Lower limb injury prevention programs in youth soccer: a survey of coach knowledge, usage, and barriers

Health And Performance Promotion in Youth (HAPPY) hybrid effectiveness-implementation cluster randomised trial: comparison of two strategies to implement an injury prevention exercise programme in Danish youth handball

OBJECTIVE

To investigate if a combination of an online and onsite implementation strategy was superior to an online-only strategy in enhancing the use of an injury prevention exercise programme (IPEP) and in reducing the risk of shoulder, knee and ankle injuries in youth community handball players (age 11-17) over a handball season.

METHODS

In this 30-week hybrid effectiveness-implementation cluster randomised type 3 study, 20 youth handball clubs were randomly assigned 1:1 to either a combined online and onsite implementation strategy (coach workshop using the health action process approach behaviour change model and health service provider (HSP) support) or an online-only strategy (control group). The primary implementation outcome was coach-reported adherence, measured as the average IPEP exercise usage by the team over 30 weeks. The primary effectiveness outcome was player-reported handball playing time to any new handball-related shoulder, knee and ankle injuries, reported weekly using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems.

RESULTS

We enrolled 63 coaches (27% women) and 945 players (mean age 14.5 years, 55% girls). Intention-to-treat analyses showed no statistically significant difference between implementation strategies in adherence (between-group difference 1.4, 95% CI -0.5 to 3.4) or in cumulative injury risk (between-group difference 5.5% points, 95% CI -2.2 to 13.1).

CONCLUSION

Our findings demonstrate that in youth community handball, a combined online and onsite implementation strategy, including a coach workshop and HSP support, was not superior to an online-only strategy regarding adherence to an IPEP or in reducing shoulder, knee and ankle injury risk.

TRIAL REGISTRATION NUMBER

NCT05294237.

ACL Injury Prevention Education Improves Implementation of Neuromuscular Training Among High School Sports Coaches: A Cross-Sectional Survey Study

BACKGROUND

Neuromuscular training (NMT) programs delivered by trained personnel have demonstrated protective effects against anterior cruciate ligament (ACL) injury among high school sports participants, but few studies have investigated the impact of education on high school sports coaches' knowledge and incorporation of NMT programs into daily practice sessions.

PURPOSE

We sought to evaluate changes in knowledge and behavior among high school sports coaches who completed an NMT-based injury prevention training program.

METHODS

High school sports coaches were invited to complete a free online training course in incorporating NMT into daily practice sessions. Anonymized surveys were administered before and after education and at 3 months to evaluate knowledge level and program effectiveness.

RESULTS

Of the 13,640 coaches who enrolled in the training course in 2019, 1641 submitted pre- and post-education and 3-month follow-up surveys. Prior to training, 4.4% reported incorporating NMT into daily training sessions and the mean knowledge score was 1.89 ± 1.55. After training, 92.7% of participants reported that they intended to incorporate NMT into their daily training sessions and the mean knowledge score was 4.87 ± 1.11. At 3-month follow-up, 88.9% of participants reported incorporating NMT into daily training sessions. A chi-square test revealed a significant association between pre- and post-education incorporation of NMT into daily practice sessions, and a multiple regression analysis resulted in a significant model with intent to incorporate NMT into daily practice sessions identified as a significant behavior predictor.

CONCLUSION

These survey results show that completion of a training course significantly improved ACL injury prevention knowledge among a cohort of high school sports coaches and likely contributed to the sustained incorporation of NMT into their daily practice sessions.

Heading in Football: insights from stakeholders in amateur football

Despite emerging research questioning the long-term effect of purposeful heading on players' brain health, heading-related perspectives and behaviours of stakeholders in amateur football in Australia (a country without heading guidelines) remain unknown. This study aimed to explore the current heading-related perspectives and behaviours of football stakeholders. In total, 290 players (aged over 11 years), 54 coaches, 34 non-coaching staff and 14 medical staff completed the survey. Of the 290 players, 56.5% reported being formally trained in heading, with female players less likely to be trained than male players (p < 0.05). Players were the least concerned about the long-term effects of heading, while medical staff were the most concerned (33.1% and 57.1%, respectively). From proposed strategies to reduce heading burden, a heading ban for all ages was least popular (2.3%), while teaching heading technique was most popular (67.3%). Our study provides insights into football stakeholders' heading-related perspectives, which could be used, along with scientific evidence, to inform pragmatic future heading guidelines.

Independent data collectors decrease bias in the measurement of adherence to anterior cruciate ligament injury prevention programs

OBJECTIVES

Studies on adherence to neuromuscular training (NMT) for anterior cruciate ligament (ACL) injury prevention are frequently biased due to the use of self-reporting by coaches or the athletes themselves. Few NMT studies use data collectors (aside from the athletes or the individuals administering the NMT program) to decrease bias when assessing the adherence of coaches and sports teams. We hypothesized that the use of a data collector who is independent of the team to evaluate adherence to NMT programs would be reliable.

METHODS

In a prior a cluster-randomized controlled trial evaluating adherence to NMT training trial, twelve boys' and nine girls' high school athletic teams in a variety of sports were enrolled. Eight data collectors (unaffiliated with the NMT program) were hired specifically to record adherence of the athletes to the NMT exercises at each team's warm-ups 2-3 times a week, prior to practices and games. In addition to the data collectors, a control group of independent observers made visits throughout the season to also record adherence (solely for the purpose of this study, alongside the data collectors and in the same fashion) in order to evaluate the data collectors' performance and determine inter-observer reliability. The inter-observer reliability between data collectors and independent observers was measured using the Kappa statistic.

RESULTS

A total of 399 warm-ups for practices or games were observed by data collectors to obtain adherence data. Independent observers also measured adherence at 58 practices or games for inter-observer reliability. Exercise instruction and alignment cues for 29 different exercises were analysed. The Kappa values ranged from 0.63 to 1.0, indicating substantial to perfect agreement. The overall Kappa values of 0.89 and 0.90 for exercise instruction and alignment cues, respectively, indicated almost perfect agreement.

CONCLUSION

The use of a data collector who is independent of the team to evaluate adherence to NMT programs (rather than athlete or coach self-reporting), was shown to be a reliable method for measurement of adherence in studies of NMT for injury prevention. Avoiding self-reporting in adherence research to NMT training may decrease bias.

LEVEL OF EVIDENCE

I.

Best practices for the dissemination and implementation of neuromuscular training injury prevention warm-ups in youth team sport: a systematic review

OBJECTIVE

To evaluate best practices for neuromuscular training (NMT) injury prevention warm-up programme dissemination and implementation (D&I) in youth team sports, including characteristics, contextual predictors and D&I strategy effectiveness.

DESIGN

Systematic review.

DATA SOURCES

Seven databases were searched.

ELIGIBILITY

The literature search followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

INCLUSION CRITERIA

participation in a team sport, ≥70% youth participants (<19 years), D&I outcomes with/without NMT-related D&I strategies. The risk of bias was assessed using the Downs & Black checklist.

RESULTS

Of 8334 identified papers, 68 were included. Sport participants included boys, girls and coaches. Top sports were soccer, basketball and rugby. Study designs included randomised controlled trials (RCTs) (29.4%), cross-sectional (23.5%) and quasi-experimental studies (13.2%). The median Downs & Black score was 14/33. Injury prevention effectiveness (vs efficacy) was rarely (8.3%) prioritised across the RCTs evaluating NMT programmes. Two RCTs (2.9%) used Type 2/3 hybrid approaches to investigate D&I strategies. 19 studies (31.6%) used D&I frameworks/models. Top barriers were time restrictions, lack of buy-in/support and limited benefit awareness. Top facilitators were comprehensive workshops and resource accessibility. Common D&I strategies included Workshops with supplementary Resources (WR; n=24) and Workshops with Resources plus in-season Personnel support (WRP; n=14). WR (70%) and WRP (64%) were similar in potential D&I effect. WR and WRP had similar injury reduction (36-72%) with higher adherence showing greater effectiveness.

CONCLUSIONS

Workshops including supplementary resources supported the success of NMT programme implementation, however, few studies examined effectiveness. High-quality D&I studies are needed to optimise the translation of NMT programmes into routine practice in youth sport.

Anterior Cruciate Ligament Injury Prevention Programs in Welsh Netball: A Survey of Knowledge, Implementation and Barriers Amongst Players and Coaches

Background Anterior cruciate ligament (ACL) injury prevention programs can reduce injury risk in various sports. The perception of ACL injury prevention programs amongst professional netball players and coaches has not been studied. Purpose The aim of this study was to determine (1) the level of awareness and experience of ACL injury prevention programs, (2) the use of ACL injury prevention programs, and (3) barriers and potential facilitators to implementing a sustainable ACL injury prevention program in netball. Materials and methods Female netball players representing Welsh senior and under-21 teams and elite and amateur coaches were invited electronically to participate in this web-based cross-sectional observational study between 1st May and 31st July 2021. Information on ACL injury susceptibility and seriousness, knowledge, experience, and implementation of ACL injury prevention programs were ascertained. Results Twenty-eight players (78%) and 29 coaches (13%) completed the questionnaire. Seventeen (61%) players and 15 (52%) coaches reported that female athletes were at greater risk of sustaining ACL injuries. Over 90% of respondents identified netball as high-risk, whilst 89% (n=25) of players and 76% (n=22) of coaches reported these injuries to be preventable. Only two (7%) players and six (21%) coaches utilised an ACL injury prevention program with a lack of time and engagement from coaches and players identified. The majority of respondents indicated that their club has neither promoted, advocated the use nor demonstrated exercises for ACL injury prevention. Over 90% of respondents would utilise an ACL injury prevention program if it minimised players' risk with appropriate information and demonstration of exercises. Conclusion This study highlights limited knowledge of female athletes' increased susceptibility to ACL injuries amongst players and coaches with a lack of communication and education on ACL injury prevention programs between sporting associations, coaches, and players. However, the results demonstrate willingness amongst both players and coaches to implement an ACL injury prevention program in netball.

Motivation and goal-pursuit for injury prevention training in amateur football coaches: a cross-sectional study using the Health Action Process Approach

BACKGROUND

Adoption of injury prevention exercise programmes (IPEPs) in team sports is contingent on behaviour change among coaches. The aim was to study motivation and goal-pursuit in IPEP use among coaches of amateur football players.

METHODS

A cross-sectional study using web-based questionnaires was administered to coaches in one Swedish regional football district. The study was carried out one season after dissemination of the IPEP Knee Control+. The questionnaire was based on the Health Action Process Approach and covered perceptions and beliefs about using Knee Control+. Questions were rated on 1-7 Likert scales.

RESULTS

440 coaches participated (response rate 32%). Coaches were neutral about injury risks (median 4-5) and knowledge about preventing injuries (median 5) but had positive outcome expectancies of preventive training (median 6). Coaches who had used an IPEP perceived they had more knowledge about preventing injuries than non-users (median 5 vs 4, small effect size d=0.43). Coaches who used Knee Control+ were positive about their practical ability to use it (median 6) and had high intention to prioritise continuous use (median 7). Highly adherent coaches to higher extent believed that specific training may prevent injuries and had plans for how to instruct the players and how to work around barriers compared with low adherent coaches.

CONCLUSION

Coaches need more knowledge and support on IPEP usage and how to structure training. Coaches who had adopted Knee Control+ had high belief in their abilities but may need constructive plans on how to use the programme and to overcome barriers.

Gaelic games players' awareness and use of, and attitudes towards injury prevention exercise programmes

OBJECTIVE

The aim was to determine the awareness of and use of injury prevention exercise programmes (IPEPs) among adult Gaelic games players and to investigate Gaelic games players' attitudes to injury prevention and barriers and facilitators to successful IPEPs use.

METHODS

A recruitment email was sent to all clubs and county boards throughout Ireland (whose email was available online) and the survey was advertised on social media platforms. Adult players completed an anonymous survey, including awareness, use, and attitudes towards injury prevention and injuries. Frequencies and descriptive statistics were conducted, a chi-squared test was used to assess any differences in awareness and use of IPEPs, a Mann-Whitney U test was used to examine differences between groups for attitudes to injury prevention (men vs women; elite vs non-elite).

RESULTS

A third of players (32.4%) stated awareness of IPEPs. However, only 13.4% correctly identified one. A significantly greater number of men (35.7%) used IPEPs compared to women (26.5%) (p = 0.04). The Activate (65.5%) and GAA15 (32.5%) were most used. Players had a positive attitude towards injury prevention but agreed that injuries were an issue (68.2%) and stated that their coach didn't have enough knowledge how to use IPEPs was a large barrier (41.6%).

CONCLUSION

Despite this positive attitude to injury prevention and believing injuries are an issue, adoption remains low. Organisations/clubs should educate players on the benefits of using IPEPs and support structures put in place to gain greater implementation, which is critical to mitigating the risk of injury.

Implementation of the injury prevention exercise programme Knee Control+: a cross-sectional study after dissemination efforts within a football district

BACKGROUND

The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework can be used for evaluation of implementation initiatives in sports injury prevention. The aim was to evaluate the implementation of the injury prevention exercise programme Knee Control+ among amateur clubs and coaches in one regional football district using all five dimensions of the RE-AIM framework.

METHODS

Dissemination of Knee Control+ during the 2021 season with information and webinars within one regional football district. This was followed by a cross-sectional study with questionnaires to club personnel and coaches after the season.

RESULTS

The reach of Knee Control+ was fair to high, 83% of club personnel and 66% of coaches knew about the programme. 41% of club personnel and 51% of coaches had adopted it. Perceived programme effectiveness was high (6 on a 1-7 Likert scale) among coaches. Regarding implementation and maintenance, 27% of club personnel had informed coaches about Knee Control+ and 57% planned to inform coaches. The coaches had implemented the programme mainly as recommended, but half used the programme once per week or less. Intention to maintain use of the programme was high (7 on a 1-7 Likert scale) among coaches.

CONCLUSION

The reach of Knee Control+ was fair to high, and adoption was fair in clubs, but there was a lack of policies for preventive training. Active strategies probably need to accompany dissemination of programme material. Reach, perceived effectiveness, adoption, implementation and planned maintenance were positive among coaches, but further studies are needed to analyse long-term maintenance.

Comparison of dynamic and static balance among professional male soccer players by position

PURPOSE

Balance is an important performance aspect of all athletes. The aim of this study was to compare static and dynamic balance in soccer players in different positions.

METHODS

Forty youth and young adult professional soccer players were divided into four groups according to their playing positions: goalkeepers (GK), defenders (DF), midfielders (MF) and forwards (FW) (10 per position). Static and dynamic balance assessed on the dominant and non-dominant legs were measured using a force platform for 30s (static one-leg stand), and "Y Balance Test" (dynamic balance).

RESULTS

GK exhibited greater ML static balance (less ML sway) compared with other players (p < 0.02-0.001). Moreover, results demonstrated better GK dynamic balance compared to DF and FW (p < 0.04-0.006). MF showed better dynamic balance than DF and FW (p < 0.019-0.007) and lower dynamic balance scores were found among DF and FW (p < 0.05).

CONCLUSION

In conclusion, these results affirm position-specific balance performance with greater static and dynamic balance of GK and dynamic balance with MF. It is suggested that evaluation of balance and postural control performance should be considered a relevant part of the position-specific functional evaluation of soccer players.

Coaches' experiences of injury prevention in youth elite athletes: An interview study of 10 coaches

INTRODUCTION

Injury prevention is important to reduce the high injury risk in youth elite athletes studying at sports high schools. Coaches are considered important in youth elite sports and injury prevention.

OBJECTIVES

The aim was to investigate perceptions and experiences of injury prevention among coaches at sports high schools.

METHODS

A manifest qualitative content analysis with an inductive approach was used based on ten semi-structured interviews with coaches who work at sports high schools.

RESULTS

An overarching theme "Coaches of youth athletes value injury prevention but have limited knowledge and support" was identified and five main categories were formed. Coaches perceived themselves to play an important role in injury prevention, yet they described limited time for knowledge acquisition and highlighted the close collaboration with other professions as a key in injury prevention.

CONCLUSION

A coach's knowledge and support are critical factors in injury prevention of youth elite athletes. Evidence-based as well as non-evidence-based approaches are used, and the biopsychosocial perspective was not always taken into consideration. A need for more interprofessional collaboration and knowledge acquisition regarding injury prevention is warranted.

Impact of COVID-19 Era on the Anterior Cruciate Ligament Injury Rehabilitation: A Scoping Review

The surgical intervention rate and the subsequent rehabilitation plan for anterior cruciate ligament (ACL) injury was crucially affected by the COVID-19 pandemic due to the necessity in the face of the emergency. This review aimed to evaluate potential persistent and residual symptoms after COVID-19 disease, including fatigue and neuromuscular disorders. A scoping review design and methodology were used due to the exploratory nature of the research question, according to literature searches on PubMed/Medline, Scopus, Web of Science (WoS), and Physiotherapy Evidence Database (PEDro) electronic databases using the following keywords: "Anterior Cruciate Ligament", "ACL", "SARS-CoV-2", and "COVID-19". Undertraining and muscular knee imbalance might cause inefficient movement strategies, lack of knee stability, and increasing load with negative implications in ACL injuries. In the post-surgery period, during COVID-19, telerehabilitation approaches appeared to be successfully applied to maintain strength and range of motion in this condition. However, no definitive data are available regarding the most effective interventions. This scoping review showed the influence of the COVID-19 pandemic and associated restrictions on postoperative and rehabilitative care of ACL injuries.

Current Practices, Willingness and Perceived Ability to Implement an Injury Prevention Exercise Program Among Post-Primary Physical Education Teachers

BACKGROUND

Musculoskeletal injuries are common in adolescents, and recently schools have been suggested as an opportune location for injury prevention strategies. This study aimed to identify the current practices and perceptions of post-primary PE teachers in Ireland on injury prevention exercise programs (IPEP), which are key to informing potential implementation strategies.

METHODS

Post-primary PE teachers (n = 287) completed an online anonymous survey. Outcome measures included current IPEP practices in PE class, teachers' attitudes toward IPEPs, willingness to implement, and perceived ability to implement an IPEP in PE class. Descriptive statistics were calculated, and Mann-Whitney U tests were used to compare differences between groups.

RESULTS

Results indicated that only 1 in 5 PE teachers currently used an IPEP in class. Of these, no teacher used an existing IPEP exactly as intended, while most teachers were willing to implement an IPEP (80.5%). Those who previously received formal IPEP education or were aware of an existing IPEP had significantly higher perceived ability to implement an IPEP in class (p < .001).

CONCLUSIONS

This study demonstrates that despite a willingness among PE teachers to implement IPEPs in class, few currently do. Thus, post-primary PE class may be an under-utilized setting for adolescent injury prevention and warrants further investigation.

Awareness and Knowledge of Medical Issues Related to Female Athletes Among Track and Field Coaches

Introduction

Little is known regarding medical knowledge pertaining to female athletes among track and field coaches and their interactions with female athletes regarding medical problems.

Methods

Participants were track and field coaches (369 males and 43 females) with Japan Sport Association certification and they completed an anonymous survey on their knowledge of medical problems pertinent to female athletes including whether the coaches knew about the female athlete triad and relative energy deficiency in sports; their feelings about female athletes' use of contraceptive pills; whether they speak about menses with the female athletes; and whether they have a gynecologist for consultation regarding their medical problems.

Results

Females coaches were significantly more likely to be aware of the triad (odds ratio (OR), 3.44; p = 0.003); to have access to a physician able to address the gynecological problems of female athletes (OR, 9.22; p < 0.001); and to talk to their female athletes about menses (OR, 2.30; p = 0.015) than their male counterparts. Coaches with more experience tended to be aware of the triad and relative energy deficiency in sports compared with those with ≤5 years of experience.

Conclusion

Females coaches are aware of the triad, talk about menses with their female athletes, and have access to a physician who can address gynecological problems with compared to male counterparts. Educating all coaches on these problems is essential to provide adequate support to female athletes.

Barriers and facilitators to the adoption and implementation of evidence-based injury prevention training programmes: a narrative review

While there is a multitude of evidence supporting the efficacy of injury prevention training programmes, the literature investigating the implementation of these programmes is, in contrast, rather limited. This narrative review sought to describe the commonly reported barriers and facilitators of the implementation of injury prevention training programmes among athletes in organised sport. We also aimed to identify necessary steps to promote the uptake and sustainable use of these programmes in non-elite athletic communities. We identified 24 publications that discussed implementing evidence-based injury prevention training programmes. Frequently reported barriers to implementation include the perceived time and financial cost of the programme, coaches lacking confidence in their ability to implement it, and the programme including exercises that were difficult or confusing to follow. Frequently reported facilitators to implementation include the coach being aware of programme efficacy, shared motivation to complete the programme from both coaches and athletes, and the ability to easily integrate the programme into practice schedules. The current literature is focused on high-income, high-resource settings. We recommend that future studies focus on understanding the best practices of programme dissemination in culturally and economically diverse regions. Programmes ought to be of no financial burden to the user, be simply adaptable to different sports and individual athletes and be available for use in easily accessible forms, such as in a mobile smartphone application.

Understanding Youth Sport Coaches' Perceptions of Evidence-Based Injury-Prevention Training Programs: A Systematic Literature Review

OBJECTIVE

To systematically review and summarize the knowledge, attitudes, beliefs, and contextual perceptions of youth sport coaches toward injury-prevention training programs by using the Theoretical Domains Framework to guide the organization of results.

DATA SOURCES

Systematic searches of PubMed and Google Scholar were undertaken in November 2021.

STUDY SELECTION

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was followed. Results were limited to full-text articles that were published in peer-reviewed journals and printed in English. Additional studies were added after a citation search of included studies. Studies were eligible for inclusion if researchers evaluated youth sport coaches' knowledge, beliefs, contextual perceptions, or all 3 of anterior cruciate ligament injury-prevention training programs.

DATA EXTRACTION

Data charting was performed by 1 author and confirmed by a separate author.

DATA SYNTHESIS

Of the 1194 articles identified, 19 were included in the final sample. Among articles in which researchers assessed knowledge (n = 19), coaches' awareness of the existence and components of injury-prevention training programs was inconsistent. Among articles in which researchers assessed beliefs (n = 19), many coaches had positive attitudes toward injury-prevention training programs, but few believed youth athletes are at a high risk of injury. Among articles in which researchers assessed contextual perceptions (n = 13), many coaches did not feel they had access to information about injury-prevention training programs and cited a lack of time, space, support, and other resources as barriers to implementation.

CONCLUSIONS

Our findings support the need for programs, protocols, and policies to enhance knowledge of and support for youth sport coaches who wish to implement injury-prevention training programs. A gap exists in the research about addressing the needs of youth sport coaches in the United States high school sports setting. The use of multilevel implementation science frameworks (such as the Theoretical Domains Framework) will be beneficial for identifying constructs that affect implementation and developing train-the-trainer programming to meet the needs of individual youth sport coaches.

Anterior cruciate ligament injury prevention

Anterior cruciate ligament injuries are a prominent issue in the field of sports medicine, especially for the female athlete. Extensive research has been performed that acknowledges the disparity in anterior cruciate ligament injury rates between male and female athletes and the high prevalence of risk factors specific to females. The underlying causes of anterior cruciate ligament injuries are widespread and are important to consider when approaching injury prevention. For example, prevention techniques aim to correct neuromuscular imbalances and improve biomechanical deficits, which are some of the most significant risk factors leading to these injuries. While there is a lack of opportunity for intervention related to anatomical and hormonal risks, awareness of their influence on injury mechanisms remains an important factor in clinical decision-making. In pursuit of addressing the risks of this injury, several prevention programs have been established that have been shown to successfully reduce anterior cruciate ligament injury rates when properly executed. The most effective programs include early intervention with continuous training and are multicomponent programs including various targeted exercises to modify associated risk factors. Unfortunately, despite the development of these readily available programs, anterior cruciate ligament injury rates remain high due to insufficient implementation of these methods. Recognizing the efficacy and feasibility of utilizing prevention strategies and continuing to develop effective techniques remain of utmost importance to reduce the incidence of this substantial injury among athletes.

The Intra- and Inter-rater Reliability of an Arm Care Screening Tool in High School Baseball Coaches

BACKGROUND

Preseason movement screening can identify modifiable risk factors, deterioration of function, and potential for injury in baseball players. Limited resources and time intensive testing procedures prevent high school coaches from accurately performing frequent movement screens on their players.

PURPOSE

To establish the intra-rater and inter-rater reliability of a novel arm care screening tool based on the concepts of the Functional Movement Screen (FMS™) and Selective Functional Movement Assessment (SFMA™) in high school coaches.

STUDY DESIGN

Methodological intra- and inter-rater reliability study.

METHODS

Thirty-one male high school baseball players (15.9 years ± 1.06) were independently scored on the Arm Care Screen (ACS) by three examiners (two coaches, one physical therapist) in real-time and again seven days later by reviewing video recordings of each players' initial screening performance. Results from each examiner were compared within and between raters using Cohen's kappa and percent absolute agreement.

RESULTS

Substantial to excellent intra-rater and inter-rater reliability were established among all raters for each component of the ACS. The mean Cohen's kappa coefficient for intra-rater reliability was 0.76 (95% confidence interval, 0.54-0.95) and percent absolute agreement ranged from 0.82-0.94 among all raters. Inter-rater reliability demonstrated a mean Cohen's kappa value of 0.89 (95% confidence interval, 0.77-0.99) while percent absolute agreement between raters ranged from 0.81-1.00. Intra- and inter-rater reliability did not differ between raters with various movement screening experience (p>0.05).

CONCLUSIONS

High school baseball coaches with limited experience screening movement can reliably score all three components of the ACS in less than three minutes with minimal training.

LEVEL OF EVIDENCE

Level 3, Reliability study.

Lateral Ankle Sprain and Subsequent Ankle Sprain Risk: A Systematic Review

OBJECTIVE

To evaluate the evidence regarding the association between lateral ankle sprain (LAS) history and the subsequent LAS risk, as well as sex differences in the observed associations.

DATA SOURCES

PubMed, CINAHL, and SPORTDiscus were searched through July 2020 for articles on LAS history and incidence during the study period.

STUDY SELECTION

Studies were included if they were prospective in nature and the authors reported the number of participants with and those without a history of LAS at study initiation as well as the number of participants in each group who sustained an LAS during the investigation.

DATA EXTRACTION

Data were study design parameters as well as the number of participants with and those without an LAS history and the number of subsequent LASs that occurred in both groups. Risk ratios (RRs) with 95% CIs compared the risk of LAS during the study period between those with and those without an LAS history for each investigation.

DATA SYNTHESIS

A total of 19 studies involving 6567 patients were included. The follow-up periods ranged from 14 weeks to 2 years. Assessment scores indicated the studies were of moderate to high quality. A significantly higher risk of LAS during the study period was observed among those with a history of LAS in 10 of 15 studies (RR range = 1.29-6.06). Similar associations were seen in 4 of 6 studies of all-male samples (RR range = 1.38-8.65) and 1 of 4 studies with an all-female sample (RR = 4.28).

CONCLUSIONS

Strong evidence indicates that a previous LAS increased the risk of a subsequent LAS injury. Men with a history of LAS appeared to be at a higher risk of sustaining a subsequent LAS, but women were not. However, further data are needed to draw definitive conclusions from the limited number of sex-specific studies.

Results of a tri-national online survey on the current status of sports injury prevention among members of the German-Speaking Orthopaedic Sports Medicine Society (GOTS)

OBJECTIVES

 To assess the current opinions and state of knowledge in primary sports injury prevention among members of the German-Speaking Society for Orthopaedic and Traumatologic Sports Medicine (GOTS).

METHODS

 On 21 August 2019, a web-based questionnaire was sent to the members of the tri-national society GOTS (Austria, Germany and Switzerland). The survey was online until 21 November 2019 and included twenty-two questions, which were divided into five sections: 1) general importance of prevention (n = 4), 2) specifications of the study population (n = 3), 3) implementation of prevention (n = 8), 4) improvement opportunities in prevention (n = 4) and 5) future research areas (n = 3).

RESULTS

 A total of 272 participants completed the survey, representing a total survey participation of 17.7 % of all members. The study population consisted of orthopaedic surgeons (55 % with surgical and 21 % with non-operative orientation), medical students (10 %), physical therapists (8 %) and sports scientists (4 %). Ninety-four percent of all participants stated that they considered the importance of sports injury prevention to be "very high" (68 %) or "high" (26 %). However, almost 70 % of all participants stated that they spend less than one hour per week on injury prevention work. The term "prevention" was clearly defined and practicable for only 40 %, understandable but difficult to implement for 51 %, and unclear and difficult to implement for 9 % of the participants. Seventy-two percent of respondents were aware of existing prevention programs such as "Stop-X" or "FIFA 11 +", whereas 28 % of participants were uninformed regarding these programs.

CONCLUSIONS

 A strong divergence was identified between participants' perception of the importance of sports injury prevention and the existing implementation of preventive measures. Future funding of prevention programs, expansion of research strategies for injury prevention and better financial reimbursement are of utmost importance.

Perceived barriers to implementation of injury prevention programs among collegiate women's soccer coaches

OBJECTIVES

Knee injury prevention programs (IPPs) reduce knee and anterior cruciate ligament (ACL) injury rates in female athletes, however, implementation of IPPs is low. The purpose of this study was to identify barriers to implementation of IPPs among collegiate women's soccer coaches.

DESIGN

Cross-sectional survey.

METHODS

A custom survey based on the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework and existing literature was sent to 151 out of 153 women's National Collegiate Athletic Association (NCAA) soccer coaches in the NCAA's Eastern Region.

RESULTS

Ten respondents reported that they did not use an IPP (Non-users), and nineteen respondents reported that they did use an IPP (Users). "Cost" was the most highly ranked barrier (median rank: 2) to implementing an IPP among Non-users. For the statement, "Who should be responsible for completing an IPP," Users said "Coaches" (47%) and "Other" (21%), while Non-users said "Strength and conditioning" (50%) and "Athletic trainers" (30%). Respondents who marked "Other", elaborated that it was the responsibility of coaches, athletes, and additional staff members.

CONCLUSIONS

Cost was the primary barrier to implementation of an IPP. Since the majority of Non-users indicated that implementation of an IPP was the responsibility of a non-coaching staff member, cost may be a surrogate for the expense of hiring an additional staff member rather than the cost of performing the IPP itself. Additionally, using a team-based approach that encompasses athletes, coaches, and non-coaching staff members may support long-term implementation of IPPs.