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Klug P, Adams J, Lents G, Long R, Herda A, Vopat B, Vopat L. Auditing the Representation of Female Athletes in Sports Medicine Research: Fifth-Metatarsal Fractures. FOOT & ANKLE ORTHOPAEDICS 2024; 9:24730114241241318. [PMID: 38584819 PMCID: PMC10996359 DOI: 10.1177/24730114241241318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
Background Female representation within athletics has increased as a result of Title IX, rising popularity, demand for equal compensation, and greater participation in multiple sports. Despite this, gender disparities in sports medicine research are apparent. This project serves to review the literature available on fifth-metatarsal fractures and assess the representation of female athletes in current literature. Methods We used a standardized protocol to audit the representation of female athletes in sports science and sports medicine research for fifth-metatarsal fractures. Primary factors included population, athletic caliber, menstrual status, research theme, sample of males and females, journal impact factor, and Altmetric score. Results Thirty articles met the inclusion criteria. A total of 472 fifth-metatarsal fractures were identified, with 373 of 472 fractures (79%) occurring in males and 99 of 472 (21%) in females. The majority of studies (18/30, 60%) were mixed cohort, followed by 10 male only (33.33%), 1 female only (3.33%), and 1 male vs female (3.33%). Out of 831 total patients in the 18 mixed-cohort studies, 605 of 831 patients (72.8%) were male and 226 of 831 patients (27%) were female. All 18 mixed-sex cohorts investigated health outcomes. Male-only studies evaluated health outcomes and performance metrics. No studies investigated female performance. The one female-only study investigated health outcomes and was the only study to account for menstrual status. There was a single metatarsal fracture in this study population. Conclusion Females are underrepresented in research regarding sports science and sports medicine research for fifth-metatarsal fractures. Research focused on female-only fifth-metatarsal fracture studies exploring the potential impact of female sex-specific factors such as menstrual status in study design are needed.
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Affiliation(s)
- Peter Klug
- Kansas University Medical Center, Kansas City, KS, USA
| | - Jacob Adams
- Kansas University Medical Center, Kansas City, KS, USA
| | - Gordon Lents
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Health System, Kansas City, KS, USA
| | - Rachel Long
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Health System, Kansas City, KS, USA
| | - Ashley Herda
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Health System, Kansas City, KS, USA
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, KS, USA
| | - Bryan Vopat
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Health System, Kansas City, KS, USA
| | - Lisa Vopat
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Health System, Kansas City, KS, USA
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Ceasar J, Yeich A, Shafeek P, Kumar K, Olympia RP. The Impact of Knee and Ankle Injuries on National Basketball Association Player Performance Post-injury. Cureus 2024; 16:e58943. [PMID: 38800310 PMCID: PMC11126319 DOI: 10.7759/cureus.58943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION Athletes in the National Basketball Association (NBA) are subjected to high levels of mechanical stress increasing their risk of injury. The purpose of this study was to see how certain lower extremity injuries affect in-game performance in relation to each NBA athlete's demographics. The hypothesis was that NBA players' post-injury performance would differ depending on their demographics and the type of injury sustained. METHODS Descriptive epidemiology study of NBA injury list designations from the 2010/2011 season to the 2018/2019 season. About 255 lower leg injuries that met the inclusion criteria were selected from the injury lists spanning from the 2010/2011 season to the 2018/2019 season. These included ligamentous knee injuries, knee sprains, knee strains, knee hyperextensions, patellar injuries, ankle injuries, and Achilles injuries. The change in performance was determined by comparing mean game scores before and after injury with single-tailed, heteroscedastic t-testing and 95% confidence intervals for mean values. RESULTS An overall statistically significant decrease in mean game score from 9.82 to 8.75 was seen in all included players (p = 0.01). Only athletes taller than the mean height (199.85 cm; p = 0.01) and heavier than the mean weight (101.63 kg; p = 0.02) showed a significant decline in performance. Ankle and knee injuries both resulted in a significant loss in game score (p = 0.04), with ankle injuries resulting in a greater average decline (-1.76 post-injury) than knee injuries (-1.34 post-injury). CONCLUSIONS These findings suggest that treatment regimens should reflect the type of injury and demographics of the specific NBA player injured. Further research is warranted to determine if treatment may be more efficacious when streamlined based on player size and injury type.
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Affiliation(s)
- Justin Ceasar
- Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, USA
| | - Andrew Yeich
- Medicine, Penn State College of Medicine, Hershey, USA
| | - Peter Shafeek
- Medicine, Penn State College of Medicine, Hershey, USA
| | - Kushagra Kumar
- Emergency Medicine, Penn State College of Medicine, Hershey, USA
| | - Robert P Olympia
- Emergency Medicine and Pediatrics, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
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Othman S, Shamloul G, Othman A, Pistorio AL. The Impact of Wrist Fractures on Long-Term Basketball Performance. J Hand Microsurg 2024; 16:100008. [PMID: 38854367 PMCID: PMC11127538 DOI: 10.1055/s-0042-1757178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
Background Wrist joint fractures may present challenging obstacles for the rehabilitating athlete upon return to play. Although current literature has examined the effects of specific injuries to the upper extremity for basketball athletes, little is known about long-term performance outcomes following wrist joint fractures. Methods Review of all National Basketball Association players who sustained wrist joint fractures was conducted. Player characteristics, preinjury and postinjury performance, and overall efficiency were analyzed. Results A total of 31 players were deemed appropriate for inclusion, with an average age of 26.2 ± 4.3 years and a mean of 5.2 ± 3.6 years played before injury and 4.1 ± 3.1 years played upon return. Operative management was pursued in 48.4% of players. Players demonstrated a significant decrease in win shares before injury (mean: 24.3 ± 31.5) compared to after return from injury (mean: 9.6 ± 19.6) (p < 0.032). Multivariate regression demonstrated that increased points per game before injury (standardized β: 0.71; 95% confidence interval [CI]: 1.2-8.5, p < 0.011) and increased win shares before injury (β: 1.0; 95% CI: 1.4-9.5, p < 0.001) were both independently predictive with increased win shares after return to play. Player position, age, management type, and all other statistics were not significantly associated with any other findings upon return. Conclusion Overall efficiency following return to play in the setting of basketball-associated wrist joint fractures appears to be decreased in athletes. However, preinjury performance as captured through win share efficiency and points per game appears to be predictive of increased productivity after successful return.
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Affiliation(s)
- Sammy Othman
- Drexel University College of Medicine, Pennsylvania, United States
| | - Gelan Shamloul
- Philadelphia College of Osteopathic Medicine, Pennsylvania, United States
| | - Ahmed Othman
- New Jersey Medical School, New Jersey, United States
| | - Ashley L. Pistorio
- Department of Plastic Surgery, University of Nevada, Las Vegas, United States
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Cassinat JJ, Aceto M, Schwartzman J, Ghattas Y, Gapinski Z, Service BC. Multivariate Analysis of Risk Factors for Injury and Surgical Interventions in Ankle and Knee Injuries in NBA Athletes. Open Access J Sports Med 2024; 15:1-8. [PMID: 38348303 PMCID: PMC10859044 DOI: 10.2147/oajsm.s442750] [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: 11/07/2023] [Accepted: 01/24/2024] [Indexed: 02/15/2024] Open
Abstract
Objective Lower extremity ankle and knee injuries occur at a high rate in the National Basketball Association (NBA) often requiring surgical intervention. This study aimed to identify surgical rates and risk factors for surgical intervention using multivariate analysis in ankle and knee injuries in NBA player. Methods Player demographics, performance metrics, advanced statistics, and injury characteristics were recorded using publicly available data. To standardize injury events over multiple years, injury events per 1000 athlete exposure events (AE, one player participating in one game) were calculated. Descriptive analysis and multivariate logistic regression were completed to find associations with surgical intervention in ankle and knee injuries. Results A total of 1153 ankle and knee injuries were included in the analysis with 73 (6.33%) lower extremity injuries treated with surgery. Knee injuries had a higher incidence of surgical intervention (0.23 AE) than ankle injuries (0.04 AE). The most frequent surgical knee injury was meniscus tear treated with meniscus repair (0.05 AE) and the most frequent ankle surgery was surgical debridement (0.01 AE) Multivariate logistic regression indicated lower extremity injuries that required surgery were associated with more minutes per game played (odds ratio [OR] 1.13; p = 0.02), a greater usage rate (OR 1.02 p < 0.001), the center position (OR 1.64; 95% [CI] 1.2-2.24; p = 0.002) and lower player efficiency rating (OR 0.96; 95% p < 0.001). Conclusion Knee surgery was significantly more frequent than ankle surgery despite similar injury rates per 1000 exposures. The center position had the greatest risk for lower extremity injury followed by minutes played while a higher player efficiency rating was protective against surgical intervention. Developing strategies to address these factors will help in the management and prevention of lower extremity injuries requiring surgical intervention.
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Affiliation(s)
- Joshua J Cassinat
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Matthew Aceto
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Jonathan Schwartzman
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Yasmine Ghattas
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Zachary Gapinski
- Department of Orthopedic Surgery, Orlando Health Jewett Orthopedic Institute, Orlando, FL, USA
| | - Benjamin C Service
- Department of Medicine, University of Central Florida College of Medicine, Orlando, FL, USA
- Department of Orthopedic Surgery, Orlando Health Jewett Orthopedic Institute, Orlando, FL, USA
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Greeves JP, Beck B, Nindl BC, O'Leary TJ. Current risks factors and emerging biomarkers for bone stress injuries in military personnel. J Sci Med Sport 2023:S1440-2440(23)00075-0. [PMID: 37188615 DOI: 10.1016/j.jsams.2023.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 04/01/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Bone stress injuries (BSIs) have plagued the military for over 150 years; they afflict around 5 to 10% of military recruits, more so in women, and continue to place a medical and financial burden on defence. While the tibia generally adapts to the rigours of basic military training, the putative mechanisms for bone maladaptation are still unclear. METHODS This paper provides a review of the published literature on current risk factors and emerging biomarkers for BSIs in military personnel; the potential for biochemical markers of bone metabolism to monitor the response to military training; and, the association of novel biochemical 'exerkines' with bone health. RESULTS The primary risk factor for BSI in military (and athletic) populations is too much training, too soon. Appropriate physical preparation before training will likely be most protective, but routine biomarkers will not yet identify those at risk. Nutritional interventions will support a bone anabolic response to training, but exposure to stress, sleep loss, and medication is likely harmful to bone. Monitoring physiology using wearables-ovulation, sleep and stress-offer potential to inform prevention strategies. CONCLUSIONS The risk factors for BSIs are well described, but their aetiology is very complex particularly in the multi-stressor military environment. Our understanding of the skeletal responses to military training is improving as technology advances, and potential biomarkers are constantly emerging, but sophisticated and integrated approaches to prevention of BSI are warranted.
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Affiliation(s)
- Julie P Greeves
- Army Health and Performance Research, Army HQ, Andover, United Kingdom; Norwich Medical School, University of East Anglia, United Kingdom; Division of Surgery and Interventional Science, UCL, United Kingdom.
| | - Belinda Beck
- School of Health Sciences and Social Work, Griffith University, Australia; The Bone Clinic, Australia.
| | - Bradley C Nindl
- School of Health and Rehabilitation Sciences, University of Pittsburgh, United States.
| | - Thomas J O'Leary
- Army Health and Performance Research, Army HQ, Andover, United Kingdom; Division of Surgery and Interventional Science, UCL, United Kingdom.
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Hoenig T, Eissele J, Strahl A, Popp KL, Stürznickel J, Ackerman KE, Hollander K, Warden SJ, Frosch KH, Tenforde AS, Rolvien T. Return to sport following low-risk and high-risk bone stress injuries: a systematic review and meta-analysis. Br J Sports Med 2023; 57:427-432. [PMID: 36720584 DOI: 10.1136/bjsports-2022-106328] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Bone stress injuries (BSIs) are classified in clinical practice as being at low- or high-risk for complication based on the injury location. However, this dichotomous approach has not been sufficiently validated. The purpose of this systematic review was to examine the prognostic role of injury location on return-to-sport (RTS) and treatment complications after BSI of the lower extremity and pelvis. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Web of Science, Cochrane CENTRAL and Google Scholar databases were searched from database inception to December 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Peer-reviewed studies that reported site-specific RTS of BSIs in athletes. RESULTS Seventy-six studies reporting on 2974 BSIs were included. Sixteen studies compared multiple injury sites, and most of these studies (n=11) described the anatomical site of injury as being prognostic for RTS or the rate of treatment complication. Pooled data revealed the longest time to RTS for BSIs of the tarsal navicular (127 days; 95% CI 102 to 151 days) and femoral neck (107 days; 95% CI 79 to 135 days) and shortest duration of time for BSIs of the posteromedial tibial shaft (44 days, 95% CI 27 to 61 days) and fibula (56 days; 95% CI 13 to 100 days). Overall, more than 90% of athletes successfully returned to sport. Treatment complication rate was highest in BSIs of the femoral neck, tarsal navicular, anterior tibial shaft and fifth metatarsal; and lowest in the fibula, pubic bone and posteromedial tibial shaft. CONCLUSION This systematic review supports that the anatomical site of BSIs influences RTS timelines and the risk of complication. BSIs of the femoral neck, anterior tibial shaft and tarsal navicular are associated with increased rates of complications and more challenging RTS. PROSPERO REGISTRATION NUMBER CRD42021232351.
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Affiliation(s)
- Tim Hoenig
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julian Eissele
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Strahl
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kristin L Popp
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
- TRIA Orthopedic Center, Bloomington, Minnesota, USA
| | - Julian Stürznickel
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kathryn E Ackerman
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Stuart J Warden
- Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis, Indiana, USA
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, Indiana, USA
| | - Karl-Heinz Frosch
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Cambridge, Massachusetts, USA
| | - Tim Rolvien
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ito E, Sato Y, Kobayashi T, Soma T, Matsumoto T, Kimura A, Miyamoto K, Matsumoto H, Matsumoto M, Nakamura M, Sato K, Miyamoto T. Low energy availability reduces bone mass and gonadal function in male mice. J Bone Miner Metab 2023; 41:182-192. [PMID: 36914793 DOI: 10.1007/s00774-023-01413-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/17/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION In women, the female athlete triad, marked by low energy availability, functional hypothalamic amenorrhea and osteoporosis, is a recognized risk for stress fractures. Stress injuries also occur in men, but by contrast risks and mechanisms underlying them are less characterized. MATERIALS AND METHODS 5 week-old wild-type male mice were fed ad libitum (ad) or subjected to 60% food restriction (FR) for five weeks. In both groups, some mice were allowed access to an exercise wheel in cages to allow voluntary wheel running (ex) and/or treated with active vitamin D analogues. Mice were sacrificed and analyzed at 10 weeks of age. RESULT Male FR mice exhibited significantly reduced testicle weight, serum testosterone levels and bone mass. Such bone losses in FR male mice were enhanced by exercise. Histological analysis revealed that both bone-resorbing and -forming activities were significantly reduced in FR or FR plus exercise (FR + ex) mice, mimicking a state of low bone turnover. Significantly reduced bone mass in FR or FR + ex male mice was significantly rescued by treatment with active vitamin D analogues, with significant restoration of osteoblastic activities. Serum levels of insulin-like growth factor I (IGF-I), which is critical for bone remodeling, were significantly lower in FR versus control male mice. CONCLUSIONS Low energy availability puts men at risk for stress injuries as well, and low energy availability is upstream of gonadal dysfunction and osteoporosis in males. Active vitamin D analogues could serve as therapeutic or preventive options for stress injuries in men.
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Affiliation(s)
- Eri Ito
- Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinano-Machi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Yuiko Sato
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Advanced Therapy for Musculoskeletal Disorders II, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Musculoskeletal Reconstruction and Regeneration Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tami Kobayashi
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Advanced Therapy for Musculoskeletal Disorders II, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Musculoskeletal Reconstruction and Regeneration Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomoya Soma
- Division of Oral and Maxillofacial Surgery, Department of Dentistry and Oral Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tatsuaki Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Atushi Kimura
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kana Miyamoto
- Department of Orthopedic Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hideo Matsumoto
- Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinano-Machi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinano-Machi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Takeshi Miyamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Department of Advanced Therapy for Musculoskeletal Disorders II, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Department of Musculoskeletal Reconstruction and Regeneration Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Department of Orthopedic Surgery, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
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Abstract
Stress fractures are a common injury that present in athletes because of the high intensity and repetitive nature of many sports. These injuries require a high index of suspicion in the treating clinician to allow for timely management. Though most low-risk fractures heal well with conservative management, high-risk stress fractures as well as any fracture in the elite athlete may warrant surgical intervention as well as an augmented treatment and rehabilitation regimen.
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Affiliation(s)
- Eric Shi
- Sutter East Bay Medical Foundation, 20101 Lake Chabot Road, Castro Valley, CA 94546, USA.
| | - Lawrence M Oloff
- Sutter Health Palo Alto Medical Foundation, Callan Boulevard, Daly City, CA 94015, USA
| | - Nicholas W Todd
- Sutter Health Palo Alto Medical Foundation, 701 East El Camino Real, Mountain View, CA 94040, USA
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Choudhry H, Singleton A, Candella K, Stegelmann S, Falbo R, Carmody C, Levine J. Return to play and performance in the National Basketball Association after undergoing operative or nonoperative treatment for foot fracture. J Orthop 2022; 34:160-165. [PMID: 36090784 PMCID: PMC9450068 DOI: 10.1016/j.jor.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/02/2022] [Indexed: 01/10/2023] Open
Abstract
Background The incidence of distal lower extremity fractures in National Basketball Association (NBA) athletes continues to increase. There is a paucity of data regarding return-to-play (RTP) rates and performance after sustaining foot fractures in these athletes. The purpose of this study is to quantify RTP rates and performance in NBA players after sustaining a foot fracture. Methods Sixty-two NBA athletes suffered foot fractures between 2005 and 2021 according to publicly accessible online data. Each athlete was matched to a control player based on age at start of career, age at index injury year, body mass index (BMI), and position played. Performance statistics from 3 seasons prior and 3 seasons following the index injury season were recorded. Results We found that players who suffered foot fracture injuries are expected to make a full recovery and reach their previous level of performance within three years. 100% of players treated nonoperatively returned to play; meanwhile only 90% of players who were treated operatively returned to play. This difference is statistically significant. Conclusion NBA athletes have a high RTP rate after sustaining a foot fracture. Players may experience an initial decrease in playing time and performance when returning to play, however, these variables were found to return to baseline over time. After three seasons, player statistics returned to baseline in mostly every category, including player efficiency rating (PER). We found that players are expected to make a full recovery and return to their previous level of performance, regardless of whether they were treated operatively or not. Players treated nonoperatively returned to play at a rate of 100% meanwhile those treated operatively returned at a rate of 90%. Therefore, it is our recommendation that players opt for nonoperative treatment when possible.
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Affiliation(s)
- Hassan Choudhry
- Mercy Health St., Vincent Medical Center, Department of Orthopedics, 2409 Cherry Street, Suite #10, Toledo, OH, 43608, USA
| | - Amy Singleton
- Mercy Health St., Vincent Medical Center, Department of Orthopedics, 2409 Cherry Street, Suite #10, Toledo, OH, 43608, USA
| | - Kristofer Candella
- Touro College of Osteopathic Medicine, 230 W 125 St 3rd Floor, New York, NY, 10027, USA
| | - Samuel Stegelmann
- Mercy Health St., Vincent Medical Center, Department of Orthopedics, 2409 Cherry Street, Suite #10, Toledo, OH, 43608, USA
| | - Ryan Falbo
- Mercy Health St., Vincent Medical Center, Department of Orthopedics, 2409 Cherry Street, Suite #10, Toledo, OH, 43608, USA
| | - Clayton Carmody
- Mercy Health St., Vincent Medical Center, Department of Orthopedics, 2409 Cherry Street, Suite #10, Toledo, OH, 43608, USA
| | - Jason Levine
- Mercy Health St., Vincent Medical Center, Department of Orthopedics, 2409 Cherry Street, Suite #10, Toledo, OH, 43608, USA
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10
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Rizzi AM, Baker HP, Lee CS, Athiviraham A. Lower Extremity Stress Fractures in the National Basketball Association, 2013-2014 Through 2018-2019. Orthop J Sports Med 2022; 10:23259671221126485. [PMID: 36225389 PMCID: PMC9549108 DOI: 10.1177/23259671221126485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/27/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Players in the National Basketball Association (NBA) are at risk for lower extremity stress fractures, partly because of the sport's high-intensity demand on the lower body. PURPOSE To provide insight on the identification and management of potential risk factors associated with lower extremity stress fractures in NBA athletes. STUDY DESIGN Case series; Level of evidence, 4. METHODS A retrospective study was conducted using the NBA electronic medical record database for all players who were on an NBA roster for ≥1 game from the 2013-2014 through 2018-2019 seasons. Player characteristics, games missed, and treatment methodology were independently analyzed. Results were presented as incidence per 1000 player-games. RESULTS There were 22 stress fractures identified in 20 NBA players over the course of 6 years, with an average of 3.67 stress fractures per year and an incidence of 0.12 stress fractures per 1000 player-games. Most stress fractures occurred in the foot (17/22), and 45% (10/22) of stress fractures were treated surgically, with the most common site of operation being the navicular. On average, approximately 37 games and 243 days were missed per stress fracture injury. There was no significant difference in time to return to play between high-risk stress fractures treated operatively versus nonoperatively (269.2 vs 243.8 days; P = .82). CONCLUSION The overall incidence of stress fractures in NBA players was 0.12 per 1000 player-games, and a high percentage of players returned to NBA activity after the injury. There was a relatively even distribution between high-risk stress fractures treated operatively and nonoperatively. When comparing high-risk stress fractures treated operatively to ones treated nonoperatively, no significant difference in average time to return to play in the NBA was found.
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Affiliation(s)
- Andrew M. Rizzi
- Department of Orthopaedic Surgery, University of Chicago Medicine,
Chicago, Illinois, USA.,Andrew M. Rizzi, MD, Department of Orthopaedic Surgery,
University of Chicago Medicine, 5841 S. Maryland Avenue, Chicago, IL 60637, USA
()
| | - Hayden P. Baker
- Department of Orthopaedic Surgery, University of Chicago Medicine,
Chicago, Illinois, USA
| | - Cody S. Lee
- Department of Orthopaedic Surgery, University of Chicago Medicine,
Chicago, Illinois, USA
| | - Aravind Athiviraham
- Department of Orthopaedic Surgery, University of Chicago Medicine,
Chicago, Illinois, USA
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11
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Mateos Conde J, Cabero Morán MT, Moreno Pascual C. Prospective epidemiological study of basketball injuries during one competitive season in professional and amateur Spanish basketball. PHYSICIAN SPORTSMED 2022; 50:349-358. [PMID: 34151718 DOI: 10.1080/00913847.2021.1943721] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION There are few Spanish epidemiological studies of basketball injuries, even though it is the second most played sport and the leading sport played by females in Spain. POPULATION We studied 117 male and female basketball players from ten amateur or professional teams from four leagues in the 2014-2015 season. RESULTS There were 11.6 injuries per 1,000 hours of sporting activity, 9.6 injuries per 1,000 hours of training and 47.3 injuries per 1,000 hours of competition. The rate of injuries requiring downtime was 2.99 per 1,000 hours of training, 41.7 per 1,000 hours of competition and 4.1 per 1,000 hours of sporting activity overall. No significant differences were found in the incidence of injuries between leagues, but a higher incidence by season was found in teams participating in international competitions, due to the increased competition time. The ankle was the main site of injuries causing ≥ 8 days of downtime and knee injuries the site of those causing ≥ 29 days of downtime. The most frequent injuries were sprains, bruises, and muscle overloads and 63.8% of players had ≥ 1 potentially-recurring injury. The most prevalent injuries were ankle sprains (50%), thigh muscle injuries (12.2%) and knee tendinitis (7.4%). The only significant predisposing factor for injury was recurrent injury (adjusted OR 1.93, 95% CI 1.029-3.62). Age, sex, height, weight, position, body mass index, and professional/amateur competition were not significantly associated with the number of injuries or ≥ 7 days downtime in the multivariate analysis. CONCLUSION Preventive measures should be applied to the team as a whole at an early age, since recurrent injuries only explained a small percentage of the total injuries.
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Affiliation(s)
- J Mateos Conde
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - M T Cabero Morán
- Deparment of Statistics, University of Salamanca, Salamanca, Spain
| | - C Moreno Pascual
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
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12
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Lu Y, Pareek A, Lavoie-Gagne OZ, Forlenza EM, Patel BH, Reinholz AK, Forsythe B, Camp CL. Machine Learning for Predicting Lower Extremity Muscle Strain in National Basketball Association Athletes. Orthop J Sports Med 2022; 10:23259671221111742. [PMID: 35923866 PMCID: PMC9340342 DOI: 10.1177/23259671221111742] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/11/2022] [Indexed: 12/23/2022] Open
Abstract
Background In professional sports, injuries resulting in loss of playing time have serious implications for both the athlete and the organization. Efforts to quantify injury probability utilizing machine learning have been met with renewed interest, and the development of effective models has the potential to supplement the decision-making process of team physicians. Purpose/Hypothesis The purpose of this study was to (1) characterize the epidemiology of time-loss lower extremity muscle strains (LEMSs) in the National Basketball Association (NBA) from 1999 to 2019 and (2) determine the validity of a machine-learning model in predicting injury risk. It was hypothesized that time-loss LEMSs would be infrequent in this cohort and that a machine-learning model would outperform conventional methods in the prediction of injury risk. Study Design Case-control study; Level of evidence, 3. Methods Performance data and rates of the 4 major muscle strain injury types (hamstring, quadriceps, calf, and groin) were compiled from the 1999 to 2019 NBA seasons. Injuries included all publicly reported injuries that resulted in lost playing time. Models to predict the occurrence of a LEMS were generated using random forest, extreme gradient boosting (XGBoost), neural network, support vector machines, elastic net penalized logistic regression, and generalized logistic regression. Performance was compared utilizing discrimination, calibration, decision curve analysis, and the Brier score. Results A total of 736 LEMSs resulting in lost playing time occurred among 2103 athletes. Important variables for predicting LEMS included previous number of lower extremity injuries; age; recent history of injuries to the ankle, hamstring, or groin; and recent history of concussion as well as 3-point attempt rate and free throw attempt rate. The XGBoost machine achieved the best performance based on discrimination assessed via internal validation (area under the receiver operating characteristic curve, 0.840), calibration, and decision curve analysis. Conclusion Machine learning algorithms such as XGBoost outperformed logistic regression in the prediction of a LEMS that will result in lost time. Several variables increased the risk of LEMS, including a history of various lower extremity injuries, recent concussion, and total number of previous injuries.
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Affiliation(s)
- Yining Lu
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota,
USA
| | - Ayoosh Pareek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota,
USA
| | - Ophelie Z. Lavoie-Gagne
- Harvard Combined Orthopaedic Surgery Program, Harvard Medical
School, Boston, Massachusetts, USA
| | - Enrico M. Forlenza
- Department of Orthopaedic Surgery, Rush University Medical Center,
Chicago, Illinois, USA
| | - Bhavik H. Patel
- Department of Orthopedic Surgery, University of Illinois at Chicago,
Chicago, Illinois, USA
| | - Anna K. Reinholz
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota,
USA
| | - Brian Forsythe
- Department of Orthopaedic Surgery, Rush University Medical Center,
Chicago, Illinois, USA
| | - Christopher L. Camp
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota,
USA.,∥Christopher L. Camp, MD, Mayo Clinic, 200
First Street SW, Rochester, MN 55905, USA (
)
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13
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Hew-Butler T, Jurczyszyn H, Sabourin J, VanSumeren M, Smith-Hale V. Too Tall for the DXA Scan? Contributions of the Feet and Head to Overall Body Composition. J Clin Densitom 2022; 25:384-391. [PMID: 34969607 DOI: 10.1016/j.jocd.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/05/2021] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
Accurate assessment of total body composition in tall (>1.96m) individuals using dual energy x-ray absorptiometry (DXA) scans is problematic due to current height restrictions of the scan table. The aim of this investigation was to quantify absolute and relative contributions of fat, bone and lean mass, of the feet and head regions, to whole-body composition DXA scan totals. Whole-body DXA scans were performed in collegiate athletes. Athlete DXA scans were included in data analyses if the entire body fit within the confines of scan table area. The feet region of interest (ROI) was delineated at the ankle joint mortise, marked superiorly by the inferior margin of the tibial plafond and encompassing all inferior anatomical structures. The head region was calculated by the DXA scan software. Both absolute (kg) and relative (feet/whole-body x 100 = feet mass %) contributions to body composition were calculated. Data presented as mean±SD. 132 National Collegiate Athletic Association (NCAA) athletes (85 female) underwent DXA scans which met the inclusion criteria. The feet region represented: 1.9±0.3kg (2.6±0.3%) of total mass; 0.4±0.3kg (2.6±0.5%) of fat mass; 1.3±0.3kg (2.5±0.3%) of lean mass; and 0.14±0.0kg (5.4±0.6%) of bone mineral content (BMC). The head region represented: 4.8±0.5kg (6.9±0.8%) of total mass; 1.2±0.2kg (8.2±3.0%) of fat mass; 3.2±0.5kg (6.1±0.9%) of lean mass; and 0.48±0.07kg (18.7±2.7%) of BMC. Significant negative relationships were found between head% versus whole-body BMC (r=-0.54;p < 0.0001), lean mass (r=-0.57;p<0.0001), and fat mass (r=-0.81;p<0.0001) and between feet% versus fat mass (r=-0.68;p<0.0001). A significant positive relationship was noted between feet% versus whole-body BMC (r=0.18;p=0.04) but not versus lean mass (r=0.15;p=0.09). Removing the feet from whole-body composition analyses reduces lean, fat and bone mass compartment totals by 3%-5%. Removing the head region reduces body composition compartments by 6%-19%, from whole-body DXA scan totals.
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Affiliation(s)
- Tamara Hew-Butler
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI USA.
| | - Haley Jurczyszyn
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI USA
| | - Jordan Sabourin
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI USA
| | - Matthew VanSumeren
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI USA
| | - Valerie Smith-Hale
- Division of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI USA
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14
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Yan C, Bice RJ, Frame JW, Warden SJ, Kersh ME. Multidirectional basketball activities load different regions of the tibia: A subject-specific muscle-driven finite element study. Bone 2022; 159:116392. [PMID: 35314384 PMCID: PMC10201946 DOI: 10.1016/j.bone.2022.116392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 11/20/2022]
Abstract
The tibia is a common site for bone stress injuries, which are believed to develop from microdamage accumulation to repetitive sub-yield strains. There is a need to understand how the tibia is loaded in vivo to understand how bone stress injuries develop and design exercises to build a more robust bone. Here, we use subject-specific, muscle-driven, finite element simulations of 11 basketball players to calculate strain and strain rate distributions at the midshaft and distal tibia during six activities: walking, sprinting, lateral cut, jumping after landing, changing direction from forward-to-backward sprinting, and changing direction while side shuffling. Maximum compressive strains were at least double maximum tensile strains during the stance phase of all activities. Sprinting and lateral cut had the highest compressive (-2,862 ± 662 με and -2,697 ± 495 με, respectively) and tensile (973 ± 208 με and 942 ± 223 με, respectively) strains. These activities also had the highest strains rates (peak compressive strain rate = 64,602 ± 19,068 με/s and 37,961 ± 14,210 με/s, respectively). Compressive strains principally occurred in the posterior tibia for all activities; however, tensile strain location varied. Activities involving a change in direction increased tensile loads in the anterior tibia. These observations may guide preventative and management strategies for tibial bone stress injuries. In terms of prevention, the strain distributions suggest individuals should perform activities involving changes in direction during growth to adapt different parts of the tibia and develop a more fatigue resistant bone. In terms of management, the greater strain and strain rates during sprinting than jumping suggests jumping activities may be commenced earlier than full pace running. The greater anterior tensile strains during changes in direction suggest introduction of these types of activities should be delayed during recovery from an anterior tibial bone stress injury, which have a high-risk of healing complications.
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Affiliation(s)
- Chenxi Yan
- Department of Mechanical Science and Engineering, University of Illinois Urbana-Champaign, United States of America
| | - Ryan J Bice
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, United States of America
| | - Jeff W Frame
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, United States of America
| | - Stuart J Warden
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, United States of America; Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, United States of America; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia.
| | - Mariana E Kersh
- Department of Mechanical Science and Engineering, University of Illinois Urbana-Champaign, United States of America; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, United States of America; Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, United States of America.
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15
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Hoenig T, Ackerman KE, Beck BR, Bouxsein ML, Burr DB, Hollander K, Popp KL, Rolvien T, Tenforde AS, Warden SJ. Bone stress injuries. Nat Rev Dis Primers 2022; 8:26. [PMID: 35484131 DOI: 10.1038/s41572-022-00352-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 01/11/2023]
Abstract
Bone stress injuries, including stress fractures, are overuse injuries that lead to substantial morbidity in active individuals. These injuries occur when excessive repetitive loads are introduced to a generally normal skeleton. Although the precise mechanisms for bone stress injuries are not completely understood, the prevailing theory is that an imbalance in bone metabolism favours microdamage accumulation over its removal and replacement with new bone via targeted remodelling. Diagnosis is achieved by a combination of patient history and physical examination, with imaging used for confirmation. Management of bone stress injuries is guided by their location and consequent risk of healing complications. Bone stress injuries at low-risk sites typically heal with activity modification followed by progressive loading and return to activity. Additional treatment approaches include non-weight-bearing immobilization, medications or surgery, but these approaches are usually limited to managing bone stress injuries that occur at high-risk sites. A comprehensive strategy that integrates anatomical, biomechanical and biological risk factors has the potential to improve the understanding of these injuries and aid in their prevention and management.
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Affiliation(s)
- Tim Hoenig
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Boston Children's Hospital, Boston, MA, USA.,Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Belinda R Beck
- School of Health Sciences & Social Work, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Gold Coast, Queensland, Australia.,The Bone Clinic, Brisbane, Queensland, Australia
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Orthopedic Surgery, Harvard Medical School and Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - David B Burr
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA.,Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Kristin L Popp
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Tim Rolvien
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adam S Tenforde
- Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA, USA.
| | - Stuart J Warden
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA. .,Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis, IN, USA. .,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia.
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16
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Lian J, Sewani F, Dayan I, Voleti PB, Gonzalez D, Levy IM, Musahl V, Allen A. Systematic Review of Injuries in the Men's and Women's National Basketball Association. Am J Sports Med 2022; 50:1416-1429. [PMID: 34213367 DOI: 10.1177/03635465211014506] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Numerous studies have reported the incidence and outcomes of injuries in the men's and women's National Basketball Association (NBA and WNBA, respectively). PURPOSE To synthesize published data regarding the incidence and outcomes of all injuries in the NBA and WNBA in a comprehensive review. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched 3 electronic databases (PubMed, MEDLINE, Embase) for studies of all levels of evidence since 1990 pertaining to injuries sustained by active players in the NBA and WNBA. Studies were excluded if the cohort of interest included ≤3 active players. RESULTS The initial search of the 3 databases yielded 1253 unique studies, of which 49 met final inclusion criteria for this review. Only 4 studies included athletes in the WNBA. Based on the mean annual incidence, the 5 most common orthopaedic sports injuries sustained in the NBA were concussions (9.5-14.9 per year), fractures of the hand (3.5-5.5 per year), lower extremity stress fractures (4.8 per year), meniscal tears (2.3-3.3 per year), and anterior cruciate ligament tears (1.5-2.6 per year). Cartilage defects treated using microfracture, Achilles tendon ruptures, and anterior cruciate ligament injuries were 3 injuries that led to significant reductions in performance measurements after injury. CONCLUSION With advances in sports technology and statistical analysis, there is rapidly growing interest in injuries among professional basketball athletes. High-quality prospective studies are needed to understand the prevalence and effect of injuries on player performance and career length. This information can inform preventative and treatment measures taken by health care providers to protect players and guide safe return to play at a high level.
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Affiliation(s)
- Jayson Lian
- Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - Faraz Sewani
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Isaac Dayan
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Pramod B Voleti
- Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - David Gonzalez
- Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - I Martin Levy
- Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - Volker Musahl
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Answorth Allen
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
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17
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Torres-Ronda L, Gámez I, Robertson S, Fernández J. Epidemiology and injury trends in the National Basketball Association: Pre- and per-COVID-19 (2017-2021). PLoS One 2022; 17:e0263354. [PMID: 35143536 PMCID: PMC8830618 DOI: 10.1371/journal.pone.0263354] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/16/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim this study was to provide an epidemiological injury analysis of the National Basketball Association, detailing aspects such as frequency rate, characteristics and impact on performance (missed games), including COVID-19 related and non-related injuries. Methods A retrospective study was conducted from the 2017–18 to 2020–2021 season. Publicly available records from the official website of the National Basketball Association were collected, including player’s profiling data, minutes played per game until the injury occurred, unique injuries and injury description [location (body area), diagnosis (or mechanism)], and missed games due to injury. Results A total of 625 players and 3543 unique injuries were registered during the period analyzed. There was an increased incidence of missed games and unique injuries ratios, from 2017–18 until 2020–21, even when excluding COVID-19 related cases. The main body areas of injuries corresponded to lower body injuries, specifically knee, ankle and foot. The tendon/ligament group, for both games missed and unique injuries, showed the higher ratios (1.16 and 0.21, respectively), followed by muscle (0.69 and 0.16, respectively) and bones (0.30 and 0.03, respectively). Irrespective of season, the higher percentage of unique injuries occurred in the group of players playing in the 26–35 minutes, followed by the 16–25 minutes played. Guards showed the highest injury ratios compared to other playing positions. Most injuries and missed games due to injury occurred from mid-season to the end of the regular season. The majority of both injuries and missed games were concentrated in the two central experience groups (from 6 to 15 years). Conclusions Despite previous efforts to better understand injury risk factors, there has been an increase in unique injuries and missed games. The distribution by body area, type of injury, when they occurred, minutes played and outcomes by play position, age a or years of experience vary between season and franchises.
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Affiliation(s)
- Lorena Torres-Ronda
- Spanish Basketball Federation, Madrid, Spain
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- * E-mail:
| | | | | | - José Fernández
- School of Behavioral and Health Science, Australian Catholic University, Melbourne, Australia
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18
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Tenforde AS, Outerleys J, Bouxsein ML, Buckless CG, Besier T, Davis IS, Bredella MA. Metatarsal Bone Marrow Edema on Magnetic Resonance Imaging and Its Correlation to Bone Stress Injuries in Male Collegiate Basketball Players. Orthop J Sports Med 2022; 10:23259671211063505. [PMID: 35071655 PMCID: PMC8777350 DOI: 10.1177/23259671211063505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/10/2021] [Indexed: 11/15/2022] Open
Abstract
Background: The presence of bone marrow edema (BME) on magnetic resonance imaging (MRI) has been used to evaluate for bone stress injuries in athletes. Purpose: To examine the prevalence of MRI findings, including BME, in a single male collegiate basketball team before and after a single season and to assess its association with clinically symptomatic metatarsal bone stress injuries. Study Design: Cohort Study; Level of evidence, 3. Methods: A total of 16 men on a single collegiate basketball team (mean age, 20.0 ± 1.8 years) underwent 1.5-T MRI focused on both midfeet during the preseason, and 13 underwent repeat MRI during the postseason. MRI findings included the presence of BME and the radiographic classification of the bone stress injury (grades 1-4). Injury surveillance performed by athletic trainers was used to identify metatarsal bone stress injuries over the course of the season. Results: Preseason MRI demonstrated metatarsal BME in 5 of the 16 participants, and postseason MRI demonstrated metatarsal BME in 4 of the 13 participants. All 4 of the participants with postseason BME had MRI findings of BME in the same metatarsals. Compared to those without BME, participants with metatarsal BME had a shorter history of basketball exposure (preseason: 10.4 ± 4.1 vs 14.2 ± 1.9 years, respectively [ P = .023]; postseason: 9.6 ± 4.1 vs 14.0 ± 2.1 years, respectively [ P = .024]), and those with postseason BME had started playing at an older age (9.8 ± 4.3 vs 6.2 ± 1.6 years, respectively; P = .050). The preseason MRI classification for metatarsals included grade 1 (n = 3), followed by grades 2 and 3 (n = 2 each). In the 4 participants with postseason MRI findings, the grade increased from 1 to 4 in 1 participant and was stable in the other 3. No participants were diagnosed clinically with a metatarsal bone stress injury during the season. BME of the sesamoids was identified in 6 participants, who trended toward being older (21.0 ± 2.2 vs 19.4 ± 1.3 years, respectively; P < .10), with the abnormalities persisting on postseason MRI in all players. Conclusion: Collegiate male basketball players may have a high prevalence of BME, often without associated symptoms. The absence of foot pain or a corresponding diagnosis of a metatarsal bone stress injury in this study suggests that MRI findings of BME in asymptomatic athletes should be interpreted with caution.
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Affiliation(s)
- Adam S. Tenforde
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Jereme Outerleys
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Mary L. Bouxsein
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Thor Besier
- University of Auckland, Auckland, New Zealand
| | - Irene S. Davis
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
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19
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Martin CL, Arundale AJH, Kluzek S, Ferguson T, Collins GS, Bullock GS. Characterization of Rookie Season Injury and Illness and Career Longevity Among National Basketball Association Players. JAMA Netw Open 2021; 4:e2128199. [PMID: 34605914 PMCID: PMC8491104 DOI: 10.1001/jamanetworkopen.2021.28199] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE There is limited research investigating injury and illness among professional basketball players during their rookie season. By improving the understanding of injury incidence and risk specific to rookie players, sports medicine clinicians may be able to further individualize injury mitigation programs that address the unique needs of rookie players. OBJECTIVE To compare incidence and rate ratio (RR) of injury and illness among professional National Basketball Association (NBA) players in their rookie season with veteran players and to explore the association of sustaining an injury rookie season with career longevity. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used an online data repository and extracted publicly available data about NBA players between the 2007 and 2008 season to the 2018 and 2019 season. Available data for initial injury and all subsequent injuries were extracted during this time frame. EXPOSURES Injury and illness based on injury status during the rookie season of professional NBA players. MAIN OUTCOMES AND MEASURES Injury and illness incidence and RR. Association of injury during the rookie season with career longevity was assessed via Poisson regressions. RESULTS Of the 12 basketball seasons analyzed, 904 NBA players were included (mean [SD] age, 24.6 [3.9] years; body mass index, 24.8 [1.8]). The injury and illness incidence for rookie players was 14.28 per 1000 athlete game exposures (AGEs). Among all body regions, ankle injuries had the greatest injury incidence among players injured during their rookie season (3.17 [95% CI, 3.15-3.19] per 1000 AGEs). Rookie athletes demonstrated higher RR compared with veterans across multiple regions of the body (ankle: 1.32; 95% CI, 1.12 to 1.52; foot/toe: 1.29; 95% CI, 0.97 to 1.61; shoulder/arm/elbow: 1.43; 95% CI, 1.10 to 1.77; head/neck: 1.21; 95% CI, 0.61 to 1.81; concussions: 2.39; 95% CI, 1.89 to 2.90; illness: 1.14; 95% CI, 0.87 to 1.40), and demonstrated a higher rate of initial injuries compared with veteran players (1.41; 95% CI, 1.29 to 1.53). Players who sustained an injury rookie season demonstrated an unadjusted decrease in total seasons played (-0.4 [95% CI, -0.5 to -0.3] log years; P < .001), but this decrease was not observed within adjusted analysis (0.1 [95% CI, -0.1 to 0.2] log years; P = .36). CONCLUSIONS AND RELEVANCE In this study, rookie athletes demonstrated the highest injury incidence at the ankle and increased RR across multiple regions. These findings may reflect differences in preseason conditioning or load variables impacting rookie athletes and warrant further investigation. Future research is needed to determine the association of cumulative injury burden vs a singular injury event on career longevity.
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Affiliation(s)
| | - Amelia J. H. Arundale
- Icahn School of Medicine at Mount Sinai Health System, New York, New York
- Red Bull Athlete Performance Center, Red Bull GmBH, Thalgau, Austria
| | - Stefan Kluzek
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, United Kingdom
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- University of Nottingham, Nottingham, United Kingdom
| | - Tyler Ferguson
- Big Data Institute, University of Oxford, United Kingdom
| | - Gary S. Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Garrett S. Bullock
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford, United Kingdom
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
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20
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Lavoie-Gagne O, Gong MF, Patel S, Cohn MR, Korrapati A, Forlenza EM, Barmonyallah M, Parvaresh KC, Wolfson TS, Forsythe B. Traumatic Leg Fractures in UEFA Football Athletes: A Matched-Cohort Analysis of Return to Play, Reinjury, Player Retention, and Performance Outcomes. Orthop J Sports Med 2021; 9:23259671211024218. [PMID: 34527753 PMCID: PMC8436324 DOI: 10.1177/23259671211024218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 02/28/2021] [Indexed: 02/03/2023] Open
Abstract
Background: The average professional soccer team experiences 1 to 2 traumatic leg fractures per season, with unknown effects on player performance. Purpose: To (1) determine the rate and time to return to play (RTP) following leg fracture, (2) investigate the rate of reinjury following RTP, and (3) investigate long-term effects that lower extremity (LE) fracture may have on elite soccer player performance. Study Design: Cohort study; Level of evidence, 3. Methods: Using publicly available records, we identified athletes sustaining a traumatic leg fracture across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2000 and 2016. Athletes with leg fracture (femur, tibia, and/or fibula) were matched 1:2 to controls by demographic characteristics and performance metrics 1 season before the index timepoint. Investigations included the RTP rate, reinjury rate, player characteristics associated with RTP within 2 seasons, long-term player retention, performance metrics during the 4 following seasons, and subgroup analysis by player position. Results: A total of 112 players with LE fracture and 224 controls were identified. Players with LE fractures were absent for a mean of 157 days (range, 24-601 days) and 21 games (range, 2-68 games). The rate of RTP within 1 season was 80%, with 4% experiencing subsequent refracture. Injured players remained active in the league at a higher rate than their uninjured counterparts. As compared with controls, injured athletes played 309 fewer total minutes (P < .05), scored 0.09 more assists per game (P < .01) 1 season after injury, and scored 0.12 more points per game 4 seasons after injury (P < .01). Defenders were most affected by an LE fracture, playing 5.24 fewer games (P < .05), 603 fewer total minutes (P < .01), and recording 0.19 more assists per 90 minutes of play as compared with controls 1 season after injury (P < .001). Attackers and midfielders demonstrated no significant difference in metrics after RTP when compared with controls. Conclusion: Most players sustaining an LE fracture returned to elite soccer at the same level after a significant loss of playing time, with a 4% rate of refracture. Player retention was higher for those sustaining an LE fracture versus uninjured controls. Overall, injured players did not experience a decline in performance after recovery from an LE fracture.
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Affiliation(s)
| | - Matthew F Gong
- Department of Orthopaedic Surgery, University of California-San Diego, San Diego, California, USA
| | - Sumit Patel
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
| | - Matthew R Cohn
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
| | | | - Enrico M Forlenza
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
| | - Moses Barmonyallah
- Department of Orthopaedic Surgery, University of California-San Diego, San Diego, California, USA
| | - Kevin C Parvaresh
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
| | | | - Brian Forsythe
- Midwest Orthopaedics at Rush, Rush University, Chicago, Illinois, USA
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21
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Jildeh TR, Buckley P, Abbas MJ, Page B, Young J, Mehran N, Okoroha KR. Impact of Patellar Tendinopathy on Player Performance in the National Basketball Association. Orthop J Sports Med 2021; 9:23259671211025305. [PMID: 34504899 PMCID: PMC8422823 DOI: 10.1177/23259671211025305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022] Open
Abstract
Background: The extent to which patellar tendinopathy affects National Basketball Association (NBA) athletes has not been thoroughly elucidated. Purpose: To assess the impact patellar tendinopathy has on workload, player performance, and career longevity in NBA athletes. Study Design: Cohort study; Level of evidence, 3. Methods: NBA players diagnosed with patellar tendinopathy between the 2000-2001 and 2018-2019 seasons were identified through publicly available data. Characteristics, return to play (RTP), player statistics, and workload data were compiled. The season of diagnosis was set as the index year, and the statistical analysis compared post- versus preindex data acutely and in the long term, both within the injured cohort and with a matched healthy NBA control cohort. Results: A total of 46 NBA athletes were included in the tendinopathy group; all 46 players returned to the NBA after their diagnosis. Compared with controls, the tendinopathy cohort had longer careers (10.50 ± 4.32 vs 7.18 ± 5.28 seasons; P < .001) and played more seasons after return from injury (4.26 ± 2.46 vs 2.58 ± 3.07 seasons; P = .001). Risk factors for patellar tendinopathy included increased workload before injury (games started, 45.83 ± 28.67 vs 25.01 ± 29.77; P < .001) and time played during the season (1951.21 ± 702.09 vs 1153.54 ± 851.05 minutes; P < .001) and during games (28.71 ± 6.81 vs 19.88 ± 9.36 minutes per game; P < .001). Players with increased productivity as measured by player efficiency rating (PER) were more likely to develop patellar tendinopathy compared with healthy controls (15.65 ± 4.30 vs 12.76 ± 5.27; P = .003). When comparing metrics from 1 year preinjury, there was a decrease in games started at 1 year postinjury (−12.42 ± 32.38 starts; P = .028) and total time played (−461.53 ± 751.42 minutes; P = .001); however, PER at 1 and 3 years after injury was unaffected compared with corresponding preinjury statistics. Conclusion: NBA players with a higher PER and significantly more playing time were more likely to be diagnosed with patellar tendinopathy. Player performance was not affected by the diagnosis of patellar tendinopathy, and athletes were able to RTP without any impact on career longevity.
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Affiliation(s)
- Toufic R Jildeh
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Patrick Buckley
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Muhammad J Abbas
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA
| | - Brendan Page
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jacob Young
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Nima Mehran
- Department of Orthopaedic Surgery, Kaiser Permanente, Los Angeles, California, USA
| | - Kelechi R Okoroha
- Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA
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22
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Zhang F, Huang Y, Ren W. Basketball Sports Injury Prediction Model Based on the Grey Theory Neural Network. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1653093. [PMID: 34471505 PMCID: PMC8405319 DOI: 10.1155/2021/1653093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 11/17/2022]
Abstract
Sports injuries will have an impact on the consistency and systemicity of the training process, as well as athlete training and performance improvement. Many talented athletes have had their careers cut short due to sports injuries. Preventing sports injuries is the best way for basketball players to reduce sports injuries. Many coaches and athletes on sports teams, on the other hand, are unaware of the importance of sports injury prevention. They only realize that the body's sports functions are abnormal when it suffers from sports injuries. As a result, this paper proposes a gray theory neural network-based athlete injury prediction model. First, from the standpoint of a single model, the improved unequal interval model is used to predict sports injury by optimizing the unequal interval model in gray theory. The findings show that it is a good predictor of sports injuries, but it is a poor predictor of the average number of injuries. Following that, in order to overcome the shortcomings of a single model, a gray neural network combination model was used. A combination model of the unequal time interval model and BP neural network was determined and established. The prediction effect is significantly improved by combining the gray neural network mapping model and the coupling model to predict the two characteristics of sports injuries. Finally, simulation experiments show that the proposed method is effective.
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Affiliation(s)
- Fengyan Zhang
- Physical Education Department, Shijiazhuang Information Engineering Vocational College, Shijiazhuang 05000, Hebei, China
| | - Ying Huang
- Department of Sports Arts, Hebei Sport University, Shijiazhuang 05000, Hebei, China
| | - Wengang Ren
- Department of Sports Training, Hebei Sport University, Shijiazhuang 05000, Hebei, China
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23
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Warden SJ, Edwards WB, Willy RW. Preventing Bone Stress Injuries in Runners with Optimal Workload. Curr Osteoporos Rep 2021; 19:298-307. [PMID: 33635519 PMCID: PMC8316280 DOI: 10.1007/s11914-021-00666-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 02/07/2023]
Abstract
Bone stress injuries (BSIs) occur at inopportune times to invariably interrupt training. All BSIs in runners occur due to an "error" in workload wherein the interaction between the number and magnitude of bone tissue loading cycles exceeds the ability of the tissue to resist the repetitive loads. There is not a single optimal bone workload, rather a range which is influenced by the prevailing scenario. In prepubertal athletes, optimal bone workload consists of low-repetitions of fast, high-magnitude, multidirectional loads introduced a few times per day to induce bone adaptation. Premature sports specialization should be avoided so as to develop a robust skeleton that is structurally optimized to withstand multidirectional loading. In the mature skeleton, optimal workload enables gains in running performance but minimizes bone damage accumulation by sensibly progressing training, particularly training intensity. When indicated (e.g., following repeated BSIs), attempts to reduce bone loading magnitude should be considered, such as increasing running cadence. Determining the optimal bone workload for an individual athlete to prevent and manage BSIs requires consistent monitoring. In the future, it may be possible to clinically determine bone loads at the tissue level to facilitate workload progressions and prescriptions.
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Affiliation(s)
- Stuart J Warden
- Department of Physical Therapy, School of Health & Human Sciences, Indiana University, 1140 W. Michigan St., CF-124, Indianapolis, IN, 46202, USA.
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, USA.
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia.
| | - W Brent Edwards
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Richard W Willy
- School of Physical Therapy & Health Sciences, University of Montana, Missoula, MT, USA
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24
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Baumfeld T, Fernandes Rezende R, Nery C, Batista JP, Baumfeld D. Fifth Metatarsal Fractures in Professional Soccer Players: Case Series. Foot Ankle Spec 2021; 14:213-218. [PMID: 32172591 DOI: 10.1177/1938640020911223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Fifth metatarsal fractures occur mainly in young athletes, with an estimated incidence of 1.8 per 1000 individuals per year. This study aims to evaluate the functional outcome of professional soccer players undergoing surgical treatment of fifth metatarsal base fractures. METHODS We appraised 34 soccer players operated on from July 2001 to June 2016. All individuals were assessed by the American Orthopedic Foot and Ankle Score (AOFAS) and Visual Analog Scale (VAS) before and after surgery, with a mean 23-month follow-up. The need for grafting, fracture healing, Torg classification, and return to sports were also evaluated. RESULTS There were 10 attackers, 7 offensive-defensive midfielders, 6 side defenders, 5 central defensive midfielders, 3 defenders, 2 goalkeepers, and 1 defensive midfielder, at an average age of 19 years. Preoperative and postoperative AOFAS averaged 42 and 99 points, respectively, whereas VAS scores were 6 and 0. The longer the time to get operated on, the greater was the need for grafting (P = .011). In our study, all fractures have consolidated. Return to sports occurred, on average, 73 days after surgical treatment, and it was not influenced by the time to get operated on, fracture healing, Torg classification, and grafting. CONCLUSION Surgical treatment of the fifth metatarsal base fracture in professional soccer players presents good clinical results. Getting back to activities after surgery is not influenced by surgery time, fracture healing, Torg classification, and grafting.Levels of Evidence: Level IV: Therapeutic studies, Case series.
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Affiliation(s)
- Tiago Baumfeld
- Universidade Federal de Minas Gerais (UFMG), MG, Brasil (TB, DB).,Hospital Felício Rocho, Belo Horizonte, MG, Brasil (RFR).,Escola Paulista de Medicina, UNIFESP, São Paulo, SP, Brasil (CN).,Centro Artroscópico Jorge Batista AS (CAJB AS), Buenos Aires, CABA, Argentina (JPB)
| | - Ricardo Fernandes Rezende
- Universidade Federal de Minas Gerais (UFMG), MG, Brasil (TB, DB).,Hospital Felício Rocho, Belo Horizonte, MG, Brasil (RFR).,Escola Paulista de Medicina, UNIFESP, São Paulo, SP, Brasil (CN).,Centro Artroscópico Jorge Batista AS (CAJB AS), Buenos Aires, CABA, Argentina (JPB)
| | - Caio Nery
- Universidade Federal de Minas Gerais (UFMG), MG, Brasil (TB, DB).,Hospital Felício Rocho, Belo Horizonte, MG, Brasil (RFR).,Escola Paulista de Medicina, UNIFESP, São Paulo, SP, Brasil (CN).,Centro Artroscópico Jorge Batista AS (CAJB AS), Buenos Aires, CABA, Argentina (JPB)
| | - Jorge P Batista
- Universidade Federal de Minas Gerais (UFMG), MG, Brasil (TB, DB).,Hospital Felício Rocho, Belo Horizonte, MG, Brasil (RFR).,Escola Paulista de Medicina, UNIFESP, São Paulo, SP, Brasil (CN).,Centro Artroscópico Jorge Batista AS (CAJB AS), Buenos Aires, CABA, Argentina (JPB)
| | - Daniel Baumfeld
- Universidade Federal de Minas Gerais (UFMG), MG, Brasil (TB, DB).,Hospital Felício Rocho, Belo Horizonte, MG, Brasil (RFR).,Escola Paulista de Medicina, UNIFESP, São Paulo, SP, Brasil (CN).,Centro Artroscópico Jorge Batista AS (CAJB AS), Buenos Aires, CABA, Argentina (JPB)
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25
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Scheer RC, Newman JM, Zhou JJ, Oommen AJ, Naziri Q, Shah NV, Pascal SC, Penny GS, McKean JM, Tsai J, Uribe JA. Ankle Fracture Epidemiology in the United States: Patient-Related Trends and Mechanisms of Injury. J Foot Ankle Surg 2021; 59:479-483. [PMID: 32354504 DOI: 10.1053/j.jfas.2019.09.016] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 09/11/2019] [Indexed: 02/03/2023]
Abstract
Current nationwide epidemiological data regarding ankle fractures are scarce. Such information is important towards better quantifying the mortality associated with such injuries, financial impact, as well as the implementation of preventative measures. This study evaluated the epidemiology of ankle fractures that occurred during a 5-year period. Specifically, we evaluated demographics, mechanism of injury, and disposition. The National Electronic Injury Surveillance System was queried to identify all patients with ankle fractures that presented to US hospital emergency departments between 2012 and 2016. Census data were used to determine the incidence rates of ankle fractures in terms of age, sex, and race. There was an estimated total of 673,214 ankle fractures that occurred during this period, with an incidence rate of 4.22/10,000 person-years. The mean age of patients with an ankle fracture was 37 ± 22.86 (SD) years; 23.5% of ankle fractures occurred in patients aged 10 to 19 years (7.56/10,000 person-years). In addition, 44% of ankle fractures occurred in men (3.81/10,000 person-years), whereas 56% occurred in women (4.63/10,000 person-years). Data on race/ethnicity were available for 71% of the subjects, with incidence rates of 2.85/10,000 person-years for whites, 3.01/10,000 person-years for blacks, and 4.08/10,000 person-years for others. The most common mechanism of injury was falls (54.83%), followed by sports (20.76%), exercise (16.84%), jumping (4.42%), trauma (2.84%), and other (0.30%). For disposition, 81.84% of patients were treated and released, 1.43% were transferred, 16.01% were admitted, 0.59% were held for observation, and 0.13% left against medical advice. The highest incidence of ankle fractures in men occurred in the 10-to-19-years age group, but women were more commonly affected in all other age groups.
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Affiliation(s)
- Ryan C Scheer
- Medical Student, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Jared M Newman
- Orthopaedic Surgery Resident, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY.
| | - Jack J Zhou
- Medical Student, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Alvin J Oommen
- Medical Student, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Qais Naziri
- Orthopaedic Surgeon, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY; Orthopaedic Surgeon, Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL
| | - Neil V Shah
- Orthopaedic Surgery Resident, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Scott C Pascal
- Orthopaedic Surgery Resident, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Gregory S Penny
- Orthopaedic Surgery Resident, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Jason M McKean
- Orthopaedic Surgeon, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY; Orthopaedic Surgeon, Department of Orthopaedic Surgery, Brookdale University Hospital Medical Center, Brooklyn, NY
| | - Justin Tsai
- Orthopaedic Surgeon, Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, New York, NY
| | - Jaime A Uribe
- Assistant Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY
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26
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Moore ML, Haglin JM, Hassebrock JD, Anastasi MB, Chhabra A. Management of ankle injuries in professional basketball players: Prevalence and rehabilitation. Orthop Rev (Pavia) 2021; 13:9108. [PMID: 33953893 PMCID: PMC8077287 DOI: 10.4081/or.2021.9108] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/27/2021] [Indexed: 11/23/2022] Open
Abstract
Basketball is a popular internationally played sport. With the physical requirements the game has on athletes, players are at risk of injury. Ankle injuries are the most common injury type suffered by basketball players. In this comprehensive review, we present an analysis and overview of the most common ankle injuries among basketball players, including sprains, fractures, impingement, and Achilles tendon pathology. The review includes treatment modalities for such injuries. More research is warranted regarding prevention strategies.
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Affiliation(s)
- M. Lane Moore
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ
| | - Jack M. Haglin
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ
| | | | | | - Anikar Chhabra
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ, USA
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27
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Allahabadi S, Su F, Lansdown DA. Systematic Review of Orthopaedic and Sports Medicine Injuries and Treatment Outcomes in Women's National Basketball Association and National Basketball Association Players. Orthop J Sports Med 2021; 9:2325967120982076. [PMID: 33623799 PMCID: PMC7878958 DOI: 10.1177/2325967120982076] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/31/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Athletes in the Women’s National Basketball Association (WNBA) and National Basketball Association (NBA) are subject to high injury rates given the physical demands of the sport. Comprehensive data regarding injury patterns and rates in these athletes are limited. Purpose: To summarize available data on orthopaedic and sports medicine–related injuries through 2020 in professional female and male basketball players. Study Design: Systematic review; Level of evidence, 4. Methods: A search was conducted using PubMed and Embase through April 5, 2020, to identify injury studies regarding WNBA and NBA players. Studies were included if the injury or surgery was considered a direct consequence of game play including musculoskeletal/orthopaedic, concussion, ophthalmologic, and craniomaxillofacial injuries. Systematic reviews, screening studies, or studies without sufficient WNBA or NBA player subgroup analysis were excluded. Results: A total of 49 studies met inclusion criteria, 43 (87.8%) of which detailed musculoskeletal injuries. The lower extremity represented 63.3% of studies. A majority (59.2%) of studies were level 4 evidence. The source of data was primarily comprehensive online search (n = 33; 67.3%), followed by official databases (n = 11; 22.4%). Only 3 studies concerned WNBA athletes compared with 47 that concerned NBA athletes. The lowest return-to-play rates were cited for Achilles tendon repairs (61.0%-79.5%). Variability in return-to-play rates existed among studies even with similar seasons studied. Conclusion: The majority of literature available on orthopaedic and sports medicine–related injuries of NBA and WNBA athletes is on the lower extremity. The injuries that had the greatest effect on return to play and performance were Achilles tendon ruptures and knee cartilage injuries treated using microfracture. The reported outcomes are limited by heterogeneity and overlapping injury studies. There are limited available data on WNBA injuries specifically.
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Affiliation(s)
- Sachin Allahabadi
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Favian Su
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Drew A Lansdown
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
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28
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Khan M, Ekhtiari S, Burrus T, Madden K, Rogowski JP, Bedi A. Impact of Knee Injuries on Post-retirement Pain and Quality of Life: A Cross-Sectional Survey of Professional Basketball Players. HSS J 2020; 16:327-332. [PMID: 33380964 PMCID: PMC7749878 DOI: 10.1007/s11420-019-09736-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Professional basketball players are at increased risk for knee injuries. Epidemiologic data exist on the prevalence of such injuries in players in the National Basketball Association (NBA), but little is known about how these injuries affect athletes before after retirement. QUESTIONS/PURPOSES The goals of this study were to evaluate the rates and characteristics of knee injury before and during NBA players' careers and how those injuries correspond to knee injury, pain, or surgery, as well as quality of life, after retirement. METHODS A cross-sectional survey study was performed. The survey instrument was designed with the aid of a multidisciplinary focus group. Data collected included patient demographics; length of professional career; injuries before, during, and after the athletes' NBA careers; and post-retirement quality of life, assessed using the EQ-5D and Tegner Activity Scale. The survey was distributed electronically to 900 retired NBA athletes. Descriptive statistics were used to present means and proportions, and multiple regression analysis was performed to assess for potential factors correlated to injury. RESULTS One hundred eight retired NBA players participated (a response rate of 12%). Almost a third (32.4%) sustained a knee injury before starting their NBA career; 51 (47.2%) sustained knee injury during professional play in the NBA, and nearly two-thirds of those players (62.7%) needed surgery. Among those who reported knee injuries during their NBA career, a majority had knee pain that continued until retirement (72.5%). Two-thirds (67%) reported having knee pain currently (at the time of the survey). More than a third (34.0%) underwent knee surgery after retirement, which included nine total knee arthroplasties (8.3%). CONCLUSION A majority of retired NBA athletes in our study had knee pain, and many needed operative management during and after their NBA careers. NBA players score lower on quality-of-life measures than average North American men of similar age. Further research is needed to elucidate the best strategies for recognizing and treating knee injuries in these athletes.
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Affiliation(s)
- Moin Khan
- grid.214458.e0000000086837370University of Michigan, Ann Arbor, MI USA ,grid.25073.330000 0004 1936 8227McMaster University, Department of Surgery, 50 Charleton Avenue East, Hamilton, ON L8N 4A6 Canada
| | - Seper Ekhtiari
- grid.214458.e0000000086837370University of Michigan, Ann Arbor, MI USA
| | - Tyrrell Burrus
- grid.214458.e0000000086837370University of Michigan, Ann Arbor, MI USA
| | - Kim Madden
- grid.214458.e0000000086837370University of Michigan, Ann Arbor, MI USA
| | | | - Asheesh Bedi
- grid.214458.e0000000086837370University of Michigan, Ann Arbor, MI USA
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29
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Kaneko F, Edama M, Ikezu M, Matsuzawa K, Hirabayashi R, Kageyama I. Anatomic Characteristics of Tissues Attached to the Fifth Metatarsal Bone. Orthop J Sports Med 2020; 8:2325967120947725. [PMID: 32995346 PMCID: PMC7503013 DOI: 10.1177/2325967120947725] [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: 03/21/2020] [Accepted: 04/06/2020] [Indexed: 11/15/2022] Open
Abstract
Background Two types of stress, bending stress and traction stress, have been reported to be involved in the mechanism of Jones fracture. However, little is known about the risk factors for traction stress. Purpose To classify the attachment position of the peroneus brevis muscle (PB), peroneus tertius (PT), lateral band of the plantar aponeurosis (LB), and the long plantar ligament (LPL), focusing on the zone where a Jones fracture occurs (zone 2), and to compare the footprint area of each tissue type. Study Design Descriptive laboratory study. Methods This study examined 102 legs from 55 Japanese cadavers. Type classification was performed by focusing on the positional relationship between each tissue attachment and the zone where Jones fracture occurs (zone 2). The classifications were as follows: type I, attached proximal to the border between zones 1 and 2; type IIa, attached to the border between zones 1 and 2 with one attached part; and type IIb, attached across the border between zones 1 and 2 with two or more attached parts. The footprint areas of the PB, PT, LB, and LPL were compared between tissue types and within each attachment classification. Results The PB was recorded as type I in 41 feet (40.2%), type IIa in 56 feet (54.9%), and type IIb in 5 feet (4.9%); the PT was recorded as type IIa in 54 feet (60.0%) and type IIb in 36 feet (40.0%); and the LB was recorded as type I in 27 feet (26.5%) and type IIa in 75 feet (73.5%). The LPL did not attach to the fifth metatarsal bone. No significant difference was found in the footprint area between type I PB and type I LB. Conclusion The results indicate that type I, which attaches proximal to zone 2, occurs with PB and LB, and there was no significant difference in the footprint area between them. These findings suggest that type I is involved in traction stress. In the future, biomechanical research based on the results of this study will be necessary. Clinical Relevance The results of this study provide basic research for investigating the mechanism of Jones fracture and the cause of delayed healing.
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Affiliation(s)
- Fumiya Kaneko
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Mutsuaki Edama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Anatomy, School of Life Dentistry at Niigata, Nippon Dental University, Niigata, Japan
| | - Masahiro Ikezu
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kanta Matsuzawa
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryo Hirabayashi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Ikuo Kageyama
- Department of Anatomy, School of Life Dentistry at Niigata, Nippon Dental University, Niigata, Japan
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Burland JP, Outerleys JB, Lattermann C, Davis IS. Reliability of wearable sensors to assess impact metrics during sport-specific tasks. J Sports Sci 2020; 39:406-411. [PMID: 32951565 DOI: 10.1080/02640414.2020.1823131] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There is little information on the reliability of inertial measurement units for capturing impact load metrics during sport-specific movements. The purpose of this study is to determine the reliability of the Blue Trident IMU sensors in measuring impact load, step count and cumulative bone stimulus during a series of soccer-related tasks. Ten healthy recreational soccer players (age: 27.9 ± 2.18; height: 1.77 ± 0.10 m; mass: 79.02 ± 13.07 kg) volunteered for a 3-visit study and performed 4 tasks. Bilateral impact load, total number of steps and cumulative bone stimulus during the tasks were collected. Data were sampled using a dual-g sensor. Intraclass correlation coefficients (ICC3,1) with 95% confidence intervals assessed between-day reliability. Impact load (0.58-0.89) and cumulative bone stimulus (0.90-0.97) had good to excellent reliability across tasks. ICC values for right/left step count were good to excellent during acceleration-deceleration (0.728-0.837), change direction (0.734-0.955) and plant/cut manoeuvres (0.701-0.866) and fair to good during the ball kick (0.588-0.683). This suggests that wearable sensors can reliably measure the cumulative impact load during outdoor functional movements; however, kicking manoeuvres are less reliable. Measuring impact load in the field expands the ability to capture more ecologically valid data.
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Affiliation(s)
- Julie P Burland
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts, USA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School , Boston, Massachusetts, USA.,Harvard Medical School , Boston, MA, USA
| | - Jereme B Outerleys
- Department of Physical Medicine and Rehabilitation, Harvard Medical School , Boston, Massachusetts, USA.,Harvard Medical School , Boston, MA, USA
| | - Christian Lattermann
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts, USA.,Harvard Medical School , Boston, MA, USA
| | - Irene S Davis
- Department of Physical Medicine and Rehabilitation, Harvard Medical School , Boston, Massachusetts, USA.,Harvard Medical School , Boston, MA, USA
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Ekhtiari S, Khan M, Burrus T, Madden K, Gagnier J, Rogowski JP, Maerz T, Bedi A. Hip and Groin Injuries in Professional Basketball Players: Impact on Playing Career and Quality of Life After Retirement. Sports Health 2019; 11:218-222. [PMID: 31013191 DOI: 10.1177/1941738119838274] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Professional basketball players are at increased risk of hip and groin pain. Epidemiologic data exist on the prevalence of hip and groin issues among players in the National Basketball Association (NBA), but little is known about how these injuries affect athletes after retirement. HYPOTHESIS A high proportion of retired NBA athletes would have hip and/or groin pain. STUDY DESIGN Cross-sectional survey. LEVEL OF EVIDENCE Level 4. METHODS A survey was developed through an interdisciplinary focus group. The survey was developed to capture data regarding demographics, collegiate and professional athletic injuries, and current quality of life and musculoskeletal health. The questionnaire was electronically distributed to all members of the National Basketball Players Association using SurveyMonkey (N = 900). RESULTS A total of 108 (12%) retired NBA players completed the survey. More than one-third (36.3%) of athletes report currently experiencing hip and/or groin pain, and 17.6% had received injections for hip or groin conditions since retiring from the NBA. Since retiring, 14.7% of respondents had undergone total hip arthroplasty. The median Tegner activity level scale was 3 out of 10. Nearly one-third (32.4%) of athletes report moderate to severe problems with mobility, and close to half (48%) had moderate to extreme pain/discomfort. CONCLUSION Hip and groin injuries are common among NBA athletes, affecting players throughout their careers and into retirement. A subset of athletes may exist in whom intra-articular hip pathology is not appropriately identified and treated while playing in the NBA. CLINICAL RELEVANCE Retired NBA athletes are at high risk of hip and groin pain after retirement and are more likely to require total hip arthroplasty compared with the general population.
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Affiliation(s)
- Seper Ekhtiari
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Moin Khan
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Tyrrell Burrus
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Kim Madden
- Department of Health Research Methods, McMaster University, Hamilton, Ontario, Canada
| | - Joel Gagnier
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | | | - Tristan Maerz
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Asheesh Bedi
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
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Brumitt J, Hutchison MK, Houck J, Isaak D, Engilis A, Loew J, Duey D, Nelson K, Arizo K. COMPARISON OF NON-CONTACT AND CONTACT TIME-LOSS LOWER QUADRANT INJURY RATES IN MALE COLLEGIATE BASKETBALL PLAYERS: A PRELIMINARY REPORT. Int J Sports Phys Ther 2018; 13:963-972. [PMID: 30534462 PMCID: PMC6253759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Male collegiate basketball (BB) players are at risk for musculoskeletal injury. The rate of time-loss injury in men's collegiate BB, for all levels of National Collegiate Athletic Association (NCAA) competition, ranges from 2.8 to 4.3 per 1000 athletic exposures (AE) during practices and 4.56 to 9.9 per 1000 AE during games. The aforementioned injury rates provide valuable information for sports medicine professionals and coaching staffs. However, many of the aforementioned studies do not provide injury rates based on injury mechanism, region of the body, or player demographics. HYPOTHESIS/ PURPOSE The purpose of this study is two-fold. The first purpose of this study was to report lower quadrant (LQ = lower extremities and low back region) injury rates, per contact and non-contact mechanism of injury, for a cohort of male collegiate basketball (BB) players. The second purpose was to report injury risk based on prior history of injury, player position, and starter status. STUDY DESIGN Prospective, descriptive, observational cohort. METHODS A total of 95 male collegiate BB players (mean age 20.02 ± 1.68 years) from 7 teams (NCAA Division II = 14, NCAA Division III = 43, NAIA = 21, community college = 17) from the Portland, Oregon region were recruited during the 2016-2017 season to participate in this study. Each athlete was asked to complete an injury history questionnaire. The primary investigator collected the following information each week from each team's athletic trainer: athletic exposures (AE; 1 AE = game or practice) and injury updates. RESULTS Thirty-three time-loss LQ injuries occurred during the study period. The overall time-loss injury rate was 3.4 per 1000 AE. Division III BB players had the highest rates of injury. There was no difference in injury rates between those with or without prior injury history. Guards had a significantly greater rate of non-contact time-loss injuries (p = 0.04). CONCLUSIONS Guards experienced a greater rate of LQ injury than their forward/center counterparts. Starters and athletes with a prior history of injury were no more likely to experience a non-contact time-loss injury than nonstarters or those without a prior history of injury. These preliminary results are a novel presentation of injury rates and risk for this population and warrant continued investigation. LEVEL OF EVIDENCE 2.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kevin Arizo
- Clackamas Community College, Oregon City, OR, USA
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