tenforde A, Krabak B. Recommendations on Youth Participation in Ultra-Endurance Running Events: A Consensus Statement. Sports Med 2021; 51:1123-1135. [PMID: 33704697 DOI: 10.1007/s40279-021-01441-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2021] [Indexed: 12/28/2022]
Abstract
Participation in ultra-endurance running (UER) events continues to grow across ages, including youth athletes. The 50- and 100-km are the most popular distances among youth athletes. Most youth athletes are between 16-18 years; however, some runners younger than 12 years have successfully completed UER events. Parents, athletes, coaches, race directors, and medical professionals often seek advice regarding the safety of youth athletes participating in these events, especially with regard to potential short and long-term health consequences. UER may impact key organ systems during growth and development. We propose a decision-making process, based on current knowledge and the experience of the consensus group that addresses age regulations, medical and psychological well-being, training status and race-specific factors (such as distance, elevation change, remoteness, ambient temperatures, level of medical assistance, and type of provisions provided by the race organizers) to use until evidence of long-term consequences of UER in youth athletes is available. These recommendations are aimed at safe participation in UER events for youth athletes with a proper and individualized assessment.
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Affiliation(s)
- Volker Scheer
- Ultra Sports Science Foundation, 109 Boulevard de l'Europe, 69310, Pierre-Benite, France. .,Health Science Department, Universidad a Distancia de Madrid (UDIMA), Madrid, Spain.
| | - Ricardo J S Costa
- Department of Nutrition Dietetics and Food, Monash University, Melbourne, Australia
| | | | - Beat Knechtle
- Medbase St. Gallen am Vadianplatz, St. Gallen, Switzerland.,Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | | | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Oliver Stoll
- Institute of Sport Science, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Adam S Tenforde
- Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Brian Krabak
- University of Washington and Seattle Children's Sports Medicine, Seattle, WA, USA
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14
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Haraldsdottir K, Watson AM. Psychosocial Impacts of Sports-related Injuries in Adolescent Athletes. Curr Sports Med Rep 2021; 20:104-108. [PMID: 33560034 DOI: 10.1249/jsr.0000000000000809] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Adolescence represents a time of tremendous physical, social, and emotional growth, and sport participation can provide significant mental health benefits for young athletes. Injuries are unfortunately common in sports and represent a threat to the short- and long-term health of athletes. While injury management has typically revolved around the minimization of pain and the restoration of physical function, emerging evidence suggests that the psychological consequences of injury may be significant, potentially jeopardizing return to play, increasing subsequent reinjury risk, and even leading to the development of mental health disorders. The majority of this research has been conducted in adult athletes and less is known about outcomes in youth athletes following injury. This review examines what is known about the psychosocial impact of sports injuries in youth athletes to identify areas of future research and to aid clinicians in the management of this population.
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Affiliation(s)
- Kristin Haraldsdottir
- Department of Orthopedics, University of Wisconsin School of Medicine and Public Health, Madison, WI
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15
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Benito-de-Pedro M, Becerro-de-Bengoa-Vallejo R, Elena Losa-Iglesias M, Rodríguez-Sanz D, López-López D, Palomo-López P, Mazoteras-Pardo V, Calvo-Lobo AC. Effectiveness of Deep Dry Needling vs Ischemic Compression in the Latent Myofascial Trigger Points of the Shortened Triceps Surae from Triathletes on Ankle Dorsiflexion, Dynamic, and Static Plantar Pressure Distribution: A Clinical Trial. PAIN MEDICINE 2021; 21:e172-e181. [PMID: 31502640 DOI: 10.1093/pm/pnz222] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the immediate efficacy of a single session of deep dry needling (DDN) vs ischemic compression (ICT) in a latent myofascial trigger point (MTrP) of the shortened triceps surae from triathletes for ankle dorsiflexion and redistribution of plantar pressures and stability. DESIGN A randomized simple blind clinical trial (NCT03273985). SETTING An outpatient clinic. SUBJECTS Thirty-four triathletes with a latent MTrP in the shortened gastrocnemius. METHODS Triathletes were randomized to receive a single session of DDN (N = 17) or ICT (N = 17) in a latent MTrP of the shortened triceps surae. The primary outcome was ankle dorsiflexion range of motion (ROM) by a universal goniometer. Secondary objectives were distribution of dynamic and static plantar pressures by T-Plate platform pressure, with measurements both before and after five, 10, 15, 20, and 25 minutes of treatment. RESULTS There were no statistically significant differences (P > 0.05) for ankle dorsiflexion ROM or dynamic and static plantar pressures between the experimental group treated with DDN and the control group treated with ICT before and after treatment. CONCLUSIONS DDN vs ICT carried out in latent MTrPs of the shortened gastrocnemius of triathletes did not present differences in terms of dorsiflexion ROM of the tibiofibular-talar joint or in static and dynamic plantar pressure changes before and immediately after treatment.
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Affiliation(s)
- María Benito-de-Pedro
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences. Faculty of Nursing and Podiatry, Universidade da Coruña, Coruña, Spain
| | - Patricia Palomo-López
- Department of Nursing, University Center of Plasencia, University of Extremadura, Extremadura, Spain
| | - Victoria Mazoteras-Pardo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - And César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
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16
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Stögner VA, Kaltenborn A, Laser H, Vogt PM. Hand injuries in sports - a retrospective analysis of 364 cases. BMC Musculoskelet Disord 2020; 21:826. [PMID: 33292173 PMCID: PMC7724715 DOI: 10.1186/s12891-020-03807-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 11/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand injuries are common in sports and associated with high dropout rates and costs. Hence, efforts should strive for further risk prevention measures in order to increase safety in sports. This implies knowledge of sports injury risk profiles. So far, major surveillance programs exist mainly in Anglo-American countries, reflecting the specific concerns of sports in this part of the world. Data on sports injuries within Europe are scarce. As sports behaviour appears to vary demographically, we hypothesised that risk injury profiles differ as well. METHODS To assess whether the described sports injuries of the hand are applicable to the German population, we performed a five-year retrospective, single-centre analysis of sports-related hand injuries, using data from the Enterprise Clinical Research Data Warehouse of the Hannover Medical School. RESULTS Notable differences in comparison to other data were observed. Ball sports, cycling and equestrian sports caused most of the recorded hand injuries, which were predominantly fractures of the wrist and hand. Hand injuries in equestrian sports were associated with significantly higher operation and hospitalisation rates as well as a significantly longer inpatient treatment. CONCLUSION Risk profiles for sports-related hand injuries appear to differ not only in terms of age- and sex, but also geographically. Nation- and Europe-wide hand trauma registries as well as a broad registry participation are necessary in order to accurately assess the risk patterns in Europe; henceforth reducing hand injuries and their sequelae.
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Affiliation(s)
- Viola A Stögner
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
| | - Alexander Kaltenborn
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.,Department of Trauma and Orthopedic Surgery, Plastic, Hand and Reconstructive Surgery, Armed Forces Hospital Westerstede, Lange Strasse 38, 26655, Westerstede, Germany
| | - Hans Laser
- Department for Educational and Scientific IT Systems, Centre for Information Management, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Peter M Vogt
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
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17
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Krabak BJ, Roberts WO, Tenforde AS, Ackerman KE, Adami PE, Baggish AL, Barrack M, Cianca J, Davis I, D'Hemecourt P, Fredericson M, Goldman JT, Harrast MA, Heiderscheit BC, Hollander K, Kraus E, Luke A, Miller E, Moyer M, Rauh MJ, Toresdahl BG, Wasfy MM. Youth running consensus statement: minimising risk of injury and illness in youth runners. Br J Sports Med 2020; 55:305-318. [PMID: 33122252 DOI: 10.1136/bjsports-2020-102518] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2020] [Indexed: 01/25/2023]
Abstract
Despite the worldwide popularity of running as a sport for children, relatively little is known about its impact on injury and illness. Available studies have focused on adolescent athletes, but these findings may not be applicable to preadolescent and pubescent athletes. To date, there are no evidence or consensus-based guidelines identifying risk factors for injury and illness in youth runners, and current recommendations regarding suitable running distances for youth runners at different ages are opinion based. The International Committee Consensus Work Group convened to evaluate the current science, identify knowledge gaps, categorise risk factors for injury/illness and provide recommendations regarding training, nutrition and participation for youth runners.
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Affiliation(s)
- Brian J Krabak
- Rehabilitation, Orthopedics and Sports Medicine, Univesrity of Washington, Seattle, Washington, USA
| | - William O Roberts
- Family Medicine and Community Health, University of Minnesota, St Paul, Minnesota, USA
| | - Adam S Tenforde
- Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | | | - Paolo Emilio Adami
- Health and Science, IAAF Health & Science Department, International Association of Athletics Federations (IAAF), Monaco
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Michelle Barrack
- Family and Consumer Sciences, California State University, Long Beach, Long Beach, California, USA
| | - John Cianca
- Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Irene Davis
- Physical Medicine and Rehabilitation, National Running Center, Cambridge, Massachusetts, USA
| | | | | | - Joshua T Goldman
- Sports Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Mark A Harrast
- Rehabilitation, Orthopedics and Sports Medicine, Univesrity of Washington, Seattle, Washington, USA
| | - Bryan C Heiderscheit
- Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Emily Kraus
- Orthopaedic Surgery, Stanford Hospital and Clinics, Stanford, California, USA
| | - Anthony Luke
- Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Emily Miller
- Sports Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Melissa Moyer
- Sports Physical Therapy, Sanford Health, Sioux Falls, South Dakota, USA
| | - Mitchell J Rauh
- School of Exercise and Nutritional Sciences, Doctor of Physical Therapy Program, San Diego State University, San Diego, California, USA
| | - Brett G Toresdahl
- Primary Care Sports Medicine, Hospital for Special Surgery, New York, New York, USA
| | - Meagan M Wasfy
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
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18
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Post EG, Trigsted SM, Schaefer DA, Cadmus-Bertram LA, Watson AM, McGuine TA, Brooks MA, Bell DR. Knowledge, Attitudes, and Beliefs of Youth Sports Coaches Regarding Sport Volume Recommendations and Sport Specialization. J Strength Cond Res 2020; 34:2911-2919. [DOI: 10.1519/jsc.0000000000002529] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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19
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Lee ASY, Standage M, Hagger MS, Chan DKC. Predictors of in-school and out-of-school sport injury prevention: A test of the trans-contextual model. Scand J Med Sci Sports 2020; 31:215-225. [PMID: 32939848 PMCID: PMC7756760 DOI: 10.1111/sms.13826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 08/20/2020] [Accepted: 09/04/2020] [Indexed: 11/28/2022]
Abstract
The current study aimed to predict secondary school students’ motivation toward sport injury prevention in “in‐school” and “out‐of‐school” contexts, and their sport injury prevention behavior at 3‐month follow‐up using the trans‐contextual model (TCM). Hong Kong secondary school students (N = 1566; mean age = 13.34 years, range = 11 to 19; female = 49.42%) were recruited. Participants were asked to complete a survey comprising previously validated scales measuring TCM constructs at baseline and a measure of sport injury prevention behavior at follow‐up three months later. Structural equation modeling (SEM) was used to examine the hypothesized paths among TCM constructs. A SEM specifying hypothesized paths among TCM variables showed acceptable fit with the data (χ2(29) = 418.55, CFI = .93, TLI = .90, and RMSEA = .09, 90% CI [.09, .10], and SRMR = .05). Findings supported tenets of the TCM: the effects of perceived autonomy support from PE teachers on in‐school autonomous motivation toward injury prevention, the trans‐contextual relationship between students' “in‐school” and “out‐of‐school” autonomous motivation toward injury prevention, and the effects of autonomous motivation toward injury prevention on social cognitive variables and subsequent sport injury prevention behaviors. Results supported the tenets proposed within the TCM in predicting students' “in‐school” and “out‐of‐school” autonomous motivation toward sport injury prevention. Findings underscore the potential importance of autonomy support from PE teachers in facilitating students’ sport injury prevention behaviors. Further longitudinal and intervention research is warranted to establish temporal and causal effects of TCM variables in sport injury prevention.
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Affiliation(s)
- Alfred S Y Lee
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Martyn Standage
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Martin S Hagger
- SHARPP Lab, Psychological Sciences, University of California, Merced, CA, USA.,Faculty of Sport and Health Sciences, University of University of Jyväskylä, Jyväskylä, Finland
| | - Derwin K C Chan
- School of Public Health, The University of Hong Kong, Hong Kong, China.,Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong, China.,School of Psychology, Curtin University, Perth, WA, Australia
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20
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Schmidt JD, Rawlins MLW, Lynall RC, D'Lauro C, Clugston JR, McAllister TW, McCrea M, Broglio SP. Medical Disqualification Following Concussion in Collegiate Student-Athletes: Findings from the CARE Consortium. Sports Med 2020; 50:1843-1855. [PMID: 32557231 DOI: 10.1007/s40279-020-01302-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The absence of evidence-based guidelines make medical disqualification (MDQ) following concussion one of the most challenging decision-making processes faced by sports medicine professionals. OBJECTIVE We aimed to compare premorbid and postmorbid factors between student-athletes that were and were not medically disqualified from sport following a concussion. METHODS Among 1832 student-athletes diagnosed with concussion within the CARE Consortium, 53 (2.9%) were medically disqualified (MDQ +) and 1779 (97.1%) were not medically disqualified (MDQ-). We used contingency tables and descriptive statistics for an initial evaluation of a broad list of premorbid and postmorbid factors. For those factors showing association with MDQ status, we calculated odds ratios and 95% confidence intervals for the odds of being MDQ + in the presence of the identified factor. RESULTS History of 2 (OR: 3.2, 95% CI 1.5, 6.9) or 3 + (OR: 7.4, 95% CI 3.4, 15.9) previous concussions; 1 + headaches in past 3 months (OR: 1.8, 95% CI 1.0, 3.2); immediate removal from play (OR: 2.4, 95% CI 1.2, 4.9); alcohol (OR: 2.6, 95% CI 1.2, 5.4), tobacco (OR: 3.3, 95% CI 1.1, 9.5), or marijuana use since injury (OR: 5.4, 95% CI 1.5, 19.0); as well as prolonged recovery due to mental health alterations (OR: 5.3, 95% CI 2.0, 14.1) or motivation/malingering (OR: 7.5, 95% CI 3.3, 17.0) increased odds of being MDQ + . The MDQ + group took longer to become asymptomatic relative to the MDQ- group (MDQ + : 23.5 days, 95% CI 15.8, 31.2; MDQ-: 10.6 days, 95% CI 9.5, 11.6; p < 0.001). CONCLUSIONS MDQ following concussion was relatively rare. We identified three patterns related to MDQ following concussion: (1) concussion and headache history were the only premorbid factors that differed (2) initial concussion presentation was more severe and more immediate in the MDQ + group, and (3) post-concussion recovery outcomes expressed the greatest differences between groups.
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Affiliation(s)
- Julianne D Schmidt
- UGA Concussion Research Laboratory, University of Georgia, 330 River Rd, Athens, GA, USA.
- Department of Kinesiology, University of Georgia, 330 River Rd, Athens, GA, USA.
| | | | - Robert C Lynall
- UGA Concussion Research Laboratory, University of Georgia, 330 River Rd, Athens, GA, USA
- Department of Kinesiology, University of Georgia, 330 River Rd, Athens, GA, USA
| | - Christopher D'Lauro
- Department of Behavioral Science and Leadership, United States Air Force Academy, USAF, Air Force Academy, CO, USA
| | - James R Clugston
- Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, USA
| | - Tom W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
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21
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Sweeney EA, Wilson JC, Potter MN, Dahab KS, Denay KL, Howell DR. Symptom profiles and postural control after concussion in female artistic athletes. Brain Inj 2020; 34:928-933. [DOI: 10.1080/02699052.2020.1763464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Emily A. Sweeney
- Department of Orthopedics, University of Colorado School of Medicine , Aurora, CO, USA
- Sports Medicine Center, Children’s Hospital Colorado , Aurora, CO, USA
| | - Julie C. Wilson
- Department of Orthopedics, University of Colorado School of Medicine , Aurora, CO, USA
- Sports Medicine Center, Children’s Hospital Colorado , Aurora, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine , Aurora, CO, USA
| | - Morgan N. Potter
- Department of Physical Therapy, University of Delaware , Newark, DE, USA
| | - Katherine S. Dahab
- Department of Orthopedics, University of Colorado School of Medicine , Aurora, CO, USA
- Sports Medicine Center, Children’s Hospital Colorado , Aurora, CO, USA
| | - Keri L. Denay
- Department of Family Medicine, University of Michigan Medical School , Ann Arbor, MI, USA
| | - David R. Howell
- Department of Orthopedics, University of Colorado School of Medicine , Aurora, CO, USA
- Sports Medicine Center, Children’s Hospital Colorado , Aurora, CO, USA
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22
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Baker HP, Young-Hoon Lee K, Dayton SR, Terry MA, Tjong VK. Response to letter to the editor. PHYSICIAN SPORTSMED 2020; 48:124. [PMID: 31648580 DOI: 10.1080/00913847.2019.1676137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hayden P Baker
- Department of Orthopaedic Surgery, The University of Chicago, Chicago, IL, USA
| | | | - Steven R Dayton
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael A Terry
- Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Vehniah K Tjong
- Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Chicago, IL, USA
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23
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Abstract
Participation in youth soccer in the United States continues to increase steadily, with a greater percentage of preadolescent participants than perhaps any other youth sport. Despite the wide-ranging health benefits of participation in organized sports, injuries occur and represent a threat to the health and performance of young athletes. Youth soccer has a greater reported injury rate than many other contact sports, and recent studies suggest that injury rates are increasing. Large increases in the incidence of concussions in youth soccer have been reported, and anterior cruciate ligament injuries remain a significant problem in this sport, particularly among female athletes. Considerable new research has identified a number of modifiable risk factors for lower-extremity injuries and concussion, and several prevention programs have been identified to reduce the risk of injury. Rule enforcement and fair play also serve an important role in reducing the risk of injury among youth soccer participants. This report provides an updated review of the relevant literature as well as recommendations to promote the safe participation of children and adolescents in soccer.
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Affiliation(s)
- Andrew Watson
- Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; and
| | - Jeffrey M Mjaanes
- Department of Orthopedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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24
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Benito-de-Pedro M, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Rodríguez-Sanz D, López-López D, Cosín-Matamoros J, Martínez-Jiménez EM, Calvo-Lobo C. Effectiveness between Dry Needling and Ischemic Compression in the Triceps Surae Latent Myofascial Trigger Points of Triathletes on Pressure Pain Threshold and Thermography: A Single Blinded Randomized Clinical Trial. J Clin Med 2019; 8:E1632. [PMID: 31590390 PMCID: PMC6832626 DOI: 10.3390/jcm8101632] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/28/2019] [Accepted: 10/02/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Deep dry needling (DDN) and ischemic compression technic (ICT) may be considered as interventions used for the treatment of Myofascial Pain Syndrome (MPS) in latent myofascial trigger points (MTrPs). The immediate effectiveness of both DDN and ICT on pressure pain threshold (PPT) and skin temperature of the latent MTrPs of the triceps surae has not yet been determined, especially in athletes due to their treatment requirements during training and competition. OBJECTIVE To compare the immediate efficacy between DDN and ICT in the latent MTrPs of triathletes considering PPT and thermography measurements. METHOD A total sample of 34 triathletes was divided into two groups: DDN and ICT. The triathletes only received a treatment session of DDN (n = 17) or ICT (n = 17). PPT and skin temperature of the selected latent MTrPs were assessed before and after treatment. RESULTS Statistically significant differences between both groups were shown after treatment, showing a PPT reduction (p < 0.05) in the DDN group, while PPT values were maintained in the ICT group. There were not statistically significant differences (p > 0.05) for thermographic values before and treatment for both interventions. CONCLUSIONS Findings of this study suggested that ICT could be more advisable than DDN regarding latent MTrPs local mechanosensitivity immediately after treatment due to the requirements of training and competition in athletes' population. Nevertheless, further studies comparing both interventions in the long term should be carried out in this specific population due to the possible influence of delayed onset muscle soreness and muscle damage on PPT and thermography values secondary to the high level of training and competition.
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Affiliation(s)
- María Benito-de-Pedro
- Facultad de Enfermería, Fisioterapia y Podología. Universidad Complutense de Madrid, Madrid 28040 Spain.
| | | | | | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología. Universidad Complutense de Madrid, Madrid 28040 Spain.
| | - Daniel López-López
- Research, Health and Podiatry Unit. Department of Health Sciences. Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol 15403, Spain.
| | - Julia Cosín-Matamoros
- Facultad de Enfermería, Fisioterapia y Podología. Universidad Complutense de Madrid, Madrid 28040 Spain.
| | - Eva María Martínez-Jiménez
- Facultad de Enfermería, Fisioterapia y Podología. Universidad Complutense de Madrid, Madrid 28040 Spain.
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología. Universidad Complutense de Madrid, Madrid 28040 Spain.
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25
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Oliver GD, Saper MG, Drogosz M, Plummer HA, Arakkal AT, Comstock RD, Anz AW, Andrews JR, Fleisig GS. Epidemiology of Shoulder and Elbow Injuries Among US High School Softball Players, 2005-2006 Through 2016-2017. Orthop J Sports Med 2019; 7:2325967119867428. [PMID: 31523693 PMCID: PMC6732867 DOI: 10.1177/2325967119867428] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Injury prevalence has been well described among baseball athletes; similarly,
a better understanding of injuries in softball athletes is needed. Purpose: To examine shoulder and elbow injury epidemiology among high school softball
athletes in the United States. Study Design: Descriptive epidemiological study. Methods: Injury data were obtained from the National High School Sports-Related Injury
Surveillance System, which captures data from a large national sample of US
high schools. Annually, a random sample of 100 high schools provided a
representative sample with respect to the 4 US Census geographic regions and
2 school sizes (cutoff point, 1000 students). Athletic trainers from
participating schools reported data for athlete-exposures (AEs; practice or
competition) and shoulder and elbow injuries from 2005-2006 through
2016-2017. Results: A total of 239 shoulder injuries and 85 elbow injuries occurred within
2,095,329 AEs. The overall shoulder injury rate was 1.14 per 10,000 AEs,
whereas the overall elbow injury rate was 0.41 per 10,000 AEs. Injuries to
the shoulder were more likely to occur during competition as compared with
practice (rate ratio, 1.28; 95% CI, 0.99-1.65). Half of the shoulder (50.4%)
and elbow 48.9% injuries were due to an overuse/chronic mechanism. Of the
athletes sustaining an injury, 86.8% with shoulder injuries and 93.0% with
elbow injuries returned to play within 21 days. Only 16.7% of shoulder
injuries and 17.5% of elbow injuries were sustained by pitchers. Conclusion: Shoulder and elbow injury rates, time to return, and percentage of injuries
among pitchers were far lower in high school softball than previously
reported values for high school baseball. There were relatively low
incidences of shoulder and elbow injuries in high school softball as
compared with baseball, with few injuries requiring lengthy time to return
to play.
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Affiliation(s)
- Gretchen D Oliver
- Sports Medicine and Movement Lab, School of Kinesiology, Auburn University, Auburn, Alabama, USA
| | - Michael G Saper
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington, USA
| | - Monika Drogosz
- American Sports Medicine Institute, Birmingham, Alabama, USA
| | - Hillary A Plummer
- Andrews Research and Education Foundation, Gulf Breeze, Florida, USA
| | - Alan T Arakkal
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado, USA
| | - R Dawn Comstock
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado, USA
| | - Adam W Anz
- Andrews Research and Education Foundation, Gulf Breeze, Florida, USA
| | - James R Andrews
- American Sports Medicine Institute, Birmingham, Alabama, USA.,Andrews Research and Education Foundation, Gulf Breeze, Florida, USA
| | - Glenn S Fleisig
- American Sports Medicine Institute, Birmingham, Alabama, USA
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26
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Baker HP, Young-Hoon Lee K, Dayton SR, Terry M, Tjong VK. Thursday Night Football's impact on all-cause injuries in NFL players during 2012 - 2017. PHYSICIAN SPORTSMED 2019; 47:350-352. [PMID: 30848976 DOI: 10.1080/00913847.2019.1587565] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: This study sought to determine whether shortened recovery periods between regularly scheduled Sunday NFL games and Thursday Night Football games significantly increased the incidence of injury in NFL players. Methods: NFL injury reports and injury reserve data were collected for every NFL player, on all 32 NFL teams, for each week during the regular season, for the 2012-2013, 2013-2014, 2014-2015, 2015-2016, and 2016-2017 NFL seasons. Injuries were defined as any reported injury, not previously documented in an injury report prior to said injury. Calculated injury rates per 1000 athletic exposures for Sunday and Monday night games versus Thursday night games was used to generate relative risk of injury using 95% confidence intervals. Results: The all-cause injury rate during NFL Sunday and Monday Night Football games was found to be 7,598 per 1000 athletic exposures, while the all-cause injury rate during Thursday Night Football games was found to be 6,072 per 1,000 athletic exposures. The relative risk of injury during Thursday Night Football games was calculated to be 0.97 compared to Sunday and Monday night games. Therefore, the rate of injury during Thursday Night Football games was significantly less than the rate of injury during Sunday and Monday night games, despite the lack of additional recovery time. Conclusion: This study suggests that eliminating Thursday Night Football is unlikely to improve the statistical injury rate among NFL players.
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Affiliation(s)
- Hayden P Baker
- The University of Illinois College of Medicine , Chicago , IL , USA
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27
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Claudino JG, Capanema DDO, de Souza TV, Serrão JC, Machado Pereira AC, Nassis GP. Current Approaches to the Use of Artificial Intelligence for Injury Risk Assessment and Performance Prediction in Team Sports: a Systematic Review. SPORTS MEDICINE-OPEN 2019; 5:28. [PMID: 31270636 PMCID: PMC6609928 DOI: 10.1186/s40798-019-0202-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 06/19/2019] [Indexed: 12/13/2022]
Abstract
Background The application of artificial intelligence (AI) opens an interesting perspective for predicting injury risk and performance in team sports. A better understanding of the techniques of AI employed and of the sports that are using AI is clearly warranted. The purpose of this study is to identify which AI approaches have been applied to investigate sport performance and injury risk and to find out which AI techniques each sport has been using. Methods Systematic searches through the PubMed, Scopus, and Web of Science online databases were conducted for articles reporting AI techniques or methods applied to team sports athletes. Results Fifty-eight studies were included in the review with 11 AI techniques or methods being applied in 12 team sports. Pooled sample consisted of 6456 participants (97% male, 25 ± 8 years old; 3% female, 21 ± 10 years old) with 76% of them being professional athletes. The AI techniques or methods most frequently used were artificial neural networks, decision tree classifier, support vector machine, and Markov process with good performance metrics for all of them. Soccer, basketball, handball, and volleyball were the team sports with more applications of AI. Conclusions The results of this review suggest a prevalent application of AI methods in team sports based on the number of published studies. The current state of development in the area proposes a promising future with regard to AI use in team sports. Further evaluation research based on prospective methods is warranted to establish the predictive performance of specific AI techniques and methods. Electronic supplementary material The online version of this article (10.1186/s40798-019-0202-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- João Gustavo Claudino
- University of São Paulo, School of Physical Education and Sport - Laboratory of Biomechanics, Av. Prof. Mello de Morais, 65 - Cidade Universitária, São Paulo, São Paulo, 05508-030, Brazil. .,Research and Development Department, LOAD CONTROL, Contagem, Minas Gerais, Brazil.
| | | | | | - Julio Cerca Serrão
- University of São Paulo, School of Physical Education and Sport - Laboratory of Biomechanics, Av. Prof. Mello de Morais, 65 - Cidade Universitária, São Paulo, São Paulo, 05508-030, Brazil
| | | | - George P Nassis
- Department of Sports Science, City Unity College, Athens, Greece.,School of Physical Education & Sport Training, Shanghai University of Sport, Qingyuanhuan Rd 650, Yangpu District, Shanghai, 200438, China
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Petushek EJ, Sugimoto D, Stoolmiller M, Smith G, Myer GD. Evidence-Based Best-Practice Guidelines for Preventing Anterior Cruciate Ligament Injuries in Young Female Athletes: A Systematic Review and Meta-analysis. Am J Sports Med 2019; 47:1744-1753. [PMID: 30001501 PMCID: PMC6592422 DOI: 10.1177/0363546518782460] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Injury prevention neuromuscular training (NMT) programs reduce the risk for anterior cruciate ligament (ACL) injury. However, variation in program characteristics limits the potential to delineate the most effective practices to optimize injury risk reduction. PURPOSE To evaluate the common and effective components included in ACL NMT programs and develop an efficient, user-friendly tool to assess the quality of ACL NMT programs. STUDY DESIGN Systematic review and meta-analysis. METHODS Study inclusion required (1) a prospective controlled trial study design, (2) an NMT intervention aimed to reduce incidence of ACL injury, (3) a comparison group, (4) ACL injury incidence, and (5) female participants. The following data were extracted: year of publication, study design, sample size and characteristics, and NMT characteristics including exercise type and number per session, volume, duration, training time, and implementer training. Analysis entailed both univariate subgroup and meta-regression techniques using random-effects models. RESULTS Eighteen studies were included in the meta-analyses, with a total of 27,231 participants, 347 sustaining an ACL injury. NMT reduced the risk for ACL injury from 1 in 54 to 1 in 111 (odds ratio [OR], 0.51; 95% CI, 0.37-0.69]). The overall mean training volume was 18.17 hours for the entire NMT (24.1 minutes per session, 2.51 times per week). Interventions targeting middle school or high school-aged athletes reduced injury risk (OR, 0.38; 95% CI, 0.24-0.60) to a greater degree than did interventions for college- or professional-aged athletes (OR, 0.65; 95% CI, 0.48-0.89). All interventions included some form of implementer training. Increased landing stabilization and lower body strength exercises during each session improved prophylactic benefits. A meta-regression model and simple checklist based on the aforementioned effective components (slope = -0.15, P = .0008; intercept = 0.04, P = .51) were developed to allow practitioners to evaluate the potential efficacy of their ACL NMT and optimize injury prevention effects. CONCLUSION Considering the aggregated evidence, we recommend that ACL NMT programs target younger athletes and use trained implementers who incorporate lower body strength exercises (ie, Nordic hamstrings, lunges, and heel-calf raises) with a specific focus on landing stabilization (jump/hop and hold) throughout their sport seasons. CLINICAL RELEVANCE Clinicians, coaches, athletes, parents, and practitioners can use the developed checklist to gain insight into the quality of their current ACL NMT practices and can use the tool to optimize programming for future ACL NMT to reduce ACL injury risk.
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Affiliation(s)
- Erich J. Petushek
- Department of Radiology, College of Human Medicine,
Michigan State University, East Lansing, Michigan, USA.,School of Health and Human Performance, Northern
Michigan University, Marquette, Michigan, USA.,Address correspondence to Erich J. Petushek, PhD,
Department of Radiology, College of Human Medicine, Michigan State University,
846 Service Rd, East Lansing, MI 48824, USA
()
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention,
Waltham, Massachusetts, USA.,Department of Orthopaedic Surgery, Harvard Medical
School, Boston, Massachusetts, USA.,Division of Sports Medicine, Department of
Orthopaedics, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Michael Stoolmiller
- Department of Pediatrics, College of Human Medicine,
Michigan State University, East Lansing, Michigan, USA
| | - Grace Smith
- Kalamazoo College, Kalamazoo, Michigan, USA.,Department of Physical Therapy, Grand Valley
State University, Grand Rapids, Michigan, USA
| | - Gregory D. Myer
- The Micheli Center for Sports Injury Prevention,
Waltham, Massachusetts, USA.,The SPORT Center, Division of Sports
Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,
USA.,Departments of Pediatrics and Orthopaedic
Surgery, University of Cincinnati, Cincinnati, Ohio, USA
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Zuckerman SL, Kerr ZY, Pierpoint L, Kirby P, Than KD, Wilson TJ. An 11-year analysis of peripheral nerve injuries in high school sports. PHYSICIAN SPORTSMED 2019; 47:167-173. [PMID: 30392428 DOI: 10.1080/00913847.2018.1544453] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Sports surveillance databases provide valuable information regarding common ailments, yet fewer studies have focused on more rare peripheral nerve injuries. Our objective was to characterize peripheral nerve injuries in high school athletics with respect to incidence, time loss, mechanism, and diagnoses. METHODS Sport-related nerve injury data on high school athletes were collected during the 2005/2006 through 2015/2016 academic years via the High School Reporting Information Online (RIO) database. All injuries were reported by certified athletic trainers (ATs). Descriptive statistics were performed. RESULTS A total of 588 peripheral nerve injuries were recorded during the 2005/06-2015/16 academic years, with an overall incidence of 1.46/100,000 athlete-exposures (AE; 95%CI: 1.34, 1.58). Boys' football had the majority of injuries (71.3%) and the highest injury rate (5.46/100,000AE; 95%CI: 4.93, 5.98), followed by boys' wrestling (7.1%) and boys' baseball (3.4%). Over half (50.3%) of peripheral nerve injuries resulted in time loss < 1 week, while 9.4% resulting in the athletes prematurely ending their seasons. The most common mechanisms were player contact (67.3%), overuse (10.0%), and surface contact (9.7%). A specific diagnosis was available for 40 (6.8%) injuries, including upper extremity stinger (n = 26), spinal cord neurapraxia (n = 3), subacromial nerve impingement (n = 2) neuroma (n = 2), axillary nerve palsy (n = 1), sciatic nerve impingement (n = 1), femoral nerve impingement (n = 1), tarsal tunnel syndrome (n = 1), peroneal neuropathy (n = 1), thoracic outlet syndrome (n = 1), and ulnar nerve subluxation (n = 1). DISCUSSION Recognized peripheral nerve injuries are rare among high school athletes, occurring most commonly in boys' football. While most are minor, approximately 1:10 were season-ending. Specific diagnoses were available for 7% of injuries, with upper extremity stingers being the most commonly reported diagnosis. Working with ATs to identify and implement methods to obtain more specific diagnostic information via surveillance will help researchers better understand the epidemiology of peripheral nerve injuries.
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Affiliation(s)
- Scott L Zuckerman
- a Vanderbilt Sports Concussion Center , Vanderbilt University Medical Center , Nashville , TN , USA.,b Department of Neurological Surgery , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Zachary Y Kerr
- c Department of Exercise and Sport Science , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Lauren Pierpoint
- d Department of Epidemiology, Colorado School of Public Health , University of Colorado Anschutz , Aurora , CO , USA
| | - Paul Kirby
- a Vanderbilt Sports Concussion Center , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Khoi D Than
- e Department of Neurological Surgery , Oregon Health and Sciences University , Portland , OR , USA
| | - Thomas J Wilson
- f Department of Neurological Surgery , Stanford University , Stanford , CA , USA
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30
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Loughran GJ, Vulpis CT, Murphy JP, Weiner DA, Svoboda SJ, Hinton RY, Milzman DP. Incidence of Knee Injuries on Artificial Turf Versus Natural Grass in National Collegiate Athletic Association American Football: 2004-2005 Through 2013-2014 Seasons. Am J Sports Med 2019; 47:1294-1301. [PMID: 30995074 DOI: 10.1177/0363546519833925] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The use of artificial turf in American football continues to grow in popularity, and the effect of these playing surfaces on athletic injuries remains controversial. Knee injuries account for a significant portion of injuries in the National Collegiate Athletic Association (NCAA) football league; however, the effect of artificial surfaces on knee injuries remains ill-defined. HYPOTHESIS There is no difference in the rate or mechanism of knee ligament and meniscal injuries during NCAA football events on natural grass and artificial turf playing surfaces. STUDY DESIGN Descriptive epidemiology study. METHODS The NCAA Injury Surveillance System Men's Football Injury and Exposure Data Sets for the 2004-2005 through 2013-2014 seasons were analyzed to determine the incidence of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), medial meniscus, and lateral meniscal tear injuries. Injury rates were calculated per 10,000 athlete exposures, and rate ratios (RRs) were used to compare injury rates during practices and competitions on natural grass and artificial turf in NCAA football as a whole and by competition level (Divisions I, Divisions II and III). Mechanisms of injury were calculated for each injury on natural grass and artificial turf surfaces. RESULTS A total of 3,009,205 athlete exposures and 2460 knee injuries were reported from 2004 to 2014: 1389 MCL, 522 ACL, 269 lateral meniscal, 164 medial meniscal, and 116 PCL. Athletes experienced all knee injuries at a significantly higher rate when participating in competitions as compared with practices. Athletes participating in competitions on artificial turf experienced PCL injuries at 2.94 times the rate as those playing on grass (RR = 2.94; 95% CI, 1.61-5.68). When stratified by competition level, Division I athletes participating in competitions on artificial turf experienced PCL injuries at 2.99 times the rate as those playing on grass (RR = 2.99; 95% CI, 1.39-6.99), and athletes in lower NCAA divisions (II and III) experienced ACL injuries at 1.63 times the rate (RR = 1.63; 95% CI, 1.10-2.45) and PCL injuries at 3.13 times the rate (RR = 3.13; 95% CI, 1.14-10.69) on artificial turf as compared with grass. There was no statistically significant difference in the rate of MCL, medial meniscal, or lateral meniscal injuries on artificial turf versus grass when stratified by event type or level of NCAA competition. No difference was found in the mechanisms of knee injuries on natural grass and artificial turf. CONCLUSION Artificial turf is an important risk factor for specific knee ligament injuries in NCAA football. Injury rates for PCL tears were significantly increased during competitions played on artificial turf as compared with natural grass. Lower NCAA divisions (II and III) also showed higher rates of ACL injuries during competitions on artificial turf versus natural grass.
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Affiliation(s)
| | | | - Jordan P Murphy
- School of Medicine, Georgetown University, Washington, DC, USA
| | - David A Weiner
- MedStar Union Memorial Hospital, Baltimore, Maryland, USA
| | | | | | - Dave P Milzman
- School of Medicine, Georgetown University, Washington, DC, USA
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31
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Apple RP, Karpinos AR, Bellamy DM. Novel Mobile Device-Based Tool to Document Sideline Evaluation of Athletes. Curr Sports Med Rep 2019; 18:172-177. [DOI: 10.1249/jsr.0000000000000594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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32
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Bedo BLS, Manechini JPV, Nunomura M, Menezes RP, Silva SRDD. Injury Frequency in Handball Players: A Descriptive Study of Injury Pattern in São Paulo State Regional Teams. MOTRIZ: REVISTA DE EDUCACAO FISICA 2019. [DOI: 10.1590/s1980-6574201900020020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Åman M, Forssblad M, Larsén K. National injury prevention measures in team sports should focus on knee, head, and severe upper limb injuries. Knee Surg Sports Traumatol Arthrosc 2019; 27:1000-1008. [PMID: 30413861 PMCID: PMC6514082 DOI: 10.1007/s00167-018-5225-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 10/17/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE To examine acute injuries in licensed floorball, football, handball, and ice hockey players in all ages nationwide in Sweden, and to identify the most common and severe injuries in each body location and recommend injury prevention measures. METHODS Using national sport insurance data from years 2006-2015 was the incidence and proportion of acute injuries, and injuries leading to permanent medical impairment (PMI), calculated in the four team sports. The most common injury type and injured body part was identified, with a particular focus of the severe injuries. Comparison between sexes was made. RESULTS In total, there were 92,162 registered injuries in all sports together. Knee injuries were most common, and also had the highest incidence of PMI, in all ball sports and in female ice hockey players. In male ice hockey, the most common injury was a dental and face injury, and PMI injuries were mostly in the shoulder. The most severe PMI injuries were rare and most often a face/eye injury in male floorball and ice hockey, a concussion in female ice hockey, and a knee injury in female floorball, and in both sexes in football and handball. CONCLUSIONS To achieve the greatest impact in reducing the adverse effects of acute sport injuries nationwide in Sweden, preventive measures should focus on knee injuries in all the investigated team sports. The severe head/face and upper limb injuries also need attention. Protective equipment, neuromuscular training programs, rules enforcements, and fair-play interventions may reduce the incidence of injuries.
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Affiliation(s)
- Malin Åman
- GIH, The Swedish School of Sport and Health Sciences, Lidingövägen 1, Box 5626, 114 86, Stockholm, Sweden.
| | - Magnus Forssblad
- 0000 0004 1937 0626grid.4714.6Stockholm Sports Trauma Research Center, Karolinska Institutet, Box 5605, 114 86 Stockholm, Sweden
| | - Karin Larsén
- 0000 0001 1034 3451grid.12650.30Department of Surgery and Perioperative Sciences, Clinical Physiology, Umeå University, 901 85 Umeå, Sweden
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Åman M, Larsén K, Forssblad M, Näsmark A, Waldén M, Hägglund M. A Nationwide Follow-up Survey on the Effectiveness of an Implemented Neuromuscular Training Program to Reduce Acute Knee Injuries in Soccer Players. Orthop J Sports Med 2018; 6:2325967118813841. [PMID: 30622995 PMCID: PMC6304704 DOI: 10.1177/2325967118813841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: A cruciate ligament (CL) injury is a severe injury in soccer. Neuromuscular
training programs have a well-documented preventive effect, but there are
few studies on the effectiveness of such a program at a national level. The
Swedish Knee Control Program (KCP) was found to be effective in preventing
CL injuries in youth female soccer players. The KCP was implemented
nationwide in Sweden in 2010. Purpose: To evaluate the effectiveness of the Swedish KCP in reducing acute knee
injuries in soccer players at a nationwide level. Study Design: Descriptive epidemiology study. Methods: All licensed soccer players in Sweden are covered by the same insurance
company. Using this insurance database, around 17,500 acute knee injuries
that were reported to the insurance company between 2006 and 2015 were
included in the study. By matching the number of licensed soccer players
with the number of reported injuries each year, the annual incidence of knee
and CL injuries was able to be calculated. To evaluate the spread of the KCP
nationally, a questionnaire was sent to all 24 Swedish district football
associations (FAs) with questions regarding KCP education. The number of
downloads of the KCP mobile application (app) was obtained. Results: The incidence of CL injuries decreased during the study period for both male
(from 2.9 to 2.4 per 1000 player-years) and female players (from 4.9 to 3.9
per 1000 player-years). The overall incidence of knee injuries decreased in
both male (from 5.6 to 4.6 per 1000 player-years) and female players (from
8.7 to 6.4 per 1000 player-years). Comparing before and after the nationwide
implementation of the KCP, there was a decrease in the incidence of CL
injuries by 6% (rate ratio [RR], 0.94 [95% CI, 0.89-0.98]) in male players
and 13% (RR, 0.87 [95% CI, 0.81-0.92]) in female players and a decrease in
the incidence of knee injuries by 8% (RR, 0.92 [95% CI, 0.89-0.96]) and 21%
(RR, 0.79 [95% CI, 0.75-0.83]), respectively (P < .01
for all). This trend corresponded to a reduction of approximately 100 CL
injuries each year in Sweden. A total of 21 of 24 district FAs held
organized KCP educational courses during the study period. The percentage of
district FAs holding KCP courses was between 46% and 79% each year. There
were 101,236 downloads of the KCP app. Conclusion: The KCP can be considered partially implemented nationwide, and the incidence
of knee and CL injuries has decreased in both sexes at a nationwide
level.
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Affiliation(s)
- Malin Åman
- Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Karin Larsén
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Magnus Forssblad
- Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden
| | | | - Markus Waldén
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Martin Hägglund
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Abstract
Lower-extremity musculoskeletal injuries are common in sports such as basketball and soccer. Athletes competing in sports of this nature must maneuver in response to the actions of their teammates, opponents, etc. This limits their ability to preplan movements. The purpose of this study was to compare impact accelerations during preplanned versus unplanned lateral cutting. A total of 30 subjects (15 males and 15 females) performed preplanned and unplanned cuts while the authors analyzed impact accelerations using an accelerometer secured to their tibia. For the preplanned condition, subjects were aware of the movement to perform before initiating a trial. For the unplanned condition, subjects initiated their movement and then reacted to the illumination of one of 3 visual stimuli which dictated whether they would cut, land, or land-and-jump. A mixed-model analysis of variance with a between factor of sex (male and female) and a within factor of condition (preplanned and unplanned) was used to analyze the magnitude and variability of the impact accelerations for the cutting trials. Both males and females demonstrated higher impact accelerations (P = .01) and a trend toward greater intertrial variability (P = .07) for the unplanned cutting trials (vs preplanned cuts). Unplanned cutting may place greater demands on the musculoskeletal system.
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36
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Montgomery C, Porter A, Parks C, Sachleben B, Blasier RD, Rabenhorst B. Football-Related Pediatric Extremity Fractures and Dislocations: Size Matters. Orthopedics 2018; 41:216-221. [PMID: 30035799 DOI: 10.3928/01477447-20180628-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/17/2018] [Indexed: 02/03/2023]
Abstract
Football remains a popular sport in the United States despite sometimes significant injuries, such as fractures and dislocations, occurring. The objective of this study was to evaluate pediatric extremity fractures and dislocations related to football. A retrospective review was conducted at a level 1 pediatric trauma center to identify patients who were treated specifically for American football-related injuries (International Classification of Diseases, Ninth Revision, code E007.0). All patients with football-related injuries presenting to the emergency department during a 6-year period (2007-2012) were reviewed for inclusion in the study. Patients with only fractures or dislocations involving the extremities were analyzed. Exclusion criteria included patients older than 18 years, non-football-related sports-related injuries, and patients presenting to non-emergency department health care facilities. Demographic information was collected in addition to type of injury, body mass index, and type of treatment. A total of 193 patients with 96 fractures and 7 dislocations were included. More than two-thirds of all fractures occurred in the lower extremities, with tibia (17.0%) and femoral shaft (14.2%) fractures being the most common. Thirty-five percent of the fractures and dislocations required operative treatment. No statistically significant correlations were identified pertaining to age, race, and timing of the injuries in the season. Regarding body mass index, underweight patients were associated with 3.6 times greater odds of sustaining a fracture when compared with patients who were not underweight (P=.006). Underweight patients may be at a higher risk for fractures or dislocations. Identifying at-risk children may result in improved patient and coach education, potentially leading to better preventive measures and fewer injuries. [Orthopedics. 2018; 41(4):216-221.].
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37
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Baker HP, Varelas A, Shi K, Terry MA, Tjong VK. The NFL's Chop-Block Rule Change: Does It Prevent Knee Injuries in Defensive Players? Orthop J Sports Med 2018; 6:2325967118768446. [PMID: 29780842 PMCID: PMC5954335 DOI: 10.1177/2325967118768446] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The chop block, a football maneuver in which an offensive player blocks an opponent around the thigh while another offensive player engages the same opponent above the waist, was declared illegal by the National Football League (NFL) before the 2016-2017 season. Chop blocks have been hypothesized to be associated with medial collateral ligament and anterior cruciate ligament injury, especially in offensive/defensive linemen. Purpose: To quantify the impact that the chop-block rule change had on the incidence of knee injuries to defensive players in the NFL over 4 seasons (2014-2018). Study Design: Cohort study; Level of evidence, 3. Methods: NFL injury data for all defensive players from regular-season games played from 2014 through 2018 were collected. For this study, all knee injuries were attributed to competitive game play. Injury rates were reported as the number of injuries per 1000 athletic exposures (with 95% CIs). Results: A total of 256 games were played during the 2014-2015, 2015-2016, 2016-2017, and 2017-2018 NFL regular seasons, and all were included in this study. Among defensive players, the relative risk for a knee injury per 1000 athletic exposures was 0.84 (95% CI, 0.75-0.96) for the 2 seasons after the chop-block rule change (2016-2017 and 2017-2018) versus the 2 seasons before (2014-2015 and 2015-2016) (P = .009). Thus, the relative risk reduction was 16%. The relative risk for a defensive player to be placed on injured reserve per season was 0.90 (95% CI, 0.72-1.13) for the 2 seasons after the rule change versus the 2 seasons before (P = .39). Conclusion: The NFL’s recent ruling against in-game chop blocks may have reduced the incidence of knee injuries among defensive players.
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Affiliation(s)
- Hayden P. Baker
- The University of Illinois College of Medicine, Chicago, Illinois, USA
- Hayden Baker, BA, 1537 West Barry Avenue, Chicago, IL 60657, USA ()
| | - Antonios Varelas
- The University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Kevin Shi
- Rush University Medical Center, Chicago, Illinois, USA
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Oosterhoff JHF, Bexkens R, Vranceanu AM, Oh LS. Do Injured Adolescent Athletes and Their Parents Agree on the Athletes' Level of Psychologic and Physical Functioning? Clin Orthop Relat Res 2018; 476:767-775. [PMID: 29480883 PMCID: PMC6260074 DOI: 10.1007/s11999.0000000000000071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although a parent's perception of his or her child's physical and emotional functioning may influence the course of the child's medical care, including access to care and decisions regarding treatment options, no studies have investigated whether the perceptions of a parent are concordant with that of an adolescent diagnosed with a sports-related orthopaedic injury. Identifying and understanding the potential discordance in coping and emotional distress within the athlete adolescent-parent dyads are important, because this discordance may have negative effects on adolescents' well-being. QUESTIONS/PURPOSES The purposes of this study were (1) to compare adolescent and parent proxy ratings of psychologic symptoms (depression and anxiety), coping skills (catastrophic thinking about pain and pain self-efficacy), and upper extremity physical function and mobility in a population of adolescent-parent dyads in which the adolescent had a sport-related injury; and (2) to compare scores of adolescents and parent proxies with normative scores when such are available. METHODS We enrolled 54 dyads (eg, pairs) of adolescent patients (mean age 16 years; SD = 1.6) presenting to a sports medicine practice with sports-related injuries as well as their accompanying parent(s). We used Patient-reported Outcomes Measurement Information System questionnaires to measure adolescents' depression, anxiety, upper extremity physical function, and mobility. We used the Pain Catastrophizing Scale short form to assess adolescents' catastrophic thinking about pain and the Pain Self-efficacy Scale short form to measure adolescents' pain self-efficacy. The accompanying parent, 69% mothers (37 of 54) and 31% fathers (17 of 54), completed parent proxy versions of each questionnaire. RESULTS Parents reported that their children had worse scores (47 ± 9) on depression than what the children themselves reported (43 ± 9; mean difference 4.0; 95% confidence interval [CI], -7.0 to 0.91; p = 0.011; medium effect size -0.47). Also, parents reported that their children engaged in catastrophic thinking about pain to a lesser degree (8 ± 5) than what the children themselves reported (13 ± 4; mean difference 4.5; 95% CI, 2.7-6.4; p < 0.001; large effect size 1.2). Because scores on depression and catastrophic thinking were comparable to the general population, and minimal clinically important difference scores are not available for these measures, it is unclear whether the relatively small observed differences between parents' and adolescents' ratings are clinically meaningful. Parents and children were concordant on their reports of the child's upper extremity physical function (patient perception 47 ± 10, parent proxy 47 ± 8, mean difference -0.43, p = 0.70), mobility (patient perception 43 ± 9, parent proxy 44 ± 9, mean difference -0.59, p = 0.64), anxiety (patient perception 43 ± 10, parent proxy 46 ± 8, mean difference -2.1, p = 0.21), and pain self-efficacy (patient perception 16 ± 5, parent proxy 15 ± 5, mean difference 0.70, p = 0.35). CONCLUSIONS Parents rated their children as more depressed and engaging in less catastrophic thinking about pain than the adolescents rated themselves. Although these differences are statistically significant, they are of a small magnitude making it unclear as to how clinically important they are in practice. We recommend that providers keep in mind that parents may overestimate depressive symptoms and underestimate the catastrophic thinking about pain in their children, probe for these potential differences, and consider how they might impact medical care. LEVEL OF EVIDENCE Level I, prognostic study.
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Affiliation(s)
- Jacobien H F Oosterhoff
- J. H. F. Oosterhoff, R. Bexkens, L. S. Oh, Department of Orthopaedic Surgery, Sports Medicine Service, Massachusetts General Hospital, Boston, MA, USA A. M. Vranceanu, Department of Psychiatry, Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
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Bartley JH, Murray MF, Kraeutler MJ, Pierpoint LA, Welton KL, McCarty EC, Comstock RD. Epidemiology of Injuries Sustained as a Result of Intentional Player Contact in High School Football, Ice Hockey, and Lacrosse: 2005-2006 Through 2015-2016. Orthop J Sports Med 2017; 5:2325967117740887. [PMID: 29270440 PMCID: PMC5731628 DOI: 10.1177/2325967117740887] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Lacrosse and ice hockey are quickly growing in popularity, while football remains the most popular sport among high school student-athletes. Injuries remain a concern, given the physical nature of these contact sports. Purpose: To describe the rates and patterns of injuries sustained as a result of intentional player contact in United States high school boys’ football, ice hockey, and lacrosse. Study Design: Descriptive epidemiology study. Methods: We conducted a secondary analysis of High School RIO (Reporting Information Online) data, including exposure and injury data collected from a large sample of high schools in the United States from 2005-2006 through 2015-2016. Data were analyzed to calculate rates, assess patterns, and evaluate potential risk factors for player-to-player contact injuries. Results: A total of 34,532 injuries in boys’ football, ice hockey, and lacrosse occurred during 9,078,902 athlete-exposures (AEs), for a rate of 3.80 injuries per 1000 AEs in the 3 contact sports of interest. The risk of injuries was found to be greater in competition compared with practice for all 3 sports, with the largest difference in ice hockey (rate ratio, 8.28) and the smallest difference in lacrosse (rate ratio, 3.72). In all 3 contact sports, the most commonly injured body site in competition and practice caused by both tackling/checking and being tackled/checked was the head/face. However, a significantly greater proportion of concussions sustained in football were the result of tackling compared with being tackled (28.2% vs 24.1%, respectively). In addition, a significantly greater proportion of concussions were sustained in competition compared with practice for all 3 sports. Conclusion: This study is the first to collectively compare injury rates and injury patterns sustained from intentional player-to-player contact in boys’ high school football, ice hockey, and lacrosse. Notably, there was a relatively high risk of injuries and concussions during football practices.
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Affiliation(s)
- Justin H Bartley
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Monica F Murray
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado, USA
| | - Matthew J Kraeutler
- Department of Orthopaedic Surgery, Seton Hall-Hackensack Meridian School of Medicine, South Orange, New Jersey, USA
| | - Lauren A Pierpoint
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado, USA
| | - K Linnea Welton
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Eric C McCarty
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - R Dawn Comstock
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado, USA
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Johnson BK, Brou L, Fields SK, Erkenbeck AN, Comstock RD. Hand and Wrist Injuries Among US High School Athletes: 2005/06-2015/16. Pediatrics 2017; 140:peds.2017-1255. [PMID: 29162658 DOI: 10.1542/peds.2017-1255] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The risk of hand/wrist injuries is present across various sports. Little is known about the epidemiology of such injuries. The objective of this study was to calculate the rates of hand/wrist injuries and investigate injury patterns among high school athletes. METHODS Athlete exposure (AE) and hand/wrist injury data were collected during 11 academic years, 2005/06 through 2015/16, from a large sample of US high schools as part of the National High School Sports-Related Injury Surveillance Study. RESULTS There were 6723 hand/wrist injuries sustained during 40 195 806 AEs, a rate of 1.7 per 10 000 AEs. The rate of injury in competition (3.3) was higher than in practice (1.1) (95% confidence interval: 2.8-3.1). Rates of hand/wrist injuries varied by sport, with the highest rates in football (4.3), boys' lacrosse (1.9), girls' softball (1.9), wrestling (1.8), girls' field hockey (1.7), boys' ice hockey (1.7), and girls' basketball (1.7). The most common injuries were fracture (45.0%), contusion (11.6%), and ligament sprain (9.0%). Athletes most frequently returned to play in <7 days (45.7%), but 12.4% of injuries kept athletes out ≥3 weeks. CONCLUSIONS High school athletes are at risk for hand/wrist injuries. Such injuries can keep athletes out of play and many require substantial medical treatment. Stick and ball or puck sports and full contact sports have high rates of hand/wrist injuries relative to other sports, which is indicative of a need for sport-specific prevention efforts.
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Affiliation(s)
- Bernadette K Johnson
- Children's Hospital Colorado, Aurora, Colorado; .,Section of Emergency Medicine, Department of Pediatrics, School of Medicine
| | - Lina Brou
- Children's Hospital Colorado, Aurora, Colorado.,Section of Emergency Medicine, Department of Pediatrics, School of Medicine
| | - Sarah K Fields
- Department of Communication, College of Liberal Arts and Sciences, University of Colorado Denver, Denver, Colorado
| | - Alexandria N Erkenbeck
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado; and
| | - R Dawn Comstock
- Section of Emergency Medicine, Department of Pediatrics, School of Medicine.,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz, Aurora, Colorado; and.,Pediatric Injury Prevention, Education, and Research Program, Aurora, Colorado
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McGuine TA, Post EG, Hetzel SJ, Brooks MA, Trigsted S, Bell DR. A Prospective Study on the Effect of Sport Specialization on Lower Extremity Injury Rates in High School Athletes. Am J Sports Med 2017; 45:2706-2712. [PMID: 28735552 DOI: 10.1177/0363546517710213] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Sport specialization is associated with an increased risk of musculoskeletal lower extremity injuries (LEIs) in adolescent athletes presenting in clinical settings. However, sport specialization and the incidence of LEIs have not been investigated prospectively in a large population of adolescent athletes. PURPOSE To determine if sport specialization was associated with an increased risk of LEIs in high school athletes. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Participants (interscholastic athletes in grades 9-12) were recruited from 29 Wisconsin high schools during the 2015-2016 school year. Participants completed a questionnaire identifying their sport participation and history of LEIs. Sport specialization of low, moderate, or high was determined using a previously published 3-point scale. Athletic trainers reported all LEIs that occurred during the school year. Analyses included group proportions, odds ratios (ORs) and 95% CIs, and days lost due to injury (median and interquartile range [IQR]). Multivariate Cox proportional hazard ratios (HRs) with 95% CIs were calculated to investigate the association between the incidence of LEIs and sport specialization level. RESULTS A total of 1544 participants (50.5% female; mean age, 16.1 ± 1.1 years) enrolled in the study, competed in 2843 athletic seasons, and participated in 167,349 athlete-exposures. Sport specialization was classified as low (59.5%), moderate (27.1%), or high (13.4%). Two hundred thirty-five participants (15.2%) sustained a total of 276 LEIs that caused them to miss a median of 7.0 days (IQR, 2.0-22.8). Injuries occurred most often to the ankle (34.4%), knee (25.0%), and upper leg (12.7%) and included ligament sprains (40.9%), muscle/tendon strains (25.4%), and tendinitis/tenosynovitis (19.6%). The incidence of LEIs for moderate participants was higher than for low participants (HR, 1.51 [95% CI, 1.04-2.20]; P = .03). The incidence of LEIs for high participants was higher than for low participants (HR, 1.85 [95% CI, 1.12-3.06]; P = .02). CONCLUSION Athletes with moderate or high sport specialization were more likely to sustain an LEI than athletes with low specialization. Sports medicine providers need to educate coaches, parents, and interscholastic athletes regarding the increased risk of LEIs for athletes who specialize in a single sport.
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Affiliation(s)
- Timothy A McGuine
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Eric G Post
- University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Scott J Hetzel
- University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | | | - David R Bell
- University of Wisconsin-Madison, Madison, Wisconsin, USA
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Barber Foss KD, Le Cara E, McCambridge T, Hinton R, Kushner A, Myer GD. Epidemiology of injuries in men's lacrosse: injury prevention implications for competition level, type of play, and player position. PHYSICIAN SPORTSMED 2017; 45:224-233. [PMID: 28707498 DOI: 10.1080/00913847.2017.1355209] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The growth in participation in men's lacrosse has increased the likelihood of sport-specific injuries, yet there continues to be a need for specific epidemiological data concerning lacrosse injuries. The purpose of this literature review is to aggregate available published data on injuries that occur in the sport of men's lacrosse at the youth, high school, collegiate, and professional levels. METHODS A comprehensive literature search was performed in PubMed, High Wire Press, SPORTDiscus, Google Scholar, and Ovid, using the keywords Lacrosse Injuries, Epidemiology Lacrosse Injuries, Lacrosse Injury, Lacrosse AND Injury and limited to 1990-2016. All bibliographies were cross-referenced to identify any additional publications. Sources were categorized based on data provided and were aggregated into groups based on reported overall injury rates, rates by setting (competition vs. practice), nature of injury, location, type, severity, and player position. RESULTS The game and practice injury rates in college are greater than the rates in high school, similarly rates greater for high school players than in youth leagues. Rates of injury varied from 0.095-12.98 per 1000 athlete exposures. Game injury rates were higher across all studies. Injuries in men's lacrosse occur most often from player-to-player contact, which result in immediate injuries, such as concussions, contusions, and lacerations. Overall concussion incidence was reported to range from 0.11-0.84 per 1000 AE. The most common types of injuries were sprain, strain, concussion, and contusions and the most common area of injury was hand (23%), with a significant proportion of these (59.4%) being to the thumb. Limited evidence of different injuries among the player positions suggests there might be a pattern that midfield players had the most injuries, followed by offensive players and then defensive players. CONCLUSIONS The potential for sports-related injury is of relative concern; especially considering rising participation and total number of injuries. Further development and proper enforcement of safety rules on player contact and protective equipment are recommended to decrease the rate of lacrosse-related injury. Additional longitudinal research is needed to better classify and to ultimately predict lacrosse injury factors and mechanisms across all levels of play.
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Affiliation(s)
- Kim D Barber Foss
- a The SPORT Center, Division of Sports Medicine , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | | | | | - Richard Hinton
- d Department of Sports Medicine , MedStar Union Memorial Hospital , Baltimore , MD , USA
| | - Adam Kushner
- e Department of Human Genetics , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | - Gregory D Myer
- a The SPORT Center, Division of Sports Medicine , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
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Åman M, Forssblad M, Larsén K. Incidence and body location of reported acute sport injuries in seven sports using a national insurance database. Scand J Med Sci Sports 2017; 28:1147-1158. [PMID: 28782303 DOI: 10.1111/sms.12956] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 01/14/2023]
Abstract
Sports with high numbers of athletes and acute injuries are an important target for preventive actions at a national level. Both for the health of the athlete and to reduce costs associated with injury. The aim of this study was to identify injuries where injury prevention should focus, in order to have major impact on decreasing acute injury rates at a national level. All athletes in the seven investigated sport federations (automobile sports, basketball, floorball, football (soccer), handball, ice hockey, and motor sports) were insured by the same insurance company. Using this insurance database, the incidence and proportion of acute injuries, and injuries leading to permanent medical impairment (PMI), at each body location, was calculated. Comparisons were made between sports, sex, and age. In total, there were 84 754 registered injuries during the study period (year 2006-2013). Athletes in team sports, except in male ice hockey, had the highest risk to sustain an injury and PMI in the lower limb. Females had higher risk of injury and PMI in the lower limb compared to males, in all sports except in ice hockey. This study recommends that injury prevention at national level should particularly focus on lower limb injuries. In ice hockey and motor sports, head/neck and upper limb injuries also need attention.
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Affiliation(s)
- M Åman
- GIH- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - M Forssblad
- Karolinska Institutet, Stockholm Sports Trauma Research Center, Stockholm, Sweden
| | - K Larsén
- GIH- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
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Yuan W, Leach J, Maloney T, Altaye M, Smith D, Gubanich PJ, Barber Foss KD, Thomas S, DiCesare CA, Kiefer AW, Myer GD. Neck Collar with Mild Jugular Vein Compression Ameliorates Brain Activation Changes during a Working Memory Task after a Season of High School Football. J Neurotrauma 2017; 34:2432-2444. [DOI: 10.1089/neu.2016.4834] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - James Leach
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Thomas Maloney
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - David Smith
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Paul J. Gubanich
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Kim D. Barber Foss
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Division of Health Sciences, Department of Athletic Training, Mount St. Joseph University, Cincinnati, Ohio
- Rocky Mountain University of Health Professions, Provo, Utah
| | - Staci Thomas
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Christopher A. DiCesare
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Adam W. Kiefer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Center for Cognition, Action and Perception, Department of Psychology, University of Cincinnati, Cincinnati, Ohio
| | - Gregory D. Myer
- Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
- The SPORT Center, Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania
- The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
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Post EG, Bell DR, Trigsted SM, Pfaller AY, Hetzel SJ, Brooks MA, McGuine TA. Association of Competition Volume, Club Sports, and Sport Specialization With Sex and Lower Extremity Injury History in High School Athletes. Sports Health 2017. [PMID: 28628419 PMCID: PMC5665112 DOI: 10.1177/1941738117714160] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: High school athletes are increasingly encouraged to participate in 1 sport year-round to increase their sport skills. However, no study has examined the association of competition volume, club sport participation, and sport specialization with sex and lower extremity injury (LEI) in a large sample of high school athletes. Hypothesis: Increased competition volume, participating on a club team outside of school sports, and high levels of specialization will all be associated with a history of LEI. Girls will be more likely to engage in higher competition volume, participate on a club team, and be classified as highly specialized. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: High school athletes completed a questionnaire prior to the start of their competitive season regarding their sport participation and previous injury history. Multivariable logistic regression analyses were used to investigate associations of competition volume, club sport participation, and sport specialization with history of LEI, adjusting for sex. Results: A cohort of 1544 high school athletes (780 girls; grades 9-12) from 29 high schools completed the questionnaire. Girls were more likely to participate at high competition volume (23.2% vs 11.0%, χ2 = 84.7, P < 0.001), participate on a club team (61.2% vs 37.2%, χ2 = 88.3, P < 0.001), and be highly specialized (16.4% vs 10.4%, χ2 = 19.7, P < 0.001). Athletes with high competition volume, who participated in a club sport, or who were highly specialized had greater odds of reporting a previous LEI than those with low competition volume (odds ratio [OR], 2.08; 95% CI, 1.55-2.80; P < 0.001), no club sport participation (OR, 1.50; 95% CI, 1.20-1.88; P < 0.001), or low specialization (OR, 2.58; 95% CI, 1.88-3.54; P < 0.001), even after adjusting for sex. Conclusion: Participating in high sport volume, on a club team, or being highly specialized was associated with history of LEI. Girls were more likely to participate at high volumes, be active on club teams, or be highly specialized, potentially placing them at increased risk of injury. Clinical Relevance: Youth athletes, parents, and clinicians should be aware of the potential risks of intense, year-round participation in organized sports.
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Affiliation(s)
- Eric G Post
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.,Wisconsin Injury in Sport Laboratory, University of Wisconsin-Madison, Madison, Wisconsin
| | - David R Bell
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.,Wisconsin Injury in Sport Laboratory, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
| | - Stephanie M Trigsted
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.,Wisconsin Injury in Sport Laboratory, University of Wisconsin-Madison, Madison, Wisconsin
| | - Adam Y Pfaller
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
| | - Scott J Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin
| | - M Alison Brooks
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
| | - Timothy A McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
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Best TM, Caplan A, Coleman M, Goodrich L, Hurd J, Kaplan LD, Noonan B, Schoettle P, Scott C, Stiene H, Huard J. Not Missing the Future. Curr Sports Med Rep 2017; 16:202-210. [DOI: 10.1249/jsr.0000000000000357] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
In the modern era, rehabilitation after sports injury has become a domain for specialists, and its evolution has necessarily brought together the sports physiotherapist, the sports physician, and the orthopedic surgeon. The changing profile of sports related injury, as well as limited availability of facilities for rehabilitation in many areas of India, is a matter of concern. Elite sportspersons have some protection, but the average athlete is often left to fend for himself. Key factors in successful sports injury rehabilitation protocols are the application of modern rehabilitation protocols under appropriate supervision, appropriate and well timed surgical interventions, and judicious and need based use of pharmaceutical agents. Modern rehabilitation protocols emphasize teamwork and proper rehabilitation planning, and the rehabilitation team has to be lead by a trained sports physiotherapist, with an understanding of the protocols and interventions required at various stages. Injury specific rehabilitation protocols are being practiced worldwide but need to be introduced according to the nature of the sport as well as available facilities. Even in India, sports physicians are increasingly joining specialist rehabilitation teams, and they can help with medication, nutritional supplements, and specialized tests that could improve injury understanding. Inputs from surgeons are mandatory if surgical interventions have been performed. What is often missing in the underdeveloped world is psychological support and a clear understanding by the athlete of his/her rehabilitation protocols. World over, the primary aims are safe return to sports and minimizing reinjury on return to sport; this involves rehabilitation in stages, and current methodology clearly demarcates acute and chronic phases of injury. Close coordination with trainers and coaches is mandatory, and all need to understand that the reconditioning phase is crucial; skill assessment before progression has now become a specialized domain and needs to be introduced at all levels of the sport. A key factor in all sports injury rehabilitation protocols is injury prevention; this involves data maintenance by teams or trainers, which is still not fully developed in the Indian context. The injury and subsequent problems need to be comprehended both by athletes and their coaches. The current review is an attempt to clarify some of the issues that are important and routinely used world over, with the aim to improving rehabilitation after sports even in the underdeveloped world.
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Affiliation(s)
| | - Sidak Dhilllon
- Department of Sports Medicine, Sri Ramachandra Medical University, Chennai, Tamil Nadu, India
| | - Mandeep S Dhillon
- Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation Medicine, Sports Injury Clinic, PGIMER, Chandigarh, India,Address for correspondence: Prof. Mandeep S Dhillon, 1027, Sector 24 B, Chandigarh - 160 023, India. E-mail:
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