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Duncan MJ, Heering T, Tallis J, Guimaraes-Ferreira L, Martins R, Crotti M, Barnett L, Lander N, Lyons M. The Relationship Between Motor Competence and Landing Error Scoring System Performance in Youth Soccer Players. J Strength Cond Res 2024:00124278-990000000-00494. [PMID: 39074203 DOI: 10.1519/jsc.0000000000004843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
Abstract
Duncan, MJ, Heering, T, Tallis, J, Guimaraes-Ferreira, L, Martins, R, Crotti, M, Barnett, L, Lander, N, and Lyons, M. The relationship between motor competence and landing error scoring system performance in youth soccer players. J Strength Cond Res XX(X): 000–000, 2024—This study examined the relationship between motor competence (MC) and Landing Error Scoring System (LESS) performance in a sample of male junior grassroots footballers aged 10–13 years. Ninety-eight boys aged 10–13 years (mean ± SD = 11.7 ± 1 years) undertook assessment of MC, using the Test of Gross Motor Development (third edition) and anterior cruciate ligament (ACL) injury risk using the LESS. Height and mass were assessed from which maturity status was predicted. Multiple backward linear regressions indicated a significant model (p = 0.001), which explained 49% of the variance in LESS scores. Locomotor MC (β = −0.538, p = 0.001), object control MC (β = −0.261, p = 0.004), and age (β = 1.17, p = 0.03) significantly contributed to the model. Maturity offset (p = 0.100) was not significant. Analysis of covariance (controlling for age and maturity offset) indicated a significant difference in locomotor MC between those classified as poor for LESS. A similar result was observed for object control MC (p = 0.003,
= 0.09), where those classed as poor for LESS had significantly poorer object control MC compared with those classed as excellent, good, and moderate. The results of this study indicate that there is a relationship between both locomotor and object control MC and errors in drop jump landing mechanics in boys aged 10–13 years, with MC explaining nearly 50% of the variance in LESS scores. Practically, this study indicates that MC, particularly locomotor MC, has potential to identify performance in jump landing tests that are associated with increased risk of ACL injury in boys who play grassroots soccer.
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Affiliation(s)
- Michael J Duncan
- Center for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Theresa Heering
- Center for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, United Kingdom
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia; and
| | - Jason Tallis
- Center for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Lucas Guimaraes-Ferreira
- Center for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Ricardo Martins
- Center for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Matteo Crotti
- Center for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Lisa Barnett
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia; and
| | - Natalie Lander
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia; and
| | - Mark Lyons
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
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2
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Matthews M, Mulley J, Williams K, Mutch S. Injured adolescent athlete: optimising health and performance through collaborative rehabilitation. Br J Sports Med 2024:bjsports-2024-108815. [PMID: 39029950 DOI: 10.1136/bjsports-2024-108815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 07/21/2024]
Affiliation(s)
| | - Jake Mulley
- Jake Mulley Physiotherapy Limited, London, UK
- Complete Physio, London, UK
| | - Katy Williams
- Department of Sports Development and Recreation, University of Bath, Bath, UK
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3
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Ramos AP, de Mesquita RS, Migliorini F, Maffulli N, Okubo R. FIFA 11+ KIDS in the prevention of soccer injuries in children: a systematic review. J Orthop Surg Res 2024; 19:413. [PMID: 39026353 PMCID: PMC11264619 DOI: 10.1186/s13018-024-04876-9] [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: 03/19/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND The "FIFA 11+" is an injury prevention program conceived for soccer athletes aged over 14. The use of FIFA 11+ Kids in soccer was associated with a reduction of the overall risk of injuries in children by 48%, and of 74% for serious injuries. However, to the best of our knowledge, a systematic review of the literature on the effects of FIFA 11+ Kids is still missing. Therefore, a systematic review was conducted to ascertain the benefits of the "FIFA 11+ KIDS" program in children who practice soccer. METHODS This systematic review was conducted according to the PRISMA recommendations and prospectively registered in PROSPERO. The electronic search was conducted in the following databases: Web of Science, PubMed, Medline via Ovid, EMBASE and SportDiscuss via EBSCO. Database searches were performed in January 2024. This review included studies that evaluated the effects of the "FIFA 11+ KIDS" program. Eligible studies had to describe program implementation and the mean age of the children. RESULTS A total of 11 articles were included in this systematic review from a pool of 8513 articles screened across various databases. These articles involved over 10,000 young participants from 8 countries, primarily aged 7-14 years, with the majority being soccer athletes. Study quality varied, with four categorized as high, four as good, and three as fair quality. Objectives varied across studies, with four focusing on FIFA 11+ Kids' efficacy in injury prevention, five examining its impact on performance and physical abilities, and two assessing its effects on children's focus and attention skills. Notably, injury prevention studies reported around a 50% reduction in overall injuries and nearly 60% in severe injuries, with a dose-response relationship observed with increased weekly sessions. Significant improvements were noted in physical and functional tests such as the Y balance, jump tests, and various soccer skills, along with positive effects on children's focus and attention, as indicated by 13-18% improvements in Attention Scale for Elementary School Children (ASESC) scores. CONCLUSION The FIFA 11+ KIDS injury prevention program appears to be effective in reducing injuries in young football players. This can positively influence player and team overall performance and might support the long-term athlete development of these young athletes. These findings highlight the importance and necessity of injury prevention in young athletes.
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Affiliation(s)
- Ana Paula Ramos
- Departament of Physiotherapy, University of South of Santa Catarina (UNISUL), Florianópolis, SC, Brazil
| | - Raphael Schmidt de Mesquita
- Physical Therapy Graduate Program, Department of Physiotherapy, University of the State of Santa Catarina, Florianópolis, SC, Brazil
| | - Filippo Migliorini
- Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Via Lorenz Böhler 5, 39100, Bolzano, Italy.
- Department of Life Sciences, Health, and Health Professions, Link Campus University, 00165, Rome, Italy.
| | - Nicola Maffulli
- Faculty of Medicine and Psychology, University La Sapienza, Rome, Italy
- Faculty of Medicine, School of Pharmacy and Bioengineering, Keele University, Stoke on Trent, ST4 7QB, England
- Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, London, E1 4DG, England
| | - Rodrigo Okubo
- Physical Therapy Graduate Program, Department of Physiotherapy, University of the State of Santa Catarina, Florianópolis, SC, Brazil
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Cerezal A, Roriz D, Canga A, Cerezal L. Imaging of sports injuries in adolescents. Pediatr Radiol 2024:10.1007/s00247-024-05991-9. [PMID: 38995428 DOI: 10.1007/s00247-024-05991-9] [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: 05/16/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
Musculoskeletal injuries in adolescents tend to occur in particular locations and have distinct characteristics, as they affect an immature skeleton. Increased engagement in sports, extended training and competition periods, and early specialization in specific sports, among other factors, have contributed significantly to the rise in musculoskeletal sports injuries in adolescents. Furthermore, females show a particularly pronounced increase in sports participation, where anatomical and hormonal factors play crucial roles in the development and increased frequency of sports-related injuries. Consequently, there is a growing demand for diagnostic imaging techniques. Musculoskeletal and pediatric radiologists require a comprehensive understanding of intrinsic and extrinsic risk factors and the successive stages of skeletal development that can influence the specific characteristics of sports injuries in adolescents. These aspects are crucial for the diagnostic, prognostic, and therapeutic management of these injuries and for mitigating chronic conditions that could compromise future sports participation. This review analyzes the primary musculoskeletal injuries in adolescent athletes and highlights the pivotal role of different imaging methods in their diagnosis and management.
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Affiliation(s)
- Alvaro Cerezal
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario La Paz, Madrid, Spain
| | - Diogo Roriz
- Department of Radiology, ULSAM, Viana Do Castelo, Portugal
| | - Ana Canga
- Department of Radiology, Valdecilla University Hospital, Santander, Spain
| | - Luis Cerezal
- Department of Radiology, Diagnóstico Médico Cantabria (DMC), Calle Castilla 6, 39002, Santander, Spain.
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5
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Qin Z, Qin Y, Wang J. Neuromuscular Training Effects on Athletes' Jumping and Lower Limb Injury: A Systematic Review. J Mot Behav 2024:1-14. [PMID: 38967242 DOI: 10.1080/00222895.2024.2369699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/09/2024] [Indexed: 07/06/2024]
Abstract
This study assessed the impact of integrated neuromuscular training (INT) on athletes' jumping performance and lower limb injury prevention. A thorough search across multiple databases, including PubMed, Web of Science, Science Direct, and the Cochrane Library, identified a sample of 19,805 athletes aged between 8.5 and 27.7 years. Results showed that INT led to a significant improvement in jumping ability (SMD = 0.45, 95% CI 0.30-0.60, P = 0.000) and a reduction in lower limb injuries (SMD = 0.68, 95% CI 0.62-0.74, P = 0.000). The most effective interventions lasted at least 25 minutes, conducted 2-5 times per week, for a minimum of 9 weeks. This approach was particularly beneficial for children and adolescents, as it enhanced their countermovement jump (CMJ) ability and helped in the prevention of injuries.
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Affiliation(s)
- Zhikai Qin
- Capital University of Physical Education and Sports, Beijing, China
| | | | - Junsheng Wang
- Capital University of Physical Education and Sports, Beijing, China
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Valente CRM, Marques CG, Nakamoto FP, Salvalágio BR, Lucin GA, Velido LCSB, Dos Reis AS, Mendes GL, Bergamo ME, Okada DN, D Angelo RA, de Lázari EC, Dos Santos Quaresma MVL. Household food insecurity among child and adolescent athletics practitioners: A cross-sectional, descriptive, and exploratory study. Nutrition 2024; 123:112407. [PMID: 38503001 DOI: 10.1016/j.nut.2024.112407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/08/2024] [Accepted: 02/17/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE The aim of the study was to explore the prevalence of food insecurity among child and adolescent athletics practitioners and to investigate factors associated with exercise performance, dietary habits, body composition, sleep, and socioeconomic status based on food security status. METHODS This was a cross-sectional, descriptive, and exploratory study conducted in Campinas, São Paulo, Brazil, between June and July 2023. The convenience sample included children and adolescents (7-17 y old) of both sexes. We evaluated exercise performance, household food insecurity (HFI), dietary-related parameters, and other body composition, lifestyle, and social-related variables. Exercise performance was assessed using the counter movement jump (CMJ), squat jump (SJ), horizontal long jump (HLJ), 50-m sprint test (50-m ST) and throwing strength test (TST). The assessment of HFI was conducted using the food insecurity experience scale (FIES). Comparisons and associations were investigated based on food security status. RESULTS The total sample size was comprised of 138 children (n = 42; 30.4%) and adolescents (n = 96; 69.6%). We found an association between food security status and sex (X2(138,1) = 4.42; P = 0.036). SJ was higher in the food security group than in the HFI group (t(117) = 2.112; P = 0.037; ES = 0.39). Sleep- and dietary-related factors did not differ between the groups. CONCLUSIONS In summary, the prevalence of HFI among child and adolescent athletics participants was approximately 40%. Regarding exercise performance, SJ was better in the food security group than in the HFI group. Concerning dietary-related data, the HFI group had a lower number of meals per day than the food security group, and other dietary data did not differ between the groups. Body composition and sleep-related parameters were similar between the groups.
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Affiliation(s)
| | - Camila G Marques
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo SP, Brasil
| | | | - Beatriz R Salvalágio
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo SP, Brasil
| | | | | | | | - Gabriela L Mendes
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo SP, Brasil
| | - Maria Eduarda Bergamo
- Curso de Nutrição, Centro Universitário São Camilo, São Paulo SP, Brasil; Instituto Vanderlei Cordeiro de Lima, Campinas SP, Brasil
| | - Daniele N Okada
- Curso de Nutrição, Centro Universitário São Camilo, São Paulo SP, Brasil
| | - Ricardo Antônio D Angelo
- Instituto Vanderlei Cordeiro de Lima, Campinas SP, Brasil; Departamento de Ciências do Esporte, Universidade Estadual de Campinas, Campinas SP, Brasil
| | - Evandro C de Lázari
- Instituto Vanderlei Cordeiro de Lima, Campinas SP, Brasil; Departamento de Ciências do Esporte, Universidade Estadual de Campinas, Campinas SP, Brasil
| | - Marcus Vinicius L Dos Santos Quaresma
- Curso de Pós-Graduação Stricto Sensu em Nutrição, Centro Universitário São Camilo, São Paulo SP, Brasil; Curso de Nutrição, Centro Universitário São Camilo, São Paulo SP, Brasil; Instituto Vanderlei Cordeiro de Lima, Campinas SP, Brasil.
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7
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Demirel M, Yenigün MY, Mert L, Kendirci AŞ, Yağci TF, Demir TB, Sağlam Y, Cirdi Y, Yağdiran B, Korkmazer B. Intra- and inter-observer reliability of Dias-Tachdjian classification in pediatric ankle fractures: do clinical experience and expertise matter? J Pediatr Orthop B 2024; 33:240-245. [PMID: 37266919 DOI: 10.1097/bpb.0000000000001097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The Dias-Tachdjian classification is the most commonly used system for the classification of pediatric ankle fractures, but its inter- and intra-observer reliability has not been studied in detail. Also, the impact of the clinician's experience and expertise on the reliability of this system is unknown. This study aimed: (1) to determine the intra- and inter-observer reliability of the Dias-Tachdjian classification and (2) to investigate the effect of the clinician's experience and expertise on the reliability of this system. Anteroposterior and lateral ankle radiographs of 56 children (34 male, 22 female) with ankle fractures, aged between 3 and 14 years, with open growth cartilages, were retrospectively identified and included in the study. Each patient radiograph was examined by 10 observers from two different specialties with different levels of clinical experience (two orthopedic surgeons with interest in pediatric orthopedics, three orthopedic surgeons with no interest in pediatric orthopedics, three orthopedic residents, and two radiology specialists) from two different specialties (orthopedics and radiology). All observers were then asked to classify pediatric ankle fractures at 6-week intervals per the Dias-Tachdjian classification system. Overall, intra-observer reliability as substantial to very good (κ = 0.77-0.95, P < 0.01), but inter-observer reliability as fair for both assessments (κ = 0.21, P < 0.01 and κ = 0.20, P < 0.01 for the first and second occasions, respectively). Inter-observer reliability among pediatric orthopedic surgeons as very good (κ = 0.90, 95% CI = 0.86-0.94, P < 0.01 and κ = 0.82, 95% CI = 0.71-0.93, P < 0.01 for the first and second occasions, respectively). Orthopedic surgeons with no special interest in pediatric orthopedics demonstrated substantial agreement in the first occasion (κ = 0.63, 95% CI = 0.53-0.72, P < 0.01) but moderate in the second one. Orthopedic residents exhibited moderate levels of agreement in each assessment period (κ = 0.58, 95% CI = 0.47-0.68, P < 0.01 and κ = 0.44, 95% CI = 0.37-0.51, P < 0.01 for the first and second occasion, respectively). Considering that the specialists dealing with pediatric orthopedics show very good consistency for Dias-Tachdjian classification, both within and between observers, consistency in the identification of the ankle fracture models increases as the interest in the field of pediatric orthopedics intensifies.
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Affiliation(s)
- Mehmet Demirel
- Department of Orthopedics and Traumatology, İstanbul School of Medicine, İstanbul University
| | - Mehmet Yağiz Yenigün
- Department of Orthopedics and Traumatology, İstanbul School of Medicine, İstanbul University
| | - Lezgin Mert
- Department of Orthopedics and Traumatology, İstanbul School of Medicine, İstanbul University
| | - Alper Şükrü Kendirci
- Department of Orthopedics and Traumatology, İstanbul School of Medicine, İstanbul University
| | - Taha Furkan Yağci
- Department of Orthopedics and Traumatology, İstanbul School of Medicine, İstanbul University
| | - Taha Bedir Demir
- Department of Orthopedics and Traumatology, İstanbul School of Medicine, İstanbul University
| | - Yavuz Sağlam
- Department of Orthopedics and Traumatology, İstanbul School of Medicine, İstanbul University
| | - Yiğit Cirdi
- Department of Orthopedics and Traumatology, Acibadem Hospitals, İstanbul
| | - Burak Yağdiran
- Department of Radiology, School of Medicine, Baskent University, Ankara
| | - Bora Korkmazer
- Department of Radiology, School of Medicine, Cerrahpasa University, İstanbul, Turkey
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8
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Nyland J, Sirignano MN, Richards J, Krupp RJ. Regenerative Anterior Cruciate Ligament Healing in Youth and Adolescent Athletes: The Emerging Age of Recovery Science. J Funct Morphol Kinesiol 2024; 9:80. [PMID: 38804446 PMCID: PMC11130880 DOI: 10.3390/jfmk9020080] [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: 01/03/2024] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
Anterior cruciate ligament (ACL) injuries mainly arise from non-contact mechanisms during sport performance, with most injuries occurring among youth or adolescent-age athletes, particularly females. The growing popularity of elite-level sport training has increased the total volume, intensity and frequency of exercise and competition loading to levels that may exceed natural healing capacity. Growing evidence suggests that the prevailing mechanism that leads to non-contact ACL injury from sudden mechanical fatigue failure may be accumulated microtrauma. Given the consequences of primary ACL injury on the future health and quality of life of youth and adolescent athletes, the objective of this review is to identify key "recovery science" factors that can help prevent these injuries. Recovery science is any aspect of sports training (type, volume, intensity, frequency), nutrition, and sleep/rest or other therapeutic modalities that may prevent the accumulated microtrauma that precedes non-contact ACL injury from sudden mechanical fatigue failure. This review discusses ACL injury epidemiology, current surgical efficacy, the native ACL vascular network, regional ACL histological complexities such as the entheses and crimp patterns, extracellular matrix remodeling, the concept of causal histogenesis, exercise dosage and ligament metabolism, central nervous system reorganization post-ACL rupture, homeostasis regulation, nutrition, sleep and the autonomic nervous system. Based on this information, now may be a good time to re-think primary ACL injury prevention strategies with greater use of modified sport training, improved active recovery that includes well-planned nutrition, and healthy sleep patterns. The scientific rationale behind the efficacy of regenerative orthobiologics and concomitant therapies for primary ACL injury prevention in youth and adolescent athletes are also discussed.
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Affiliation(s)
- John Nyland
- Norton Orthopedic Institute, 9880 Angie’s Way, Suite 250, Louisville, KY 40241, USA (J.R.); (R.J.K.)
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9
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Monasterio X, Cumming SP, Larruskain J, Johnson DM, Gil SM, Bidaurrazaga-Letona I, Lekue JA, Diaz-Beitia G, Santisteban JM, Williams S. The combined effects of growth and maturity status on injury risk in an elite football academy. Biol Sport 2024; 41:235-244. [PMID: 38188110 PMCID: PMC10765440 DOI: 10.5114/biolsport.2024.129472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/26/2023] [Accepted: 05/18/2023] [Indexed: 01/09/2024] Open
Abstract
This study aimed to explore the interaction between growth rate on specific injury incidence and burden on pre-, circa- and post-peak height velocity (PHV) periods. Injury and stature data collected during the 2000-2020 seasons in an elite football academy were retrospectively analysed. Only players with height measurements from childhood until the attainment of adult height were included in the study (N = 84). Growth data were smoothed using a cubic spline to calculate daily growth rate and height. Growth rate was categorised into three groups: fast (> 7.2 cm/year), moderate (3.5-7.2 cm/year) and slow (< 3.5 cm/year). Percentage of observed adult height was used to classify players as pre-PHV (< 88%), circa-PHV (88-95%) or post-PHV (> 95%). Overall and specific injury incidence and burden and rate ratios for comparisons between growth rate groups were calculated on pre-, circa- and post-PHV periods, separately. Overall injury incidence and burden were greater in pre-PHV players with quicker growth rates compared to players growing moderately and slowly. All in all, players with more rapid growth-rates were at higher risk for growth-related injuries in all pre-, circa- and post-PHV periods. Post-PHV, the incidence and burden of joint/ligament injuries were 2.4 and 2.6-times greater in players growing slowly compared to players growing moderately. Practitioners should monitor growth rate and maturity status and consider their interaction to facilitate the design of targeted injury risk reduction strategies.
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Affiliation(s)
- Xabier Monasterio
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
- Medical Services, Athletic Club, Lezama, Spain
- Department for Health, University of Bath, Bath, United Kingdom
| | - Sean P Cumming
- Department for Health, University of Bath, Bath, United Kingdom
| | | | - David M Johnson
- Department for Health, University of Bath, Bath, United Kingdom
| | - Susana M Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Iraia Bidaurrazaga-Letona
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Jose A Lekue
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
- Medical Services, Athletic Club, Lezama, Spain
| | - Gontzal Diaz-Beitia
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
- Medical Services, Athletic Club, Lezama, Spain
| | - Juan M Santisteban
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
- Medical Services, Athletic Club, Lezama, Spain
| | - Sean Williams
- Department for Health, University of Bath, Bath, United Kingdom
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10
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Al-Qahtani MA, Allajhar MA, Alzahrani AA, Asiri MA, Alsalem AF, Alshahrani SA, Alqahtani NM. Sports-Related Injuries in Adolescent Athletes: A Systematic Review. Cureus 2023; 15:e49392. [PMID: 38146581 PMCID: PMC10749669 DOI: 10.7759/cureus.49392] [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: 11/25/2023] [Indexed: 12/27/2023] Open
Abstract
Sports participation among adolescents is increasing, offering numerous health benefits and exposing them to the risk of sports-related injuries. This paper aims to understand that the prevalence and risk factors associated with these injuries are crucial for effective injury prevention and the overall well-being of adolescent athletes. This systematic review synthesizes the existing literature on sports-related injuries in adolescent athletes. A comprehensive search was conducted, yielding 11 relevant studies. The studies were analyzed to determine the prevalence of injuries and identify associated risk factors. A qualitative synthesis of the findings was performed. The included studies collectively highlight the significant burden of sports-related injuries among adolescent athletes, with prevalence rates ranging from 34.1% to 65%. Specific risk factors associated with these injuries include body mass index (BMI), physical activity patterns, age, gender, sport type, previous injuries, and training practices. Obese adolescents, those engaged in excessive weekly practice hours, younger athletes, and females were found to be at higher risk. Certain sports, such as soccer and football, exhibited higher injury rates. Sports-related injuries in adolescent athletes are a multifaceted issue influenced by various factors. Tailored injury prevention strategies are essential, considering the specific needs of adolescent athletes in different sports and age groups. Interventions should encompass physical and educational components, emphasizing proper warm-ups, protective equipment use, and injury prevention education. Longitudinal studies and standardized injury reporting systems are needed to monitor injury trends and evaluate prevention strategies effectively. This systematic review contributes to our understanding of sports-related injuries in adolescent athletes and underscores the importance of evidence-based injury prevention efforts.
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Affiliation(s)
| | | | | | | | | | - Salha A Alshahrani
- Epidemiology and Public Health, General Directorate of Health Affairs in Assir Region, Assir, SAU
| | - Naif M Alqahtani
- Epidemiology and Public Health, General Directorate of Health Affairs in Assir Region, Abha, SAU
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11
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Mallinos A, Jones K, Davis BL. Comparison of side-cutting maneuvers versus low impact baseball swing on knee ligament loading in adolescent populations. Clin Biomech (Bristol, Avon) 2023; 106:106004. [PMID: 37257274 DOI: 10.1016/j.clinbiomech.2023.106004] [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: 10/27/2022] [Revised: 04/26/2023] [Accepted: 05/15/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND High impact sports are associated with an increased incidence rate for knee ligament injuries, specifically pertaining to the anterior cruciate ligament and medial collateral ligament. What is less clear is (i) the extent to which high impact activities preferentially load the anterior cruciate ligament versus the medial collateral ligament, and (ii) whether both ligaments experience similar stretch ratios during high loading scenarios. Therefore, the goal of this project was to assess how different loading conditions experienced through more at-risk sporting maneuvers influence the relative displacements of the anterior cruciate ligament and medial collateral ligament. The focus of the study was on adolescent patients - a group that has largely been overlooked when studying knee ligament biomechanics. METHODS Through kinetic knee data obtained through motion capture experimentation, two different loading conditions (high vs low impact) were applied to 22 specimen-specific adolescent finite element knee models to investigate the biomechanical impact various sporting maneuvers place on the knee ligaments. FINDINGS The high impact side cutting maneuver resulted in 102% and 47% increases in ligament displacement compared to the low impact baseball swing (p < 0.05) for both the anterior cruciate ligament and medial collateral ligament. INTERPRETATION Quantifying biomechanical risks that sporting activities place on adolescent subjects provides physicians with insight into knee ligament vulnerability. More specifically, knowing the risks that various sports place on ligaments helps guide the selection of sports for at-risk patients (especially those who have undergone knee ligament surgery).
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Affiliation(s)
- Alexandria Mallinos
- Department of Biomedical Engineering, Cleveland State University, Cleveland, OH, USA.
| | - Kerwyn Jones
- Department of Orthopedics, Akron Children's Hospital, Akron, OH, USA
| | - Brian L Davis
- Department of Biomedical Engineering, Cleveland State University, Cleveland, OH, USA; Department of Mechanical Engineering, Cleveland State University, Cleveland, OH, USA
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12
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Chesler KC, Howell DR, Khodaee M, Pierpoint LA, Comstock RD, Provance AJ. Are Different Aged Youth Skiers and Snowboarders Experiencing Different Injury Characteristics? Wilderness Environ Med 2023; 34:45-54. [PMID: 36610917 DOI: 10.1016/j.wem.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/15/2022] [Accepted: 10/14/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Skiing and snowboarding are popular winter sports with significant youth participation and inherent potential for injury. We investigated the relationship between age and injury characteristics exhibited by youth skiers and snowboarders. METHODS In this cross-sectional study, we investigated injury characteristics among youth skiers and snowboarders at a ski resort, examining the association between age and injury type. We compared injury characteristics among young children (aged 3-6 y), school-aged children (aged 7-14 y), and older adolescents (aged 15-17 y) using χ2, and examined predictive variables for injuries at different anatomical locations using logistic regression. RESULTS Compared with snowboarding, skiing was associated with greater odds of lower extremity (adjusted odds ratio [aOR]=6.8, 95% confidence interval [CI]: 4.89, 9.47, P<0.001) and head/face/neck (aOR=1.63, 95% CI: 1.20, 2.21, P=0.002) injuries. Compared with skiing, snowboarding was associated with greater odds of upper extremity injury (aOR=5.9, 95% CI: 4.6, 7.6, P<0.001). Age group significantly affected injury mechanism (χ2 [df=12, n=1129]=42.882, P<0.0001) and diagnosis (χ2 [df=12, n=1129]=43.093, P<0.0001). Young child skiers had the highest proportion of injuries to the head/neck/face and lower extremities and a significantly higher proportion of collision injuries and fractures than older skiers. Young child skiers most frequently injured the lower leg/ankle, while older skiers most frequently injured the knee. CONCLUSIONS Youth skiers exhibited predominately lower extremity injuries, while snowboarders exhibited predominately upper extremity injuries. Age significantly affected injury mechanism and injury diagnosis in youth skiers. Specifically, younger skiers tended to suffer more fractures and collision injuries than older youth skiers.
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Affiliation(s)
| | - David R Howell
- University of Colorado School of Medicine, Aurora, CO; Children's Hospital of Colorado, Aurora, CO.
| | | | | | | | - Aaron J Provance
- University of Colorado School of Medicine, Aurora, CO; Children's Hospital of Colorado, Aurora, CO; University of Utah School of Medicine, Salt Lake City, UT
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13
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Monasterio X, Gil SM, Bidaurrazaga-Letona I, Lekue JA, Santisteban JM, Diaz-Beitia G, Lee DJ, Zumeta-Olaskoaga L, Martin-Garetxana I, Bikandi E, Larruskain J. The burden of injuries according to maturity status and timing: A two-decade study with 110 growth curves in an elite football academy. Eur J Sport Sci 2023; 23:267-277. [PMID: 34767492 DOI: 10.1080/17461391.2021.2006316] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Injuries have a negative impact on the development of football players. Maturation is a potential risk factor for football injuries but available data on this topic provide limited evidence due to methodological shortcomings. The aim of this study was to describe the injury burden of male academy football players according to growth curve-derived maturity status and timing. Injury and growth data were collected from 2000 to 2020. Longitudinal height records for 110 individual players were fitted with the Super-Imposition by Translation and Rotation model to estimate age at peak height velocity (PHV). Players were clustered according to maturity status (pre-, circa-, post-PHV, or adults) and timing (early, on-time, late maturers). Overall and specific injury burdens (days lost/player-season) and rate ratios for comparisons between groups were calculated. Overall injury burden increased with advanced maturity status; pre-PHV players had 3.2-, 3.7-, and 5.5-times lower burden compared with circa-PHV, post-PHV, and adult players, respectively. Growth-related injuries were more burdensome circa-PHV, while muscle and joint/ligament injuries had a higher impact post-PHV and in adults. Further, in the pre-PHV period, late maturers showed lower burden of overall, growth-related, anterior inferior iliac spine osteochondrosis, and knee joint/ligament injuries compared with on-time maturers. In adult players, however, injuries were less burdensome for early maturers than on-time and late maturers. In addition, joint/ligament injuries of adult late maturers were 4.5-times more burdensome than those of early maturers. Therefore, monitoring maturity seems crucial to define each player's maturation profile and facilitate design of targeted injury prevention programmes.Highlights Injury burden is significantly lower in football players at pre-peak height velocity (PHV). Growth-related injuries are most burdensome circa-PHV, while muscle and joint/ligament injuries are more burdensome post-PHV and especially in adults.Before PHV, growth-related and knee joint/ligament injuries have lower burden in players who mature late than those who mature on-time. Adult late maturers have greater burden of overall and joint/ligament injuries than early maturers.Football academies should regularly assess the maturity status and timing of young football players, as the impact of injuries varies with maturation status and timing.Management of the maturity-related injury risk profile, in combination with other relevant factors (training load, neuromuscular and biomechanical factors, physiotherapy, coaching, communication, psychosocial factors …), might help improve the success of player development programmes and protect the health of young football players.
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Affiliation(s)
- Xabier Monasterio
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU) Leioa, Spain.,Medical Services, Athletic Club Lezama, Spain
| | - Susana M Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU) Leioa, Spain
| | - Iraia Bidaurrazaga-Letona
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU) Leioa, Spain
| | - Jose A Lekue
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU) Leioa, Spain.,Medical Services, Athletic Club Lezama, Spain
| | - Juan M Santisteban
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU) Leioa, Spain.,Medical Services, Athletic Club Lezama, Spain
| | - Gontzal Diaz-Beitia
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU) Leioa, Spain.,Medical Services, Athletic Club Lezama, Spain
| | - Dae-Jin Lee
- Basque Center for Applied Mathematics (BCAM), Bilbao, Spain
| | | | - Imanol Martin-Garetxana
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU) Leioa, Spain.,Medical Services, Athletic Club Lezama, Spain
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14
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Monasterio X, Gil S, Bidaurrazaga-Letona I, Lekue JA, Diaz-Beitia G, Santisteban JM, Lee DJ, Zumeta-Olaskoaga L, Martin-Garetxana I, Larruskain J. Peak Height Velocity Affects Injury Burden in Circa-PHV Soccer Players. Int J Sports Med 2023; 44:292-297. [PMID: 36410710 DOI: 10.1055/a-1983-6762] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Growth and maturation are potential risk factors for soccer injuries. This research sought to describe how peak height velocity (PHV) affects overall and specific injury burden in circa- and post-PHV elite academy soccer players. Injuries and growth data collected from 2000 to 2020 were studied retrospectively. Longitudinal height records for 124 players were fitted with the Super-Imposition by Translation and Rotation model to calculate PHV (cm/year) and age at PHV. Players were classified according to PHV percentile (fast:≥75th; average: 25-75th; slow:≤25th) and maturity status (circa- or post-PHV). Overall and specific injury burden (days lost/player-season) and rate ratios for comparisons between groups were calculated based on zero-inflated negative binomial models. Confidence intervals were calculated at the 95% confidence level (CI) and the significance level was set at<0.05. In circa-PHV, players with fast PHV had 2.6 (CI: 1.4-4.8)- and 3.3 (CI:1.3-6.7)-times higher overall burden and 2.9 (CI:1.1-7.1)- and 4.1 (CI: 1.4-15.2)-times higher for growth-related injury burden compared to players with average and slow PHV, respectively. Regular monitoring of growth seems important to detect players at higher risk for being disrupted by growth-related injuries.
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Affiliation(s)
| | - Susana Gil
- Physiology, University of the Basque Country, Leioa, Spain
| | | | - Jose A Lekue
- Medical Services, Athletic Club, Lezama, Spain.,Physiology, University of the Basque Country, Leioa, Spain
| | - Gontzal Diaz-Beitia
- Medical Services, Athletic Club, Lezama, Spain.,Physiology, University of the Basque Country, Leioa, Spain
| | - Juan M Santisteban
- Medical Services, Athletic Club, Lezama, Spain.,Physiology, University of the Basque Country, Leioa, Spain
| | - Dae-Jin Lee
- Basque Center for Applied Mathematics, Basque Center for Applied Mathematics, Bilbao, Spain
| | - Lore Zumeta-Olaskoaga
- Basque Center for Applied Mathematics, Basque Center for Applied Mathematics, Bilbao, Spain
| | - Imanol Martin-Garetxana
- Medical Services, Athletic Club, Lezama, Spain.,Physiology, University of the Basque Country, Leioa, Spain
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15
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Hoge C, Sabbagh R, Morgan M, Grawe BM. Epidemiology of youth and high school American football-related injuries presenting to United States emergency departments: 2010-2019. PHYSICIAN SPORTSMED 2022; 50:332-337. [PMID: 34029497 DOI: 10.1080/00913847.2021.1931980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES American football is one of the most popular sports in the United States (US) among youth and high school athletes; however, participation is decreasing due to concerns about safety. This has led to many new safety initiatives over the last decade, but few studies have sought to evaluate if these interventions have made football safer. The purpose of this study is to investigate national-level data on football-related injuries to compare the injury characteristics and specific injury risks of high school and youth athletes over the last decade. METHODS This cross-sectional, retrospective study queried the National Electronic Injury Surveillance System (NEISS) database from 2010-2019 to compare national weighted estimates and injury characteristics of youth (ages 6-12) and high school (ages 14-18) athletes presenting to US emergency departments (EDs) with football-associated injuries. RESULTS The overall injury risk of football-related injuries presenting to US EDs for high school athletes was 16.17 (C.I. 13.85-18.38) per 1,000 participants/year compared to 11.97 (C.I. 10.34-13.41) per 1,000 participants/year in youth athletes. From 2010 to 2019, the overall injury risk for youth athletes participating in football significantly (p < 0.0001) decreased from 13.31 (C.I. 11.23-15.38) per 1,000 participants to 9.93 (C.I. 7.24-12.62) per 1,000 participants. Additionally, the overall injury risk for high school athletes participating in football significantly (p < 0.0001) decreased from 2010 (N = 18.63 [C.I. 16.05-21.21] per 1,000 participants) to 2018 (N = 13.19 [C.I. 9.94-16.44] per 1,000 participants). High school athletes were almost twice as likely and 2.37 times more likely to present with knee and shoulder injuries compared to youth athletes per 1,000 participants/year. CONCLUSION Our study provides evidence that the overall injury risk for both youth and high school football players has significantly decreased since 2010. Furthermore, our study demonstrates that these athletes sustain unique injury characteristics.
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Affiliation(s)
- Connor Hoge
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Ramsey Sabbagh
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Malik Morgan
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Brian M Grawe
- Department of Orthopaedics and Sports Medicine, University of Cincinnati, Cincinnati, OH, USA
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16
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Monasterio X, Bidaurrazaga-Letona I, Larruskain J, Lekue JA, Diaz-Beitia G, Santisteban J, Martin-Garetxana I, Gil SM. Relative skeletal maturity status affects injury burden in U14 elite academy football players. Scand J Med Sci Sports 2022; 32:1400-1409. [PMID: 35750986 DOI: 10.1111/sms.14204] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 12/07/2021] [Accepted: 06/11/2022] [Indexed: 11/30/2022]
Abstract
Maturation progresses at different times and at different rates between individuals. Thus, differences in maturity status exist among players in the same chronological age-based category, especially in U14 players. The purpose of this prospective study was to describe injury burden according to the relative skeletal maturity status in U14 elite academy football players. From 2011 to 2020 injuries and individual exposure (training and match) were prospectively recorded in 183 male U14 players. Skeletal age (SA) was assessed using the Tanner-Whitehouse 2 method. Relative skeletal maturity status [SA minus chronological age (CA)] was classified as follows: early (SA-CA > 0.5), on-time (SA-CA ± 0.5) and late (SA-CA < -0.5). Overall and specific injury burden (days lost/1000h) and rate ratios for comparisons between groups were calculated. Overall injury burden was 2.8-times higher (3.6-times in training) in early maturers compared with late maturers. Growth-related injuries were the most burdensome injuries in all three groups, but significant differences were not found between groups. Muscle injuries were 4-times more burdensome in early maturers compared with on-time and late maturers. Besides, joint/ligament injuries were 7- and 12- times less burdensome in late maturers than in on-time and late maturers, respectively. Significant differences between groups in overall and specific injury burden were not found in matches. Our results showed different injury patterns in U14 early, on-time and late maturers. Hence, monitoring maturity seems crucial to detect potential injuries that cause the greatest disruption, and facilitate design of targeted injury prevention programs.
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Affiliation(s)
- X Monasterio
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.,Medical Services, Athletic Club, Lezama, Spain
| | - I Bidaurrazaga-Letona
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | | | - J A Lekue
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.,Medical Services, Athletic Club, Lezama, Spain
| | - G Diaz-Beitia
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.,Medical Services, Athletic Club, Lezama, Spain
| | - J Santisteban
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.,Medical Services, Athletic Club, Lezama, Spain
| | - I Martin-Garetxana
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain.,Medical Services, Athletic Club, Lezama, Spain
| | - S M Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
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17
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Stinson ZS, Davelaar CMF, Kiebzak GM, Edmonds EW. Treatment Decisions in Pediatric Sports Medicine: Do Personal and Professional Bias Affect Decision-Making? Orthop J Sports Med 2021; 9:23259671211046258. [PMID: 34676272 PMCID: PMC8524719 DOI: 10.1177/23259671211046258] [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: 04/16/2021] [Accepted: 06/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Personal and professional biases can affect decision-making regarding
important issues in pediatric sports medicine. Gaining insight into the
opinions of health care professionals who specialize in pediatric sports
medicine will provide information that may be useful for directing ongoing
research in this field. Hypothesis: It was hypothesized that surgeons would demonstrate bias toward early
surgical intervention versus nonsurgeons. In addition, it was hypothesized
that youth sports medicine professionals who were parents of a child with a
previous major sports injury or concussion would be less likely to allow
their child to play American tackle football or return to football after a
concussion. Study Design: Cross-sectional study. Methods: An online survey was provided to the active members of the Pediatric Research
in Sports Medicine Society. We used both professional background information
and responses to questions related to personal experiences with youth sports
injuries to determine potential factors associated with underlying biases.
Survey responses among subgroups were compared using the Fisher exact test.
The Pearson correlation coefficient was used to evaluate years in practice
versus opioid use. Results: Of the survey participants, 62.5% were pediatric surgeons, and 37.5%
represented different nonsurgical youth sports medicine professions.
Surgeons were less likely than nonsurgeons to agree to allow their child to
return to football after sustaining a concussion and completing a concussion
protocol (48% vs 76%, P = .013). Surgeons were more likely
than nonsurgeons to agree to both elective shoulder stabilization after a
first-time dislocation and elective drilling of a stable knee
osteochondritis dissecans (OCD) before nonoperative treatment (41% vs 10%,
P = .003 and 52% vs 23%, P = .013,
respectively). Those who reported having a child with a concussion history
were more likely to support him or her returning to football after a
concussion (65% vs 33%, P = .026). Conclusion: Surgeons were more likely to favor elective shoulder-stabilization surgery
after a first-time dislocation and drilling of a stable knee OCD instead of
nonoperative management. Personal experience of having a child who sustained
a major sports injury or concussion did not demonstrate a bias against
participation in football or return to football after a concussion.
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18
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Materne O, Chamari K, Farooq A, Tabben M, Weir A, Holmich P, Bahr R, Greig M, McNaughton LR. Shedding light on incidence and burden of physeal injuries in a youth elite football academy: A 4-season prospective study. Scand J Med Sci Sports 2021; 32:165-176. [PMID: 34551163 DOI: 10.1111/sms.14059] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/21/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Physeal injuries have been overlooked in epidemiological research in youth sports. Our prospective study investigated the incidence, severity, and burden of physeal injuries in a youth elite football academy. METHODS In total, 551 youth male football players from under-9 to under-19 were included and observed over four consecutive seasons. Injuries involving the physis were diagnosed and recorded according to type, location, and diagnosis. Injury incidence (II), severity (days lost), and injury burden (IB) were calculated per squad per season (25 players/squad). RESULTS There were 307 physeal injuries: 262 apophyseal (85%), 26 physeal (9%), 2 epiphyseal (1%), and 17 other physeal injuries (5%) with 80% (n=245) causing time-loss. The overall mean incidence of time-loss physeal injuries was 6 injuries/squad-season, leading to a total of 157 days lost/squad-season. The U-16s had the highest burden with 444 days lost per squad-season [median: 20 (95% CI: 12-30) days; II: 10 (95% CI: 7.3.1-13.4)]. Apophyseal injuries of the hip-pelvis resulted in the greatest burden [median: 13 (95% CI: 10-17); II: 2.5 (95% CI: 2.1-3.0)]. Peak apophyseal injury incidence per body parts occurred in U-11 for foot-ankle (II: 2.4; 95% CI: 1.0-4.9), U-14 for knee (II: 4.5; 95% CI: 2.7-7.1), and U-17 for hip-pelvis (II: 6.4; 95% CI: 4.2-9.3). CONCLUSION Physeal injuries accounted for a quarter of all-time loss with the largest injury burden in U-16. Most physeal injuries involved the lower limb and affected the apophysis. Physeal and apophyseal injuries incidence, burden, and pattern vary substantially depending on age. Hip-pelvic apophyseal injuries accounted for the largest injury burden.
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Affiliation(s)
- Olivier Materne
- ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Aspire Health Centre, Aspire Academy, Doha, Qatar.,Rangers Football Club, Glasgow, Scotland
| | - Karim Chamari
- ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | | | | | - Adam Weir
- ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.,Sport Medicine and Exercise Clinic Haarlem (SBK), Haarlem, The Netherlands
| | - Per Holmich
- ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Sports Orthopaedic Research Center - Copenhagen (SORC-C), Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Roald Bahr
- ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Matt Greig
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK
| | - Lars R McNaughton
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, UK.,Department of Sport and Movement Studies, Faculty of Health Science, University of Johannesburg, Auckland Park, South Africa
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19
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Lentin G, Cumming S, Piscione J, Pezery P, Bouchouicha M, Gadea J, Raymond JJ, Duché P, Gavarry O. A Comparison of an Alternative Weight-Grading Model Against Chronological Age Group Model for the Grouping of Schoolboy Male Rugby Players. Front Physiol 2021; 12:670720. [PMID: 34177618 PMCID: PMC8223073 DOI: 10.3389/fphys.2021.670720] [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] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/30/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives Concerns regarding marked differences in the weights and body composition of young rugby players competing within the same age groups have led to the suggestion of alternative models for grouping young players. The aims of this study were (1) to compare variance in the body size and body composition of schoolboy rugby players (9 to 14 years), across weight- and age-grading models, and (2) to identify morphotypes for the weight model using Hattori’s body composition chart. Materials and Methods Skinfold thickness measurements were used to assess body fat mass (BF), fat-free mass (FFM), body fat mass index (BFMI), and fat-free mass index (FFMI). Standardized measure of height and weight were taken for all participants. Data were grouped according to the age categories of the French Rugby Federation (U11: Under 11 years, U13: Under 13 years, and U15: Under 15 years), and to the weight categories (W30–44.9; W45–59.9; and W60–79.9) carried out from 25th and 75th weight percentile in each age category. Body mass index status (NW normal-weight versus OW/OB overweight/obese) was considered. Extreme morphotypes are characterized from BFMI and FFMI in the weight-grading model on Hattori’s body composition chart. Results The dispersion of anthropometric characteristics decreased significantly for the weight model, except for height in all groups and BFMI for U13. Among NW, 3, 1.8, and 0% upgraded; 18.2, 68.7, and 45.5% downgraded; among OW, 50, 21.5, and 12.5%; and among OB, 91.3, 83.3, and 74.6% upgraded, respectively, in U11, U13, U15. FFMI/BFMI were correlated in U11 (r = 0.80, p < 0.001), U13 (r = 0.66, p < 0.001), and U15 (r = 0.77, p < 0.001). There was no significant correlation in W45–59.9 and low correlations in W30–44.9 (r = 0.25, p < 0.001) and W60–79.9 (r = 0.29, p < 0.001). Significant grading difference between the centroids (p < 0.05) and the distribution deviates from centroids of BFMI and FFMI (p < 0.0001) were noted between the two models. Thirteen players were located in adipo-slender, twenty-three in adipo-solid, twenty-two in lean-slender, and two located in the lean-solid morphotype in weight model. Conclusion A weight-grading model should be considered to limit mismatches in anthropometric variables. However, variations of body composition also persisted for this model. Hattori’s body composition chart allowed more detailed examination of morphological atypicalities among schoolboy rugby players.
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Affiliation(s)
- Grégory Lentin
- Research Unit "Impact of Physical Activity on Health" (IAPS n° 201723207F), University of Toulon, Toulon, France
| | - Sean Cumming
- Department of Health, University of Bath, Bath, United Kingdom
| | - Julien Piscione
- Department of Performance, French Rugby Federation, Marcoussis, France
| | - Patrick Pezery
- Research Unit "Impact of Physical Activity on Health" (IAPS n° 201723207F), University of Toulon, Toulon, France
| | - Moez Bouchouicha
- Université de Toulon, Aix Marseille Univ, CNRS, LIS, Marseille, France
| | - José Gadea
- Ligue Sud Provence-Alpes Côte d'Azur de Rugby, Le Pradet, France
| | - Jean-Jacques Raymond
- Research Unit "Impact of Physical Activity on Health" (IAPS n° 201723207F), University of Toulon, Toulon, France.,Sport Medicine and Traumatology Unit, CHITS, Toulon, France
| | - Pascale Duché
- Research Unit "Impact of Physical Activity on Health" (IAPS n° 201723207F), University of Toulon, Toulon, France
| | - Olivier Gavarry
- Research Unit "Impact of Physical Activity on Health" (IAPS n° 201723207F), University of Toulon, Toulon, France
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20
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Monasterio X, Gil S, Bidaurrazaga-Letona I, Lekue J, Santisteban J, Diaz-Beitia G, Martin-Garetxana I, Bikandi E, Larruskain J. Injuries according to the percentage of adult height in an elite soccer academy. J Sci Med Sport 2021; 24:218-223. [DOI: 10.1016/j.jsams.2020.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/27/2020] [Accepted: 08/04/2020] [Indexed: 01/27/2023]
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21
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Evaluation of Shoulder and Knee Isokinetic Strength Profile Among Elite Adolescent Badminton Players. J Sport Rehabil 2021; 30:717-724. [PMID: 33465761 DOI: 10.1123/jsr.2019-0483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 09/15/2020] [Accepted: 10/17/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Badminton continues to be a highly competitive sport where training is introduced at an early age and load has intensified. This exposes players to a greater risk of injuries, in particular when assessing related training outcomes such as strength, agonist-antagonist ratio, and bilateral deficit among adolescents where age- and sex-associated growth and development should be considered. OBJECTIVE To evaluate strength profile of the upper and lower limbs among adolescent elite Malaysian badminton players. DESIGN Cross-sectional study. SETTING Laboratory. PARTICIPANTS Forty-eight asymptomatic athletes (24 males and 24 females) were grouped into early and late adolescence (13-14 y old and 15-17 y old, respectively). MAIN OUTCOME MEASURE(S) Strength (absolute and normalized) of the external/internal rotators of the shoulder and flexor/extensor of the knee and strength derivatives, conventional strength ratio (CSR), dynamic control ratio (DCR), and bilateral deficits were measured. RESULTS Males showed greater strength in all strength indices (P < .05). The older group had greater strength compared to younger for most of the upper and lower limb indices (P < .05); these effects diminished when using normalized data. For females, there was no age group effect in the shoulder and knee strength. All players displayed lower shoulder and knee normative values for CSR and DCR. Dominant and non-dominant knee strength were comparable between sex and age groups. CONCLUSIONS For males, growth and maturation had a greater contribution to strength gained compared to training, whereas for females, growth, maturation, and training did not improve strength. The normalized data indicated that training did not improve all indices measured apart from external rotator strength in females. All players also displayed lower normative values of CSR and DCR. These results suggest that training in elite adolescent Malaysian badminton players lacks consideration of strength gain and injury risk factors.
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Stögner VA, Kaltenborn A, Laser H, Vogt PM. Hand injuries in sports - a retrospective analysis of 364 cases. BMC Musculoskelet Disord 2020; 21:826. [PMID: 33292173 PMCID: PMC7724715 DOI: 10.1186/s12891-020-03807-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 11/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hand injuries are common in sports and associated with high dropout rates and costs. Hence, efforts should strive for further risk prevention measures in order to increase safety in sports. This implies knowledge of sports injury risk profiles. So far, major surveillance programs exist mainly in Anglo-American countries, reflecting the specific concerns of sports in this part of the world. Data on sports injuries within Europe are scarce. As sports behaviour appears to vary demographically, we hypothesised that risk injury profiles differ as well. METHODS To assess whether the described sports injuries of the hand are applicable to the German population, we performed a five-year retrospective, single-centre analysis of sports-related hand injuries, using data from the Enterprise Clinical Research Data Warehouse of the Hannover Medical School. RESULTS Notable differences in comparison to other data were observed. Ball sports, cycling and equestrian sports caused most of the recorded hand injuries, which were predominantly fractures of the wrist and hand. Hand injuries in equestrian sports were associated with significantly higher operation and hospitalisation rates as well as a significantly longer inpatient treatment. CONCLUSION Risk profiles for sports-related hand injuries appear to differ not only in terms of age- and sex, but also geographically. Nation- and Europe-wide hand trauma registries as well as a broad registry participation are necessary in order to accurately assess the risk patterns in Europe; henceforth reducing hand injuries and their sequelae.
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Affiliation(s)
- Viola A Stögner
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
| | - Alexander Kaltenborn
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.,Department of Trauma and Orthopedic Surgery, Plastic, Hand and Reconstructive Surgery, Armed Forces Hospital Westerstede, Lange Strasse 38, 26655, Westerstede, Germany
| | - Hans Laser
- Department for Educational and Scientific IT Systems, Centre for Information Management, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Peter M Vogt
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
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Fort-Vanmeerhaeghe A, Milà-Villarroel R, Pujol-Marzo M, Arboix-Alió J, Bishop C. Higher Vertical Jumping Asymmetries and Lower Physical Performance are Indicators of Increased Injury Incidence in Youth Team-Sport Athletes. J Strength Cond Res 2020; 36:2204-2211. [PMID: 33009354 DOI: 10.1519/jsc.0000000000003828] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fort-Vanmeerhaeghe, A, Milà-Villarroel, R, Pujol-Marzo, M, Arboix-Alió, J, and Bishop, C. Higher vertical jumping asymmetries and lower physical performance are indicators of increased injury incidence in youth team-sport athletes. J Strength Cond Res XX(X): 000-000, 2020-To date, the literature about the association between injury-risk factors and actual injury incidence in young elite team-sports athletes is scarce. The main objective of this study was to examine how modifiable factors may affect injury incidence. Eighty-one young elite team-sports athletes (age: under-14 to under-18) performed the countermovement jump (CMJ), a single leg CMJ (SLCMJ), the one-legged hop test (OLHT), a 30-m sprint test, the V-cut test, a repeated sprint ability, and the 30-15 intermittent fitness test (IFT) during the pre-season period. Interlimb asymmetries were calculated for SLCMJ and OLHT. Injuries were recorded prospectively for the entirety of the 2017-2018 season. Comparison of injury and noninjury data was performed using a two-way analysis of variance (ANOVA). Results of the ANOVA according to injury showed significant differences in CMJ (p = 0.01), SLCMJ on the lowest performing limb (p = 0.03), and SLCMJ asymmetry (<0.001). Sex × injury interaction was significant from CMJ (p = 0.018) and 30-15 IFT (p = <0.001). In conclusion, this study indicated that athletes with greater interlimb asymmetries, less vertical jump capacity, and lower intermittent aerobic fitness had a greater predisposition to injury. Therefore, monitoring CMJ, aerobic performance, and interlimb asymmetries is recommended given their sensitivity to detect significant differences between injured and healthy youth athletes.
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Affiliation(s)
- Azahara Fort-Vanmeerhaeghe
- Faculty of Psychology, Education Sciences and Sport (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain.,School of Health Sciences (FCS) Blanquerna, Ramon Llull University, Barcelona, Spain.,Segle XXI Female Basketball Team, Catalan Federation of Basketball, Esplugues de Llobregat, Spain
| | | | - Montse Pujol-Marzo
- Consell Català de l'Esport, Generalitat de Catalunya, Barcelona, Spain.,Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jordi Arboix-Alió
- Faculty of Psychology, Education Sciences and Sport (FPCEE) Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Chris Bishop
- London Sport Institute, Middlesex University, London, United Kingdom
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24
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Sommerfield LM, Harrison CB, Whatman CS, Maulder PS. Injury Prevention Programs in Youth: A Narrative Review Targeting Females. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Steidl-Müller L, Hildebrandt C, Müller E, Raschner C. Relationship of Changes in Physical Fitness and Anthropometric Characteristics over One Season, Biological Maturity Status and Injury Risk in Elite Youth Ski Racers: A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E364. [PMID: 31948103 PMCID: PMC6982196 DOI: 10.3390/ijerph17010364] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/31/2019] [Accepted: 01/03/2020] [Indexed: 11/16/2022]
Abstract
Alpine ski racing is a sport with a high risk of injuries. In order to contribute to the longitudinal career development of young athletes, prevention measures should be elaborated. Therefore, the aim of the present study was to investigate prospectively the role of biological maturity status, and changes in anthropometric characteristics and physical fitness parameters over one season in elite youth ski racers younger than 15 years. Eighty-nine elite youth ski racers (39 females, 50 males), aged 10-14 years (mean age: 12.1 ± 1.3), were investigated. Anthropometric characteristics and physical fitness parameters were assessed prior and after the winter season; traumatic and overuse injuries were recorded over the 32 weeks. Binary logistic regression analyses (R² = 0.202-0.188) revealed that the biological maturity (Wald = 4.818; p = 0.028), and changes over the season in the jump agility test (Wald = 4.692; p = 0.03), in body height (Wald = 6.229; p = 0.013), and in leg length (Wald = 4.321; p = 0.038) represented significant injury risk factors. Athletes who could improve their jump agility performance more, had smaller changes in the anthropometric characteristics and who were closer to their peak height velocity were at a lower injury risk. In the context of injury prevention, regular neuromuscular training should be incorporated, and phases of rapid growth have to be considered.
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Affiliation(s)
- Lisa Steidl-Müller
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (C.H.); (C.R.)
| | - Carolin Hildebrandt
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (C.H.); (C.R.)
| | - Erich Müller
- Department of Sport Science and Kinesiology, University of Salzburg, 5020 Salzburg, Austria;
| | - Christian Raschner
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria; (C.H.); (C.R.)
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26
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Drury B, Ratel S, Clark CC, Fernandes JF, Moran J, Behm DG. Eccentric Resistance Training in Youth: Perspectives for Long-Term Athletic Development. J Funct Morphol Kinesiol 2019; 4:E70. [PMID: 33467385 PMCID: PMC7739302 DOI: 10.3390/jfmk4040070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023] Open
Abstract
The purpose of this narrative review is to discuss the role of eccentric resistance training in youth and how this training modality can be utilized within long-term physical development. Current literature on responses to eccentric exercise in youth has demonstrated that potential concerns, such as fatigue and muscle damage, compared to adults are not supported. Considering the importance of resistance training for youth athletes and the benefits of eccentric training in enhancing strength, power, speed, and resistance to injury, its inclusion throughout youth may be warranted. In this review we provide a brief overview of the physiological responses to exercise in youth with specific reference to the different responses to eccentric resistance training between children, adolescents, and adults. Thereafter, we discuss the importance of ensuring that force absorption qualities are trained throughout youth and how these may be influenced by growth and maturation. In particular, we propose practical methods on how eccentric resistance training methods can be implemented in youth via the inclusion of efficient landing mechanics, eccentric hamstrings strengthening and flywheel inertia training. This article proposes that the use of eccentric resistance training in youth should be considered a necessity to help develop both physical qualities that underpin sporting performance, as well as reducing injury risk. However, as with any other training modality implemented within youth, careful consideration should be given in accordance with an individual's maturity status, training history and technical competency as well as being underpinned by current long-term physical development guidelines.
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Affiliation(s)
- Benjamin Drury
- Department of Applied Sport Sciences, Hartpury University, Gloucestershire GL19 3BE, England, UK;
| | - Sébastien Ratel
- Laboratoire des Adaptations Métaboliques à l’Exercice en conditions Physiologiques et Pathologiques (AME2P, EA 3533), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Cain C.T. Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5RW, England, UK;
| | - John F.T. Fernandes
- Department of Applied Sport Sciences, Hartpury University, Gloucestershire GL19 3BE, England, UK;
| | - Jason Moran
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s Newfoundland and Labrador, A1C 5S7C, Canada;
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27
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Integrative Neuromuscular Training in Young Athletes, Injury Prevention, and Performance Optimization: A Systematic Review. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9183839] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this systematic review was to evaluate the current evidence by assessing the effectiveness of integrative neuromuscular training programs in injury prevention and sports performance in young athletes. Different data sources were analyzed up to January 2018. Eligible studies contained information on population (young athletes), intervention (neuromuscular training), comparator (control group or another exercise intervention), outcomes (injury prevention or sport performance), and study design (randomized trials or prospective studies). The trials were restricted based on the language (English) and for publication date (after January 1st, 2007). Fourteen randomized controlled trials were included: Seven included dynamic stability-related outcomes. Three assessed the coordination performing fundamental movements and sport-specific skills, while other five studies analyzed muscle strength and two assessed plyometric tests. Agility was evaluated in three studies and speed tests were also considered by four studies. Finally, fatigue resistance in three studies and injury risk in four were assessed. This review provides evidence that integrative neuromuscular training programs can enhance performance and injury prevention in young athletes, taken into account that adherence to the training program is adequate. Collectively, well-designed, randomized studies are necessary to collaborate with the present findings.
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28
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MacAlpine EM, Talwar D, Storey EP, Doroshow SM, Lawrence JTR. Weight Gain After ACL Reconstruction in Pediatric and Adolescent Patients. Sports Health 2019; 12:29-35. [PMID: 31487229 DOI: 10.1177/1941738119870192] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Adolescent athletes who sustain an anterior cruciate ligament (ACL) tear have significantly reduced activity levels during recovery. Activity level is linked to body mass index (BMI); however, it is unclear how recovery from an ACL reconstruction (ACLR) affects relative BMI and whether these changes persist after return to activity. HYPOTHESIS Patients' BMI percentile will significantly increase after ACLR, but will trend toward baseline after return to activity. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS A retrospective review of 666 pediatric and adolescent patients who underwent ACLR was performed. Body mass was assessed by evaluating change in BMI percentile at 8 standard-of-care time windows relative to BMI percentile at time of surgery. Linear regression and bivariate and multivariate analyses were used to assess the effect of time window and other demographic factors on the change in BMI percentile. These analyses were rerun after dividing patients by clinical obesity categorization (underweight, normal, overweight, or obese) at time of surgery to assess the effect of preinjury body mass levels. RESULTS BMI percentile of all BMI categories tended to increase postoperatively, peaking 6 to 9 months after surgery, with a median increase of 1.83 percentile points. After this peak, BMI approached baseline but remained elevated at 0.95 percentile points 2 years postoperatively. Beginning 3 months after surgery, the normal-weight group had significantly larger changes in BMI percentile at each time window, peaking at 4.15 points above baseline at 9 months. This BMI increase among normal-weight patients persisted in the second postoperative year, with a median percentile increase of 2.63 points. CONCLUSION Pediatric and adolescent patients, especially those with a normal BMI, undergo significant changes to their BMI during recovery from ACLR. CLINICAL RELEVANCE Patients' failure to return to their presurgical BMI percentile 2 years postoperatively suggests that ACLR may have long-reaching and often unappreciated effects on body mass.
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Affiliation(s)
- Elle M MacAlpine
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Divya Talwar
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Eileen P Storey
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Scott M Doroshow
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - J Todd R Lawrence
- Division of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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29
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Sutherland K, Clatworthy M, Fulcher M, Chang K, Young SW. Marked increase in the incidence of anterior cruciate ligament reconstructions in young females in New Zealand. ANZ J Surg 2019; 89:1151-1155. [PMID: 31452329 DOI: 10.1111/ans.15404] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/15/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Anterior cruciate ligament injuries cause significant morbidity, and may be increasing in incidence as participation in high-risk sports increases. The aim of this study is to investigate the incidence of anterior cruciate ligament reconstruction (ACLR) surgery in New Zealand, and to analyse changes over time in demographic subgroups. METHOD Data were sourced from the Accident Compensation Corporation. Data relating to primary ACLRs performed from 2009 to 2016 were evaluated (n = 20 751). Baseline population estimates were obtained from national census data to calculate the incidence, and results were compared to previous data from 2000 to 2005 (n = 7375). RESULTS The annual incidence of ACLR for 2009-2016 was 58.2 per 100 000 person-years and was greater in males than in females (72.2 and 44.9, respectively). This represents a 58% increase when compared with the period 2000-2005 (36.9 per 100 000). The greatest increase was seen in females aged 15-19 years, with the incidence increasing by 120% in the last decade, compared with 53% in females aged 20-24 years. The percentage of injuries caused by sports changed from 65% over 2000-2005 to 76% over 2009-2016, with netball, rugby and football accounting for the highest number of injuries. CONCLUSION The incidence of ACLR procedures has increased markedly in New Zealand, and this increase was most pronounced in females aged 15-19 years. A greater proportion of procedures are now due to sport-related injuries.
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Affiliation(s)
- Kirsty Sutherland
- Department of Orthopaedics, North Shore Hospital, Auckland, New Zealand
| | - Mark Clatworthy
- Department of Orthopaedics, Middlemore Hospital, Auckland, New Zealand
| | - Mark Fulcher
- Axis Sports Medicine, Southern Cross Hospital North Harbour, Auckland, New Zealand
| | - Kevin Chang
- Department of Statistics, The University of Auckland, Auckland, New Zealand
| | - Simon W Young
- Department of Orthopaedics, North Shore Hospital, Auckland, New Zealand
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30
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Sex and Maturation Differences in Performance of Functional Jumping and Landing Deficits in Youth Athletes. J Sport Rehabil 2019; 28:606-613. [PMID: 30222476 PMCID: PMC9892800 DOI: 10.1123/jsr.2017-0292] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 07/13/2018] [Accepted: 07/24/2018] [Indexed: 02/04/2023]
Abstract
CONTEXT Understanding how neuromuscular and biomechanical deficits that are associated with knee injuries change as youth mature may improve injury prevention strategies in this population. OBJECTIVE To investigate sex and maturation differences in jump-landing technique performance in youths using a practical clinical tool. DESIGN Cross-sectional study. SETTING High Performance Center Laboratory. PARTICIPANTS A total of 165 youth athletes were included in this study. MAIN OUTCOME MEASURES The main outcome measures were each of the 10 items of the modified tuck jump assessment and the total score. These measures include (1) knee valgus at landing, (2) thighs do not reach parallel, (3) thighs not equal side to side, (4) foot placement not shoulder width apart, (5) foot placement not parallel, (6) foot contact timing not equal, (7) excessive landing contact noise, (8) pause between jumps, (9) technique declines prior to 10 seconds, and (10) does not land in same footprint. RESULTS Only knee valgus at landing had a significant sex × maturation interaction. The main effect of maturation was significant for items 2, 3, 6, 7, 9, and total score. Plyometric technique performance improved with increasing maturation. The main effect of sex was significant for items 1 and 9, with males performing better than females. CONCLUSIONS Female athletes demonstrate increased knee valgus at landing and fatigue relative to males during jump-landing performance. Overall, there was a trend of improved jump-landing performance with maturation.
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32
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Salzmann GM, Niemeyer P, Hochrein A, Stoddart MJ, Angele P. Articular Cartilage Repair of the Knee in Children and Adolescents. Orthop J Sports Med 2018; 6:2325967118760190. [PMID: 29568785 PMCID: PMC5858627 DOI: 10.1177/2325967118760190] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Articular cartilage predominantly serves a biomechanical function, which begins in utero and further develops during growth and locomotion. With regard to its 2-tissue structure (chondrocytes and matrix), the regenerative potential of hyaline cartilage defects is limited. Children and adolescents are increasingly suffering from articular cartilage and osteochondral deficiencies. Traumatic incidents often result in damage to the joint surfaces, while repetitive microtrauma may cause osteochondritis dissecans. When compared with their adult counterparts, children and adolescents have a greater capacity to regenerate articular cartilage defects. Even so, articular cartilage injuries in this age group may predispose them to premature osteoarthritis. Consequently, surgery is indicated in young patients when conservative measures fail. The operative techniques for articular cartilage injuries traditionally performed in adults may be performed in children, although an individualized approach must be tailored according to patient and defect characteristics. Clear guidelines for defect dimension–associated techniques have not been reported. Knee joint dimensions must be considered and correlated with respect to the cartilage defect size. Particular attention must be given to the subchondral bone, which is frequently affected in children and adolescents. Articular cartilage repair techniques appear to be safe in this cohort of patients, and no differences in complication rates have been reported when compared with adult patients. Particularly, autologous chondrocyte implantation has good biological potential, especially for large-diameter joint surface defects.
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Affiliation(s)
- Gian M Salzmann
- Lower Extremity Orthopaedics, Musculoskeletal Center, Schulthess Clinic, Zurich, Switzerland.,Gelenkzentrum Rhein-Main, Wiesbaden, Germany
| | | | | | - Martin J Stoddart
- Musculoskeletal Regeneration Program, AO Research Institute Davos, AO Foundation, Davos, Switzerland
| | - Peter Angele
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany.,Sporthopaedicum Regensburg, Regensburg, Germany
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33
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Yellin JL, Fabricant PD, Gornitzky A, Greenberg EM, Conrad S, Dyke JA, Ganley TJ. Rehabilitation Following Anterior Cruciate Ligament Tears in Children: A Systematic Review. JBJS Rev 2018; 4:01874474-201601000-00004. [PMID: 27490007 DOI: 10.2106/jbjs.rvw.o.00001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Anterior cruciate ligament (ACL) tears are increasingly prevalent in the pediatric population. ACL rehabilitation is an essential component of recovery following injury and reconstruction, yet there are few explicit descriptions of pediatric-specific ACL rehabilitation protocols in the literature, especially in the context of varying treatment interventions. Our aim was to systematically review the literature on rehabilitation following ACL tears in children in order to describe common principles among different treatment options and areas of future research. METHODS Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we performed a systematic review of the PubMed, EMBASE, and Cochrane databases (for the past five years) to identify detailed rehabilitation protocols described in the pediatric population following ACL rupture. When available, the following aspects of rehabilitation were extracted: "prehabilitation" (exercises prior to surgery), bracing, weight-bearing status, range of motion, strength, modalities (ice, heat, electrical stimulation, etc.), plyometrics/proprioceptive exercises, return-to-sport criteria, and suggested ACL injury-prevention programs. RESULTS Two hundred and two unique articles were identified. Twenty-seven articles meeting inclusion criteria with extractible rehabilitation data were included. A table, categorized by differing orthopaedic intervention, was designed to detail the components and duration of the different aspects of rehabilitation. While there are substantial differences across protocols, several trends emerged, particularly regarding weight-bearing, bracing, range of motion, and strength training. Interestingly, we found that many current protocols are based on time frame alone rather than on functional milestones; of the fourteen unique articles that addressed return-to-sport criteria by specific orthopaedic intervention, seven were based on temporal progression whereas seven also involved achievement of physical milestones. In addition, only three of the eight articles that mentioned a future ACL injury-prevention plan described a formal prevention program. CONCLUSION We systematically identified, and subsequently outlined and compared, the current trends of the various components of pediatric-specific ACL rehabilitation protocols, categorized by orthopaedic intervention. Several protocols are based on time frames rather than milestones achieved, with newer protocols involving milestone-based progression. Newer protocols are also incorporating formal prevention programs. Just as skeletally immature patients require unique methods of operative fixation, so too do they require catered rehabilitation protocols. To effectively prevent re-rupture or contralateral injury, future research should focus on prospectively evaluating each component of the rehabilitation protocols described and return-to-sport criteria for young patients.
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Affiliation(s)
- Joseph L Yellin
- The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Richard D. Wood Ambulatory Care Building, Second Floor, Philadelphia, PA 19104
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34
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Shaw L, Finch CF, Bekker S. Infographic: Trends in paediatric and adolescent ACL injuries. Br J Sports Med 2018; 53:228. [PMID: 29331995 DOI: 10.1136/bjsports-2017-098504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Louise Shaw
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - Caroline F Finch
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
| | - Sheree Bekker
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Victoria, Australia
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35
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Johansson FR, Skillgate E, Adolfsson A, Jenner G, De Bri E, Swärd L, Cools AM. Asymptomatic elite young tennis players show lateral and ventral growth plate alterations of proximal humerus on MRI. Knee Surg Sports Traumatol Arthrosc 2017; 25:3251-3259. [PMID: 26850513 DOI: 10.1007/s00167-016-4024-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/21/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The specific aim of the study was to investigate and compare epiphyseal length and extension in the proximal humerus, closure in the growth plate and bone marrow signal intensity related to the proximal humeral physis in the dominant arm and the non-dominant arm of the asymptomatic adolescent elite tennis player. METHODS The study sample included 35 asymptomatic elite young tennis players (15 males and 20 females, mean age 17.4 years ± 2.7). Each player contributed with two shoulders to the MRI measurement. The non-dominant arm was used as a control. RESULTS Relative reliability between the radiologists was excellent (ICC 0.78-0.96). Statistically significant differences between dominant arm and non-dominant arm in epiphyseal length (mm) laterally (DA 27.3 vs NDA 26.7) were shown. Statistically significant differences were also found in epiphyseal extension (mm) laterally (DA 36.1 vs NDA 35.1) and ventrally (DA 36.2 vs NDA 34.8). No statistically significant differences were found between dominant arm and non-dominant arm in epiphyseal extension (mm) medially (DA 31.7 vs NDA 31.7) and dorsally (DA 22.6 vs NDA 22.1). CONCLUSIONS Significant findings assessing MRI measurements of the epiphyseal plate in the asymptomatic adolescent elite tennis player might reflect a development of consecutive alterations in the epiphyseal plate in the dominant arm. LEVEL OF EVIDENCE Diagnostic study, Level IV.
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Affiliation(s)
- Fredrik R Johansson
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital Ghent, De Pintelaan, 185 9000, Ghent, Belgium. .,Musculoskeletal and Sports Injury Epidemiology Center (MUSIEC), Institute of Environmental Medicine, Box 210, 171 77, Stockholm, Sweden. .,Scandinavian College of Naprapathic Manual Medicine, Kräftriket 23A, 114 19, Stockholm, Sweden.
| | - Eva Skillgate
- Musculoskeletal and Sports Injury Epidemiology Center (MUSIEC), Institute of Environmental Medicine, Box 210, 171 77, Stockholm, Sweden.,Scandinavian College of Naprapathic Manual Medicine, Kräftriket 23A, 114 19, Stockholm, Sweden
| | - Anders Adolfsson
- Medicinsk Röntgen AB Hötorget, Apelbergsgatan 48, 111 37, Stockholm, Sweden
| | - Göran Jenner
- Medicinsk Röntgen AB Hötorget, Apelbergsgatan 48, 111 37, Stockholm, Sweden
| | - Edin De Bri
- Department of Orthopaedics, Cityakuten, Olof Palmes Gata 13A, 111 37, Stockholm, Sweden
| | - Leif Swärd
- OrthoCenter/IFK kliniken, Arvid Wallgrens backe 4A, 413 46, Göteborg, Sweden
| | - Ann M Cools
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University Hospital Ghent, De Pintelaan, 185 9000, Ghent, Belgium
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36
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Müller L, Hildebrandt C, Müller E, Fink C, Raschner C. Long-Term Athletic Development in Youth Alpine Ski Racing: The Effect of Physical Fitness, Ski Racing Technique, Anthropometrics and Biological Maturity Status on Injuries. Front Physiol 2017; 8:656. [PMID: 28912731 PMCID: PMC5583226 DOI: 10.3389/fphys.2017.00656] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/17/2017] [Indexed: 11/13/2022] Open
Abstract
Alpine ski racing is known to be a sport with a high risk of injuries. Because most studies have focused mainly on top-level athletes and on traumatic injuries, limited research exists about injury risk factors among youth ski racers. The aim of this study was to determine the intrinsic risk factors (anthropometrics, biological maturity, physical fitness, racing technique) for injury among youth alpine ski racers. Study participants were 81 youth ski racers attending a ski boarding school (50 males, 31 females; 9–14 years). A prospective longitudinal cohort design was used to monitor sports-related risk factors over two seasons and traumatic (TI) and overuse injuries (OI). At the beginning of the study, anthropometric characteristics (body height, body weight, sitting height, body mass index); biological maturity [status age at peak height velocity (APHV)]; physical performance parameters related to jump coordination, maximal leg and core strength, explosive and reactive strength, balance and endurance; and ski racing technique were assessed. Z score transformations normalized the age groups. Multivariate binary logistic regression (dependent variable: injury yes/no) and multivariate linear regression analyses (dependent variable: injury severity in total days of absence from training) were calculated. T-tests and multivariate analyses of variance were used to reveal differences between injured and non-injured athletes and between injury severity groups. The level of significance was set to p < 0.05. Relatively low rates of injuries were reported for both traumatic (0.63 TI/athlete) and overuse injuries (0.21 OI/athlete). Athletes with higher body weight, body height, and sitting height; lower APHV values; better core flexion strength; smaller core flexion:extension strength ratio; shorter drop jump contact time; and higher drop jump reactive strength index were at a lower injury risk or more vulnerable for fewer days of absence from training. However, significant differences between injured and non-injured athletes were only observed with respect to the drop jump reactive strength index. Regular documentation of anthropometric characteristics, biological maturity and physical fitness parameters is crucial to help to prevent injury in youth ski racing. The present findings suggest that neuromuscular training should be incorporated into the training regimen of youth ski racers to prevent injuries.
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Affiliation(s)
- Lisa Müller
- Department of Sport Science, University of InnsbruckInnsbruck, Austria
| | | | - Erich Müller
- Department of Sport Science and Kinesiology, University of SalzburgSalzburg, Austria
| | - Christian Fink
- Research Unit for Orthopedic Sports Medicine and Injury Prevention, Institute of Psychology (ISAG), The Health & Life Sciences University (UMIT)Hall, Austria.,Gelenkpunkt - Sports and Joint SurgeryInnsbruck, Austria
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37
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Shaw L, Finch CF. Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E599. [PMID: 28587262 PMCID: PMC5486285 DOI: 10.3390/ijerph14060599] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 05/29/2017] [Accepted: 05/31/2017] [Indexed: 02/01/2023]
Abstract
Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015. There was a total of 320 cases and the overall annual rate of ACL injuries increased by 147.8% from 2.74 per 100,000 population in 2005/2006 to 6.79 per 100,000 in 2014/2015. The majority (96.9%) of these injuries were in 10- to 14-year-olds. The main in-hospital procedure provided to over 80% of the hospitalized cases involved ACL reconstruction. Sporting activities accounted for 56.6% of ACL injuries. For females, over half (52.4%) of ACL injuries occurred whilst playing ball sports, compared to 35.4% of males. The large increase in ACL injuries in 5- to 14-year-olds in the state of Victoria, Australia over a 10-year period indicates they are a significant and emerging health burden. Population-wide ACL prevention policies are required to halt these trends. Cost effective prevention programs that involve neuromuscular training must be implemented in schools and junior sports teams.
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Affiliation(s)
- Louise Shaw
- Australian Collaboration for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat 3353, Victoria, Australia.
| | - Caroline F Finch
- Australian Collaboration for Research into Injury in Sport and its Prevention, Federation University Australia, Ballarat 3353, Victoria, Australia.
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Johnsen MB, Guddal MH, Småstuen MC, Moksnes H, Engebretsen L, Storheim K, Zwart JA. Sport Participation and the Risk of Anterior Cruciate Ligament Reconstruction in Adolescents: A Population-based Prospective Cohort Study (The Young-HUNT Study). Am J Sports Med 2016; 44:2917-2924. [PMID: 27159313 DOI: 10.1177/0363546516643807] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND An anterior cruciate ligament (ACL) injury is a severe injury that may require ACL reconstruction (ACLR) to enable the return to sport. Risk factors for ACLR have not firmly been established in the general adolescent population. PURPOSE To investigate the incidence and risk factors for ACLR in a population-based cohort of adolescents. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS We prospectively followed 7644 adolescents from the adolescent part of the Nord-Trøndelag Health Study, included from 2006 to 2008. The main risk factors of interest were the level of sport participation (level I, II, or III) and sport competitions. The endpoint was primary ACLR recorded in the Norwegian National Knee Ligament Registry between January 2006 and December 2013. RESULTS A total of 3808 boys and 3836 girls were included in the analyses. We identified 69 (0.9%) ACLRs with a median of 7.3 years of follow-up, providing an overall ACLR incidence of 38.9 (95% CI, 30.7-49.3) per 100,000 person-years. The hazard ratio (HR) for ACLR associated with level I sport participation was 3.93 (95% CI, 0.92-16.80) for boys and 3.31 (95% CI, 1.30-8.43) for girls. There was a stronger association related to participating in sport competitions. Girls had over 5 times a higher risk (HR, 5.42; 95% CI, 2.51-11.70) and boys over 4 times the risk (HR, 4.22; 95% CI, 1.58-11.30) of ACLR compared with those who did not compete. CONCLUSION Participating in level I sports and sport competitions significantly increased the risk of undergoing primary ACLR. Preventive strategies should be implemented to reduce the incidence and future burden of ACLR.
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Affiliation(s)
- Marianne Bakke Johnsen
- Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway .,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Maren Hjelle Guddal
- Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway.,Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Håvard Moksnes
- Oslo Sport Trauma Research Center, Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Lars Engebretsen
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Oslo Sport Trauma Research Center, Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Kjersti Storheim
- Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - John-Anker Zwart
- Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Gornitzky AL, Lott A, Yellin JL, Fabricant PD, Lawrence JT, Ganley TJ. Sport-Specific Yearly Risk and Incidence of Anterior Cruciate Ligament Tears in High School Athletes: A Systematic Review and Meta-analysis. Am J Sports Med 2016; 44:2716-2723. [PMID: 26657853 DOI: 10.1177/0363546515617742] [Citation(s) in RCA: 183] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Anterior cruciate ligament (ACL) injury rates are affected by frequency and level of competition, sex, and sport. To date, no study has sought to quantify sport-specific yearly risk for ACL tears in the high school (HS) athlete by sex and sport played. PURPOSE To establish evidence-based incidence and yearly risk of ACL tears in HS athletes by sex for sports performed at the varsity level across the majority of US high schools. STUDY DESIGN Meta-analysis. METHODS PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched to identify all articles reporting ACL tears per athletic exposure in HS athletes. ACL injury incidence rates (IRs) by sex and sport were calculated via meta-analysis. State athletic association guidelines were used to determine the number of exposures per season to calculate yearly risk of ACL tears. RESULTS The search recovered 3779 unique articles, of which 10 met our inclusion criteria, for a total of 700 ACL injuries in 11,239,029 exposures. The IR was 0.062 injuries per 1000 exposures (95% CI, 0.058-0.067). Although more injuries were recorded in males than females, females had a higher rate of injury per exposure (relative risk, 1.57; 95% CI, 1.35-1.82). Relative risk was highest in basketball (3.80; 95% CI, 2.53-5.85) and soccer (3.67; 95% CI, 2.61-5.27). While boys' football had the highest number of ACL injuries at 273, girls' soccer had the highest IR (0.148; 95% CI, 0.128-0.172). In girls, the highest injury risks per season were observed in soccer (1.11%; 95% CI, 0.96%-1.29%), basketball (0.88%; 95% CI, 0.71%-1.06%), and lacrosse (0.53%; 95% CI, 0.19%-1.15%). In comparison, the highest risks for boys were observed in football (0.80%; 95% CI, 0.71%-0.91%), lacrosse (0.44%; 95% CI, 0.18%-0.90%), and soccer (0.30%; 95% CI, 0.22%-0.41%). CONCLUSION There is an approximately 1.6-fold greater rate of ACL tears per athletic exposure in HS female athletes than males. However, there is significant risk in both sexes, particularly in high-risk sports such as soccer, football, basketball, and lacrosse. Knowledge of sport-specific risk is essential for future injury reduction programs, parent-athlete decision making, and accurate physician counseling.
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Affiliation(s)
- Alex L Gornitzky
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Ariana Lott
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Joseph L Yellin
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Peter D Fabricant
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - J Todd Lawrence
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Theodore J Ganley
- Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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40
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Screening for musculoskeletal problems in Japanese schoolchildren: a cross-sectional study nested in a cohort. Public Health 2016; 139:189-197. [PMID: 27596483 DOI: 10.1016/j.puhe.2016.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 07/20/2016] [Accepted: 08/08/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To clarify the frequency of musculoskeletal problems in public elementary and junior high school children and to determine the advantages and problems of musculoskeletal examinations. STUDY DESIGN School-based cross-sectional study nested in a cohort. METHODS We examined 41,376 public elementary and junior high school children (aged 6-15 years) in Miyazaki, Japan, from 2008 to 2014. Participation was voluntary. Participants received an in-school primary musculoskeletal examination (clinical examination with check items and a questionnaire) and a secondary examination at an orthopaedic outpatient clinic as indicated. Estimated prevalence rates for musculoskeletal problems were calculated from the results of both examinations. RESULTS The total estimated prevalence of musculoskeletal problems was 8.6%. Prevalence by school grade ranged from 3.2% to 13.7%. Estimated prevalence rates increased as grade increased and were higher in junior high school students than in elementary school students. The secondary examination identified musculoskeletal problems on the back (65.4%), knee (8.1%), ankle or feet (7.3%) and elbow (5.4%). Of those referred for a secondary examination, 44.4% had not reported musculoskeletal complaints on the initial questionnaire. Overall, 69.8% of problems diagnosed in the secondary examination were previously undiagnosed. CONCLUSIONS School-based musculoskeletal examination enables early detection of abnormal growth and disorders of the locomotive organs and is expected to support children's musculoskeletal growth and development. We recommend musculoskeletal examinations as part of school check-ups in Japan. Our findings suggest musculoskeletal examinations should be conducted for students in higher elementary school grades and for all junior high school students. Evaluation should include both direct clinical examination and questionnaires.
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Fort-Vanmeerhaeghe A, Romero-Rodriguez D, Montalvo AM, Kiefer AW, Lloyd RS, Myer GD. Integrative Neuromuscular Training and Injury Prevention in Youth Athletes. Part I. Strength Cond J 2016. [DOI: 10.1519/ssc.0000000000000229] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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