1
|
Jo J, Boltz AJ, Williams KL, Pasquina PF, McAllister TW, McCrea MA, Broglio SP, Zuckerman SL, Terry DP, Arbogast K, Benjamin HJ, Brooks A, Cameron KL, Chrisman SPD, Clugston JR, Collins M, DiFiori J, Eckner JT, Estevez C, Feigenbaum LA, Goldman JT, Hoy A, Kaminski TW, Kelly LA, Kontos AP, Langford D, Lintner LJ, Master CL, McDevitt J, McGinty G, Miles C, Ortega J, Port N, Rowson S, Schmidt J, Susmarski A, Svoboda S. Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study. Am J Sports Med 2024; 52:1585-1595. [PMID: 38656160 DOI: 10.1177/03635465241240789] [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] [Indexed: 04/26/2024]
Abstract
BACKGROUND Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes. PURPOSE To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS The Concussion Assessment, Research and Education (CARE) Consortium database was used. The mechanism of injury was categorized into head-to-ball, head-to-head, head-to-body, and head-to-ground/equipment. Baseline/acute injury characteristics-including Sports Concussion Assessment Tool-3 total symptom severity (TSS), loss of consciousness (LOC), and altered mental status (AMS); descriptive data; and recovery (RTP and URTP)-were compared. Multivariable regression and Weibull models were used to assess the predictive value of the mechanism of injury on TSS and RTP/URTP, respectively. RESULTS Among 391 soccer SRCs, 32.7% were attributed to a head-to-ball mechanism, 27.9% to a head-to-body mechanism, 21.7% to a head-to-head mechanism, and 17.6% to a head-to-ground/equipment mechanism. Event type was significantly associated with injury mechanism [χ2(3) = 63; P < .001), such that more head-to-ball concussions occurred in practice sessions (n = 92 [51.1%] vs n = 36 [17.1%]) and more head-to-head (n = 65 [30.8%] vs n = 20 [11.1]) and head-to-body (n = 76 [36%] vs n = 33 [18.3%]) concussions occurred in competition. The primary position was significantly associated with injury mechanism [χ2(3) = 24; P < .004], with goalkeepers having no SRCs from the head-to-head mechanism (n = 0 [0%]) and forward players having the least head-to-body mechanism (n = 15 [19.2%]). LOC was also associated with injury mechanism (P = .034), with LOC being most prevalent in head-to-ground/equipment. Finally, AMS was most prevalent in head-to-ball (n = 54 [34.2%]) and head-to-body (n = 48 [30.4%]) mechanisms [χ2(3) = 9; P = .029]. In our multivariable models, the mechanism was not a predictor of TSS or RTP; however, it was associated with URTP (P = .044), with head-to-equipment/ground injuries resulting in the shortest mean number of days (14 ± 9.1 days) to URTP and the head-to-ball mechanism the longest (18.6 ± 21.6 days). CONCLUSION The mechanism of injury differed by event type and primary position, and LOC and AMS were different across mechanisms. Even though the mechanism of injury was not a significant predictor of acute symptom burden or time until RTP initiation, those with head-to-equipment/ground injuries spent the shortest time until URTP, and those with head-to-ball injuries had the longest time until URTP.
Collapse
Affiliation(s)
- Jacob Jo
- Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt University School of Medicine, Nashville, Tennessee, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adrian J Boltz
- Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kristen L Williams
- Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Paul F Pasquina
- Department of Physical Medicine and Rehabilitation at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Scott L Zuckerman
- Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Douglas P Terry
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kristy Arbogast
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Holly J Benjamin
- University of Chicago, Chicago, Illinois, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alison Brooks
- University of Wisconsin-Madison, Madison, Wisconsin, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kenneth L Cameron
- United States Military Academy, West Point, New York, USA)
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sara P D Chrisman
- University of Washington, Seattle, Washington, USA)
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James R Clugston
- University of Florida, Gainesville, Florida, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Micky Collins
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - John DiFiori
- Hospital for Special Surgery, New York, New York, USA)
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James T Eckner
- University of Michigan, Michigan, USA)
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carlos Estevez
- United States Coast Guard Academy, New London, Connecticut, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Luis A Feigenbaum
- University of Miami, Coral Gables, Florida, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Joshua T Goldman
- University of California, Los Angeles, Los Angeles, California, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - April Hoy
- Azusa Pacific University, Azusa, California, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Thomas W Kaminski
- University of Delaware, Newark, Delaware, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Louise A Kelly
- California Lutheran University, Thousand Oaks, California, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Anthony P Kontos
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Dianne Langford
- Temple University, Philadelphia, Pennsylvania, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Laura J Lintner
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christina L Master
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jane McDevitt
- Temple University, Philadelphia, Pennsylvania, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Gerald McGinty
- United States Air Force Academy, El Paso, Colorado, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chris Miles
- Wake Forest University, Winston-Salem, North Carolina, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Justus Ortega
- California State Polytechnic University, Pomona, California, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nicholas Port
- Indiana University, Bloomington, Indiana, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Steve Rowson
- Virginia Tech, Blacksburg, Virginia, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Julianne Schmidt
- University of Georgia, Athens, Georgia, USA)
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adam Susmarski
- United States Naval Academy, Annapolis, Maryland, USA)
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Steven Svoboda
- MedStar Health, Columbia, Maryland, USA
- Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
2
|
Setliff JC, Anderst WJ. A scoping review of human skeletal kinematics research using biplane radiography. J Orthop Res 2024; 42:915-922. [PMID: 38366965 DOI: 10.1002/jor.25806] [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: 07/19/2023] [Revised: 10/18/2023] [Accepted: 12/12/2023] [Indexed: 02/19/2024]
Abstract
Biplane radiography has emerged as the gold standard for accurately measuring in vivo skeletal kinematics during physiological loading. The purpose of this scoping review was to map the extent, range, and nature of biplane radiography research on humans from 2004 through 2022. A literature search was performed using the terms biplane radiography, dual fluoroscopy, dynamic stereo X-ray, and biplane videoradiography. All articles referenced in included publications were also assessed for inclusion. A secondary search was then performed using the names of the most frequently appearing principal investigators among included papers. A total of 379 manuscripts were identified and included. The first studies published in 2004 focused on the native knee, followed by studies of the ankle joint complex in 2006, the shoulder in 2007, and the spine in 2008. Nearly half (180, 47.5%) of all manuscripts investigated knee kinematics. The average number of publications increased from 21.6 per year from 2012 to 2017 to 34.6 per year from 2017 to 2022. The average number of participants per study was 16, with a range from 1 to 101. A total of 90.2% of studies featured cohorts of 30 or less. The most prolific research groups for each joint were: Mass General Hospital (lumbar spine and knee), Henry Ford Hospital (shoulder), the University of Utah (ankle and hip), The University of Pittsburgh (cervical spine), and Brown University (hand/wrist/elbow). Future advancements in biplane radiography research are dependent upon increased availability of these imaging systems, standardization of data collection protocols, and the development of automated approaches to expedite data processing.
Collapse
Affiliation(s)
- Joshua C Setliff
- Biodynamics Lab, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - William J Anderst
- Biodynamics Lab, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
3
|
Sato VN, Moriwaki TL, Ikawa MH, Sugawara LM, da Rocha Correa Fernandes A, Skaf AY, Yamada AF. Apophyseal injuries in soccer players. Skeletal Radiol 2024:10.1007/s00256-023-04542-x. [PMID: 38224380 DOI: 10.1007/s00256-023-04542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/05/2023] [Accepted: 12/05/2023] [Indexed: 01/16/2024]
Abstract
Soccer is the most popular sport worldwide, and it is associated with high injury rates, with most of these injuries occurring in the lower extremities. Particularly, in youth soccer players with immature skeleton, the physeal plate is two to five times weaker than the surrounding fibrous structures, and therefore more vulnerable to injury. The physeal plate consists of epiphyses and apophyses, with the former serving as tendon attachment sites and being subject to traction forces. There are two types of apophyseal injury: (i) apophyseal avulsion, which consists of an acute separation across the physeal plate; and (ii) apophysitis, an injury caused by chronic and repetitive contraction of musculotendon unit, leading to inflammation of the growth plate cartilage. Apophyses of the hip and pelvis are the most commonly injured in youth soccer players, due to vigorous contractions during sports activities and the fact that they tend to fuse later compared to other epiphyseal centers, making them more susceptible to injury. In this review, we will discuss the anatomy of lower limb apophyses and clinical and imaging findings of apophyseal injuries in youth soccer players, as well as briefly review treatment options and complications.
Collapse
Affiliation(s)
- Vitor Neves Sato
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - Tatiane Lumi Moriwaki
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - Marcos Hiroyuki Ikawa
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - Leonardo Massamaro Sugawara
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - Artur da Rocha Correa Fernandes
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil
- Radiology Department - Grupo de Radiologia e Diagnóstico por Imagem da Rede D'Or, São Paulo, SP, Brazil
| | - Abdalla Youssef Skaf
- Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil
| | - André Fukunishi Yamada
- Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800 - Vila Clementino, São Paulo, SP, 04024-002, Brazil.
- Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil.
- Division of Musculoskeletal Radiology, Diagnóstico das Américas (DASA), São Paulo, SP, Brazil.
| |
Collapse
|
4
|
Nguyen JC, Caine D. Youth soccer players: patterns of injury involving the primary growth plates of epiphyses. Skeletal Radiol 2024:10.1007/s00256-023-04541-y. [PMID: 38175258 DOI: 10.1007/s00256-023-04541-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/08/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
Youth soccer (football) is immensely popular internationally. Earlier participation, sport sub-specialization, and year-around practice have led to an increased incidence of injury from both acute trauma and repetitive overuse. The growth plates (physes) of the immature skeleton are particularly vulnerable to injury and delayed diagnosis can lead to future growth disturbance and long-term morbidity. Familiarity with the various components of the growth plate complex necessary for ensuring normal endochondral ossification is fundamental in understanding the various patterns of imaging findings following injury. This review discusses the zonal columnar arrangement of the growth plate proper and the contrasting function of the vasculature within the subjacent epiphysis and metaphysis. This is followed by an evidence-based discussion of the common patterns of injury involving the epiphyseal primary growth plate observed among youth soccer players: subcategorized into physeal fractures (direct injury) and physeal stress injuries (indirect insult to subjacent metaphysis). In this section, the role of imaging and characteristic imaging features will be discussed. While the normal physiologic and pathophysiologic mechanisms can be applied to other growth plates, such as primary growth plates underlying the apophyses and secondary growth plates surrounding the secondary ossificiation centers, which also undergo endochondral ossification, the current review is focused on injuries involving the primary growth plates underlying epiphyses.
Collapse
Affiliation(s)
- Jie C Nguyen
- Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Dennis Caine
- Kinesiology and Public Health Education, Division of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, 58202-8235, USA
| |
Collapse
|
5
|
Patel V, Barakat J, Fanney L, Gendler L, Brown NJ, Ganley TJ, Nguyen JC. Maturation-dependent patterns of knee injuries among symptomatic pediatric soccer players on MRI. Skeletal Radiol 2023:10.1007/s00256-023-04543-w. [PMID: 38153433 DOI: 10.1007/s00256-023-04543-w] [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: 10/22/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE To systematically investigate the prevalence of knee MRI findings among symptomatic pediatric soccer players with respect to skeletal maturity and to identify predictors of surgery. METHODS This IRB-approved, HIPAA-compliant retrospective study included soccer players (< 18 years of age) who underwent MRI examinations in the past 5 years (2018-2023). Two radiologists retrospectively and independently reviewed all examinations to categorize skeletal maturity and to identify osseous and soft tissue findings. Findings were compared between maturation groups, and logistic regression models were used to identify predictors of surgery. RESULTS Ninety-seven players (45 boys, 52 girls) included 39 skeletally immature, 21 maturing, and 37 mature knees. Kappa coefficient for interobserver reliability ranged between 0.65 and 1.00. Osgood-Schlatter disease (OSD) was more common among immature than maturing and mature knees (25% vs 14% and 5%, p = 0.04); anterior cruciate ligament (ACL) injury was more common among maturing and mature than immature knees (59% and 48%, vs 15%, p < 0.01); and meniscal tears were more common among mature than immature and maturing knees (medial, 41% vs 18% and 14%, p = 0.03; lateral, 43% vs 21% and 19%, p = 0.04). Players in the mature group were more likely to undergo surgery (p = 0.01). The presence of an effusion (OR = 19.5, 95% CI 2.8-240.9, p = 0.01), ACL injury (OR = 170.0, 95% CI 1.3-6996.9, p < 0.01), and lateral meniscal tears (OR = 10.8, 95% CI 1.8-106.1, p = 0.02) were independent predictors of surgery. CONCLUSION Differential patterns of injury were found among symptomatic pediatric soccer players; the presence of an effusion, ACL injury, and lateral meniscal tears were independent predictors of surgery, likely contributing to the higher rates of surgery among skeletally mature players.
Collapse
Affiliation(s)
- Vandan Patel
- Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Drexel University College of Medicine, Philadelphia, PA, USA
- Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, USA
| | - Jude Barakat
- Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania School of Engineering and Applied Sciences, Philadelphia, PA, USA
| | - Lewis Fanney
- Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Eastern Virginia Medical School, Norfolk, VA, USA
| | - Liya Gendler
- Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Naomi J Brown
- Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Theodore J Ganley
- Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jie C Nguyen
- Department of Radiology, Section of MSK, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
6
|
Sonesson S, Lindblom H, Hägglund M. Higher age and present injury at the start of the season are risk factors for in-season injury in amateur male and female football players-a prospective cohort study. Knee Surg Sports Traumatol Arthrosc 2023; 31:4618-4630. [PMID: 37542529 PMCID: PMC10471640 DOI: 10.1007/s00167-023-07517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/14/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE To describe the injury prevalence, injury pattern, and potential baseline risk factors for injuries in male and female adolescent and adult amateur football players. METHODS This prospective study followed adolescent and adult amateur football players over one season March-October 2020. The study was completed by 462 players (130 men, age 20.0 ± 5.7, 14-46 years) who answered a baseline survey and a weekly web survey during the season. A total of 1456 weekly surveys were registered from males and 5041 from females. Injuries were recorded with the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O2). Potential baseline risk factors (age, performance of strength/conditioning training, participation in other sports, perceived importance of sporting success, self-rated training and match load, perceived balance between training/match load and recovery, previous/present injury at start of season, and injury beliefs) and their association with injury were analysed with Poisson regressions within each sex. RESULTS Males reported 95 injuries (262 injury weeks, weekly prevalence 18.0% (95% CI 16.1-20.1)) and females 350 injuries (1206 injury weeks, weekly prevalence 23.9% (95% CI 22.8-25.1)). Gradual-onset injuries accounted for 57% of the injuries in males and 66% in females. For males, substantial injuries were most common in the hip/groin (weekly prevalence 3.8%), ankle (2.1%), posterior thigh (2.0%), and knee (2.0%); and for females, in the knee (4.3%), ankle (2.5%), and lower leg/Achilles tendon (2.0%). Significant risk factors for injury were higher age (rate ratio males 1.05 per year increase (95% CI 1.02-1.08), females 1.03 (95% CI 1.01-1.05)), and present injury at baseline (males 1.92 (95% CI 1.27-2.89), females 1.58 (95% CI 1.19-2.09)). CONCLUSION At any given week, almost one in five male and one in four female amateur football players reported new or ongoing injuries. Hip/groin injuries were more frequent in males, while female players had a higher prevalence of knee injuries. Older players and those with an existing injury at the start of the season were more prone to new injury during the season. Rehabilitation of pre-season injury and complaints are key to reduce the injury burden in amateur football. LEVEL OF EVIDENCE Level II. Trial registration number NCT04272047, Clinical trials.
Collapse
Affiliation(s)
- Sofi Sonesson
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Hanna Lindblom
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Martin Hägglund
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
7
|
Injuries of Primary School Children during Sports Activities. Zdr Varst 2023. [DOI: 10.2478/sjph-2023-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
ABSTRACT
Introduction
The purpose of the research was to analyse the injuries of primary school children in the framework of organised sports activities at school and in clubs or associations, and in leisure time without professional guidance.
Methods
We surveyed 631 participants, of which there were 282 boys and 349 girls from eight Slovenian primary schools. Frequencies were calculated and a Chi-square test was performed.
Results
In physical education (PE) at school, 32% of the participants were injured in one school year, and there were no statistically significant differences in the number of injuries according to sex (p=0.18) and age (p=0.12). Most injuries were recorded in the lower extremities (50%), in the form of wounds. The participants were injured less often in PE at school than in a club or association, and more often than in their leisure time. The participants were absent from PE classes for longer after an injury in a club or association than in PE, while no significant differences in absences after injury were found. At school, the participants were most often injured in ball games, boys in football (43%) and girls in volleyball (19%). In activities in a club or association, we recorded the most injuries in boys in martial arts (18%) and dance for girls (19%). In their leisure time, boys suffered the most injuries from football (26%) and cycling, while girls suffered the most from running and rollerblading.
Conclusion
In the last ten years, the number of injuries in PE has increased in Slovenia. Based on the obtained results, we propose measures to reduce injuries and thus encourage more sports activities among children and adolescents, while ensuring their safety.
Collapse
|
8
|
Ferraro SL, Batty M, Heyworth BE, Cook DL, Miller PE, Novais EN. Acute Pelvic and Hip Apophyseal Avulsion Fractures in Adolescents: A Summary of 719 Cases. J Pediatr Orthop 2023; 43:204-210. [PMID: 36727766 DOI: 10.1097/bpo.0000000000002355] [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: 02/03/2023]
Abstract
BACKGROUND Apophyseal avulsion fractures of the pelvis and hip are common injuries in adolescent athletes. However, high volume comparative studies elucidating the spectrum of injuries are largely absent from the literature. The current study provides a comprehensive analysis of demographic, anatomic, pathophysiological, clinical, and athletic-related variables associated with such injuries in an extensive population of affected adolescents. METHODS A retrospective review was performed of records of patients presenting to a single tertiary care pediatric hospital between January 1, 2005, and July 31, 2020, collecting variables including patient sex, age, body mass index, fracture location, injury mechanism, sport at the time of injury, and duration of prodromal symptoms. RESULTS Seven hundred nineteen fractures were identified in 709 patients. The average patient age was 14.6, and 78% of the fractures occurred in male patients. The anterior inferior iliac spine (33.4%), anterior superior iliac spine (30.5%), and ischial tuberosity (19.4%) were the most common fracture sites. The most common injury mechanisms were running (27.8%), kicking (26.7%), and falls (8.8%). The most common sports at the time of injury were soccer (38.1%), football (11.2%), and baseball (10.5%). Fracture site was significantly associated with patient sex, age, body mass index, laterality, mechanism, sport, time from injury, and presence of prodromal symptoms. The annual volume of pelvic avulsion fractures treated at the institution increased significantly from n=17 in 2005 to n=75 in 2019. CONCLUSIONS Adolescent pelvic and hip avulsion fractures occur during a narrow window of age and skeletal maturation and are frequently sustained during sporting activities. Each fracture location is associated with certain demographic, mechanistic, and patient-specific characteristics. The associations between fracture site and patient-specific or injury-specific variables offer insights into the pathophysiology and possible underlying biomechanical risk factors that contribute to these injuries. LEVEL OF EVIDENCE This is a level III retrospective study.
Collapse
Affiliation(s)
- Samantha L Ferraro
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA
| | | | | | | | | | | |
Collapse
|
9
|
Winstanley C, Reid D, Fulcher ML. Suggested improvements to the 11+ as identified by coaches, players, strength and conditioning staff and medical staff in New Zealand Football. BMJ Open Sport Exerc Med 2023; 9:e001463. [PMID: 37051575 PMCID: PMC10083849 DOI: 10.1136/bmjsem-2022-001463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 04/05/2023] Open
Abstract
The aim of this study was to investigate the experience with the 11+, attitudes towards injury prevention, and potential improvements to the 11+ and the delivery of injury prevention strategies within football. A qualitative study design was used to investigate the views of four stakeholder groups (players, coaches, strength and conditioning staff and clinicians). Twenty-two adults participated (nine women; median age 35.5 years). Participants were purposively recruited and were based in New Zealand. They represented various levels of football, including different genders, ages and levels of play. Focus group interviews were conducted, which were recorded, transcribed and subject to thematic analysis. Four key themes were identified: understanding of the 11+ injury prevention warm-up, content of an ideal injury prevention programme, structure of the programme and education, adherence and dissemination. The study found that while participants appeared to have good awareness of the existing 11+ programme and an interest in injury prevention, adherence and enthusiasm towards the programme was limited. Participants highlighted a number of elements that may help shape the development of a new injury prevention strategy, including a desire to retain many of the elements of the 11+ and to have a proven programme. Participants wanted greater variety, more football-specific elements and to implement a new strategy throughout a session, rather than being seen as a stand-alone warm-up. Whether the intervention should also include strength-based exercises, or whether this should be promoted outside of a football training session, was less certain.
Collapse
Affiliation(s)
- Colleen Winstanley
- Sports Medicine, Australasian College of Sport and Exercise Physicians, Melbourne, Victoria, Australia
| | - Duncan Reid
- Department of Physiotherapy, AUT, Auckland, New Zealand
| | - Mark L Fulcher
- Sports Medicine, Axis Sports Medicine, Auckland, New Zealand
- Department of Physiotherapy, University of Auckland, Auckland, New Zealand
| |
Collapse
|
10
|
Franchina M, Turati M, Tercier S, Kwiatkowski B. FIFA 11+ Kids: Challenges in implementing a prevention program. J Child Orthop 2023; 17:22-27. [PMID: 36755560 PMCID: PMC9900015 DOI: 10.1177/18632521221149057] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/14/2022] [Indexed: 02/10/2023] Open
Abstract
Purpose Soccer is a popular sport among children and adolescents that exposes to a high risk of injury. Several prevention programs, including the FIFA 11+ Kids program have been developed to decrease this injury rate. The aim of the study was to investigate the knowledge and use of the FIFA 11+ Kids program among soccer coaches of skeletally immature soccer players in a Swiss canton and analyze difficulties of implementing such a prevention program. Materials & methods First, an online survey was sent to all soccer coaches involved in Swiss training programs for male players from 7 to 13 years of age. Coaches were identified through existing Swiss coaching networks. A total of 237 coaches completed the survey. Second, the FIFA 11+ Kids program was implemented in three soccer teams (players from 7 to 13 years of age) during 6 months in the same canton. Utilization of FIFA 11+ Kids program and compliance of coaches were recorded by the research staff. Results Around 84% of the included coaches in the survey were certified. Of those, 59% had been taught injury prevention during their course(s). Only 14% of the included coaches knew one of the FIFA programs (11, 11+, 11+ Kids), of those, about one-third (10 out of 237) used the FIFA 11+ Kids program. After 6 months, none of the soccer coaches applied the entire FIFA 11+ Kids program twice a week. One coach had completely abandoned the program. The main reasons for their disapproval were the time and surveillance needed and the players' lack of motivation. They stated, however, that the exercises were good if used occasionally. Conclusion Injury prevention should be integrated in every soccer coach education courses. An adaptation of the FIFA 11+ Kids program should be considered, especially for the youngest players.
Collapse
Affiliation(s)
| | - Marco Turati
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Orthopedic Department, San Gerardo Hospital, Monza, Italy
- Transalpine Center of Pediatric Sports Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Department of Paediatric Orthopaedic Surgery, Hospital Couple Enfant, Grenoble Alpes University, Grenoble, France
| | - Stéphane Tercier
- SportAdo Centre, Department of Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
- Pediatric Orthopedic and Trauma Surgery Unit, Department of Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Barbara Kwiatkowski
- Pediatric Orthopedic and Trauma Surgery Unit, Department of Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| |
Collapse
|
11
|
Nozari A, Sharma A, Wang Z, Feng L, Muresanu DF, Tian ZR, Lafuente JV, Buzoianu AD, Wiklund L, Sharma HS. Co-administration of Nanowired Oxiracetam and Neprilysin with Monoclonal Antibodies to Amyloid Beta Peptide and p-Tau Thwarted Exacerbation of Brain Pathology in Concussive Head Injury at Hot Environment. ADVANCES IN NEUROBIOLOGY 2023; 32:271-313. [PMID: 37480464 DOI: 10.1007/978-3-031-32997-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Environmental temperature adversely affects the outcome of concussive head injury (CHI)-induced brain pathology. Studies from our laboratory showed that animals reared at either cold environment or at hot environment exacerbate brain pathology following CHI. Our previous experiments showed that nanowired delivery of oxiracetam significantly attenuated CHI-induced brain pathology and associated neurovascular changes. Military personnel are the most susceptible to CHI caused by explosion, blasts, missile or blunt head trauma leading to lifetime functional and cognitive impairments affecting the quality of life. Severe CHI leads to instant death and/or lifetime paralysis. Military personnel engaged in combat operations are often subjected to extreme high or low environmental temperature zones across the globe. Thus, further exploration of novel therapeutic agents at cold or hot ambient temperatures following CHI are the need of the hour. CHI is also a major risk factor for developing Alzheimer's disease by enhancing amyloid beta peptide deposits in the brain. In this review, effect of hot environment on CHI-induced brain pathology is discussed. In addition, whether nanodelivery of oxiracetam together with neprilysin and monoclonal antibodies (mAb) to amyloid beta peptide and p-tau could lead to superior neuroprotection in CHI is explored. Our results show that co-administration of oxiracetam with neprilysin and mAb to AβP and p-tau significantly induced superior neuroprotection following CHI in hot environment, not reported earlier.
Collapse
Affiliation(s)
- Ala Nozari
- Anesthesiology & Intensive Care, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Zhenguo Wang
- Shijiazhuang Pharma Group NBP Pharmaceutical Co., Ltd., Shijiazhuang, Hebei Province, China
| | - Lianyuan Feng
- Department of Neurology, Bethune International Peace Hospital, Zhongshan, Hebei Province, China
| | - Dafin F Muresanu
- Department of Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania
- "RoNeuro" Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Z Ryan Tian
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, USA
| | - José Vicente Lafuente
- LaNCE, Department of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Anca D Buzoianu
- Department of Clinical Pharmacology and Toxicology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| |
Collapse
|
12
|
Tom JE, Eckhoff MD, Tadlock JC, Garcia ESJ. A 10-Year National Analysis of Pediatric Elbow Fractures. Clin Pediatr (Phila) 2022; 62:433-440. [PMID: 36345146 DOI: 10.1177/00099228221135525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Elbow fractures comprise 15% of all fractures in children. Our study identifies risk factors and consumer products that contribute to pediatric elbow fractures. The National Electronic Injury Surveillance System was used to collect demographic and consumer product information between 2010 and 2019 for patients younger than 17 years who presented to the emergency department with elbow fractures. Of the 458,433 elbow fractures, the average age of the patients was 7.4 ± 4.1 years and 55.6% were male children. The most common consumer product was sports and recreation equipment, followed by home furnishings. Male patients (P < .0001) and patients 8 years and older (79.2% vs 51.1%, P < .0001) experienced significantly greater rates of injury with sports and recreation equipment. This study evaluates the products associated with pediatric elbow fractures and highlights the importance of safe sports and recreation equipment use and the role of parental counseling in preventing falls from furniture.
Collapse
Affiliation(s)
- Jessica E Tom
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Michael D Eckhoff
- Department of Orthopedics, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Joshua C Tadlock
- Department of Orthopedics, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - EStephan J Garcia
- Department of Orthopedics, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| |
Collapse
|
13
|
Robles-Palazón FJ, López-Valenciano A, De Ste Croix M, Oliver JL, García-Gómez A, Sainz de Baranda P, Ayala F. Epidemiology of injuries in male and female youth football players: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:681-695. [PMID: 34700052 PMCID: PMC9729930 DOI: 10.1016/j.jshs.2021.10.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/10/2021] [Accepted: 07/21/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND To conduct a systematic review and meta-analysis of epidemiological data of injuries in male and female youth football players. METHODS Searches were performed in MEDLINE/PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases. Studies were considered if they reported injury incidence rate in male and female youth (≤19 years old) football players. Two reviewers (FJRP and ALV) extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale. The Grading of Recommendations Assessment, Development, and Evaluation approach determined the quality of evidence. Studies were combined using a Poisson random effects regression model. RESULTS Forty-three studies were included. The overall incidence rate was 5.70 injuries/1000 h in males and 6.77 injuries/1000 h in females. Match injury incidence (14.43 injuries/1000 h in males and 14.97 injuries/1000 h in females) was significantly higher than training injury incidence (2.77 injuries/1000 h in males and 2.62 injuries/1000 h in females). The lower extremity had the highest incidence rate in both sexes. The most common type of injury was muscle/tendon for males and joint/ligament for females. Minimal injuries were the most common in both sexes. The incidence rate of injuries increased with advances in chronological age in males. Elite male players presented higher match injury incidence than sub-elite players. In females, there was a paucity of data for comparison across age groups and levels of play. CONCLUSION The high injury incidence rates and sex differences identified for the most common location and type of injury reinforce the need for implementing different targeted injury-risk mitigation strategies in male and female youth football players.
Collapse
Affiliation(s)
- Francisco Javier Robles-Palazón
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia 30720, Spain
| | | | - Mark De Ste Croix
- School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK
| | - Jon L Oliver
- Youth Physical Development Centre, School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF23 6XD, UK; Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland 0632, New Zealand
| | - Alberto García-Gómez
- Operative Research Centre, Miguel Hernández University of Elche, Elche 03202, Spain
| | - Pilar Sainz de Baranda
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia 30720, Spain
| | - Francisco Ayala
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia 30720, Spain; School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK
| |
Collapse
|
14
|
Sex Differences in Pre-Season Anthropometric, Balance and Range-of-Motion Characteristics in Elite Youth Soccer Players. Healthcare (Basel) 2022; 10:healthcare10050819. [PMID: 35627956 PMCID: PMC9140908 DOI: 10.3390/healthcare10050819] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/18/2022] [Accepted: 04/25/2022] [Indexed: 11/16/2022] Open
Abstract
In soccer, injury epidemiology differs between males and females. It is clinically useful to know whether there are between-sex differences in selected characteristics relevant to primary injury risk and injury prevention practices. The purpose of this study was to explore between-sex differences in anthropometric, balance, and range-of-motion characteristics in Spanish elite male and female youth soccer players. This was a pre-season cross-sectional study. Sixty-nine males (age 16.8 ± 0.9 yr; height 175.9 ± 6.8 cm; mass 67.9 ± 6.3 kg) and thirty-seven females (age 17.2 ± 1.7 yr; height 164.0 ± 6.3 cm; mass 59.0 ± 5.8 kg) participated. Anthropometrics (standing/sitting height, bodymass, right/left leg length) and right/left anterior reach test (ART), hip internal/external active range of motion, active knee extension (AKE), and weightbearing lunge test (WBLT) were measured. Between-sex differences were assessed with Bonferroni-corrected Mann−Whitney U tests and Cliff’s delta (d). Between-sex significant differences (p < 0.003, d ≥ 0.50) were observed for anthropometric data and for hip internal rotation. No between-sex significant differences were observed for ART/AKE/WBLT measures. Between-sex significant differences with large effect sizes were identified for anthropometric data and right/left hip internal rotation. The present study adds new data to the literature for young Spanish male and female soccer players. The present findings will help inform clinical reasoning processes and future injury prevention research for elite male and female youth soccer players.
Collapse
|
15
|
Poor Motor Coordination Elicits Altered Lower Limb Biomechanics in Young Football (Soccer) Players: Implications for Injury Prevention through Wearable Sensors. SENSORS 2021; 21:s21134371. [PMID: 34202369 PMCID: PMC8271557 DOI: 10.3390/s21134371] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 01/29/2023]
Abstract
Motor coordination and lower limb biomechanics are crucial aspects of anterior cruciate ligament (ACL) injury prevention strategies in football. These two aspects have never been assessed together in real scenarios in the young population. The present study aimed to investigate the influence of motor coordination on lower limb biomechanics in young footballers during an on-the-pitch training. Eighteen juvenile football players (10 y ± 2 m) were enrolled. Each player performed a training drill with sport-specific movements (vertical jump, agility ladders, change of direction) and the Harre circuit test (HCT) to evaluate players' motor coordination. Wearable inertial sensors (MTw Awinda, Xsens) were used to assess lower limb joint angles and accelerations. Based on the results of the HCT, players were divided into poorly coordinated (PC) and well-coordinated (WC) on the basis of the literature benchmark. The PC group showed a stiffer hip biomechanics strategy (up to 40% lower flexion angle, ES = 2.0) and higher internal-external hip rotation and knee valgus (p < 0.05). Significant biomechanical limb asymmetries were found only in the PC group for the knee joint (31-39% difference between dominant and non-dominant limb, ES 1.6-2.3). Poor motor coordination elicited altered hip and knee biomechanics during sport-specific dynamic movements. The monitoring of motor coordination and on-field biomechanics might enhance the targeted trainings for ACL injury prevention.
Collapse
|
16
|
Kim S, Connaughton DP. Soccer, concussions, and safety: Perceptions of parents of youth soccer participants. JOURNAL OF SAFETY RESEARCH 2021; 77:255-262. [PMID: 34092316 DOI: 10.1016/j.jsr.2021.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/17/2020] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The rate of concussions in youth soccer is among the highest of all youth sports. Parents play an important role in caring for their children and making decisions regarding whether they should participate in a sport, such as soccer, where concussions are well known. This study examined parental perceptions regarding: (a) coaches' role in concussion management, (b) heading restriction policies, and (c) overall concussion risk and participation issues. METHOD Online surveys were completed by 419 parents of youth soccer players who participated in the largest U.S. youth soccer programs nationwide. RESULTS Findings indicated 44.5% of the respondents had considered keeping their children from playing organized soccer and 47.2% were concerned about a potential decline in youth soccer participation due to concussions. Nearly 69% of responding parents agreed that heading should be banned for participants 10 years old or younger, while 56.5% thought heading should not be limited for participants 13 or older. Only 35% of parents were very confident about their child's coach's ability to properly identify concussions and remove those suspected of a concussion from play. Parents' socioeconomic status (SES), soccer coaching and playing experience, and previous history of concussion(s) were key predictors of greater perceived risk about concussions. CONCLUSIONS Findings from this study shed light on parents' perceptions about concussions and related safety issues in youth soccer. Understanding what parents believe about concussions is vital to preserve youth soccer participation and can be used to strengthen education and policies that promote a safer environment for youth sport participants. Practical Applications: Youth soccer coaches can benefit from stronger, comprehensive educational efforts at the league/club level. Additionally, parents of youth athletes who are in the lower SES communities should be targeted to receive concussion safety information and/or interventions that would improve their knowledge, attitude, and practices regarding concussion safety.
Collapse
Affiliation(s)
- Sungwon Kim
- St. John's University, 8000 Utopia Pkwy, Queens, NY 11439, USA.
| | | |
Collapse
|
17
|
Silva FMD, Canêz DB, Madeira AR, Ferreira GD. Dynamic Knee Alignment and Pelvic Balance: Comparison Regarding Gender in Young Soccer Athletes. Rev Bras Ortop 2021; 56:175-180. [PMID: 33935313 PMCID: PMC8075638 DOI: 10.1055/s-0040-1721361] [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: 09/11/2019] [Accepted: 09/16/2020] [Indexed: 11/30/2022] Open
Abstract
Objective
To evaluate knee alignment in the frontal plane and pelvic balance during the step-down test in female and male soccer players.
Methods
Cross-sectional study carried out with male and female soccer players from under-15 and under-17 teams of a professional club in Southern Brazil. The step-down test was performed, filmed with a video camera, and evaluated according to the angular measurements obtained during movement using the Kinovea software (open source), version 0.8.24.
Results
The sample consisted of 38 individuals, 19 males and 19 females. Female athletes had a greater varus angle (9.42° ± 1.65°) compared to male athletes (3.91° ± 2.0°;
p
= 0.04). There was no difference regarding the unilateral pelvic drop between the groups. In addition, the association between the hip-related pelvic drop and the projection angle on the frontal plane of the knee was weak in both genders.
Conclusion
Even though the pelvic drop was observed in both genders, young female athletes had greater varus knee angles on the step-down test, which require greater attention to minimize the risk of injury.
Collapse
Affiliation(s)
| | - Denis Bordoni Canêz
- Curso de Fisioterapia, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brasil
| | | | - Gustavo Dias Ferreira
- Departamento de Fisiologia e Farmacologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brasil
| |
Collapse
|
18
|
Epidemiology of Sports-Related Injuries and Associated Risk Factors in Adolescent Athletes: An Injury Surveillance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094857. [PMID: 34063226 PMCID: PMC8125505 DOI: 10.3390/ijerph18094857] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 11/23/2022]
Abstract
The present study aimed to determine the epidemiology of sport-related injuries in amateur and professional adolescent athletes and the incidence of different risk factors on those injuries. Four hundred ninety-eight athletes aged 14 to 21 voluntarily participated in this prospective injury surveillance, conducted from 1 January 2019 to 31 December 2019. The information collected included: personal data, sports aspects, characteristics of the injuries, and lifestyle. Forty point four percent of the participants suffered an injury in 2019 (39% of them in a previously injured area). The average injury rate was 2.64 per 1000 h. Soccer presented the highest rate (7.21). The most common injuries were: lumbar muscle strains (12.24%), ankle sprains (11.98%), and bone fractures (9.31%). Ankles (36.12%), knees (19.32%), and shoulders (6.47%) concentrated the highest number of injuries. Fifty-nine point twenty-eight percent of the injuries occurred during practices, and 40.72% during competition or peri-competition. Higher injury rates were associated (in this order) with the following factors: (a) Greater number of hours of practice per week. (b) Not performing warm-ups. (c) Using inadequate sports facilities. (d) Being aged 14–17. (e) Not performing physical preparation. (f) Inappropriate training load. (g) Not performing injury-preventive activities. (h) Performing sports technique without the supervision of one sports coach. (i) Inadequate sports equipment. In conclusion, since most injury risk factors are modifiable, it is imperative to implement strategies to reduce amateur and professional adolescent athletes’ injury rates.
Collapse
|
19
|
Rinaldo N, Gualdi-Russo E, Zaccagni L. Influence of Size and Maturity on Injury in Young Elite Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063120. [PMID: 33803535 PMCID: PMC8003020 DOI: 10.3390/ijerph18063120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023]
Abstract
The involvement of pre-adolescents in soccer is becoming more and more frequent, and this growing participation generates some concerns about the potential factors for sports injuries. The purpose of this study was to investigate sports injuries in younger (U9–U11) and older (U12–U13) children playing soccer at an elite level, analyzing potential anthropometric and maturity risk factors. A total of 88 elite soccer players aged 9–13 years were investigated. Weight, stature, and sitting height were measured at the start and at the end of the competitive season, computing the relative growth velocities. Additional body composition parameters were taken during a second survey. Maturity offset was calculated using predictive equations based on anthropometric traits such as years from age at peak height velocity (YPHV). Injuries suffered during the competitive season were recorded. Maturity and some anthropometric characteristics were significantly different according to the presence or absence of injuries among the players. Multiple logistic regression revealed that YPHV, body mass index (BMI), and calf muscle area were the factors most significantly correlated with injuries. Players with increased BMI, with decreased calf muscle area, and who were closer to their peak height velocity, were at a higher risk of injury. Findings showed that a monitoring program of anthropometric characteristics taking into account the maturational stage needs to be developed to prevent injuries.
Collapse
|
20
|
Sidharthan S, Yau A, Almeida BA, Shea KG, Greditzer HG, Jones KJ, Fabricant PD. Patterns of Articular Cartilage Thickness in Pediatric and Adolescent Knees: A Magnetic Resonance Imaging-Based Study. Arthrosc Sports Med Rehabil 2021; 3:e381-e390. [PMID: 34027446 PMCID: PMC8128992 DOI: 10.1016/j.asmr.2020.09.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/30/2020] [Indexed: 12/20/2022] Open
Abstract
Purpose To establish normative values for articular cartilage thickness in pediatric and adolescent knees using magnetic resonance imaging (MRI) and investigate for any associations with age and skeletal maturity. Methods MRI scans were analyzed in patients 7 to 18 years old without osteochondral lesions, chondral wear/pathology, intra-articular fractures, or history of knee surgery. Measurements of articular cartilage thickness at the patella (medial facet, lateral facet, median ridge), femur (medial condyle, lateral condyle, lateral trochlea), and tibia (medial plateau, lateral plateau) were made on axial, coronal, and sagittal MRI. Descriptive statistics were used to calculate mean cartilage thickness by age and sex. Analysis of variance with repeated measures, analysis of covariance, independent samples t test, and linear regression were performed to determine differences in mean cartilage thickness by anatomic location, sex, physeal status, and age, respectively. Results A total of 240 knee MRI scans were included. Articular cartilage was thickest at the patella and did not vary with age or skeletal maturity. On the femur, articular cartilage was thickest at the lateral trochlea with mean cartilage thickness of 4.4 ± 1.4 mm in male patients and 3.6 ± 1.3 mm in female patients (P < .001). Patients with open distal femoral physes had significantly thicker cartilage at the medial femoral condyle, lateral femoral condyle, and lateral trochlea compared to patients with closing/closed physes (P < .001). Linear regression analysis revealed a significant inverse association between cartilage thickness at the femur and age. Conclusions In pediatric and adolescent knees, articular cartilage is thickest at the patella, where it does not strongly correlate with age. In contrast, there is a strong inverse association between increasing age and articular cartilage thickness of the distal femoral condyles. Clinical Relevance The longitudinal reference data presented in this study can aid in pre-operative interpretation of knee cartilage under pathologic conditions in pediatric and adolescent patients.
Collapse
Affiliation(s)
- Sreetha Sidharthan
- Divisions of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
- David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Annie Yau
- Divisions of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| | - Bryan Aristega Almeida
- Divisions of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| | - Kevin G Shea
- Stanford University School of Medicine, Stanford, California, U.S.A
| | - Harry G Greditzer
- Radiology & Imaging, Hospital for Special Surgery, New York, New York, U.S.A
| | - Kristofer J Jones
- David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Peter D Fabricant
- Divisions of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A
| |
Collapse
|
21
|
Lee H, Joo CH. Differences in physical fitness after an 8-week preseason training among elite football players aged 17-19 years. J Exerc Rehabil 2020; 16:442-449. [PMID: 33178646 PMCID: PMC7609845 DOI: 10.12965/jer.2040598.299] [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] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/03/2020] [Indexed: 11/22/2022] Open
Abstract
There may be an optimal period of time to maximize the improvement of physical fitness during adolescence. The aim of this study was to examine the magnitude of changes in physical fitness after 8 weeks of preseason training according to chronological ages after the age at peak high velocity. Thirty male young football players from an elite football team (U-16, n=10; U-17, n=10; U-18, n=10) participated in the study. The players completed an 8-week general preseason football training and participated in the pre- and posttests to measure physical fitness. The 8-week preseason training improved the power of all young players (P<0.05). The 20-m sprint performance was improved by training in U-16 and U-18 (P<0.05), but no changes were found in the U-17 group (P>0.05). Significant differences were found in the arrowhead left in U-16 and U-18 (P<0.05) after training; however, no difference was observed in U-17 (P>0.05). Coordination was enhanced further in U-16 and U-17 (P<0.05) compared with that in U-18 (P>0.05). The performance of repeated sprints and Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1) were similar between pre- and posttraining in all age groups (P>0.05). Collectively, the results emphasized the importance of systematic and scientific training methods to improve the fitness levels of young football players in the preseason training period. Moreover, training to improve coordination in young football players is effective at younger ages.
Collapse
Affiliation(s)
- Hojun Lee
- Department of Human Movement Science, Seoul Women's University, Seoul, Korea
| | - Chang-Hwa Joo
- Department of Sport Science, Kangwon National University, Chuncheon, Korea
| |
Collapse
|
22
|
Owoeye OBA, VanderWey MJ, Pike I. Reducing Injuries in Soccer (Football): an Umbrella Review of Best Evidence Across the Epidemiological Framework for Prevention. SPORTS MEDICINE - OPEN 2020; 6:46. [PMID: 32955626 PMCID: PMC7505904 DOI: 10.1186/s40798-020-00274-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/19/2020] [Indexed: 01/31/2023]
Abstract
Soccer is the most popular sport in the world. Expectedly, the incidence of soccer-related injuries is high and these injuries exert a significant burden on individuals and families, including health and financial burdens, and on the socioeconomic and healthcare systems. Using established injury prevention frameworks, we present a concise synthesis of the most recent scientific evidence regarding injury rates, characteristics, mechanisms, risk and protective factors, interventions for prevention, and implementation of interventions in soccer. In this umbrella review, we elucidate the most recent available evidence gleaned primarily from systematic reviews and meta-analyses. Further, we express the exigent need to move current soccer injury prevention research evidence into action for improved player outcomes and widespread impact through increased attention to dissemination and implementation research. Additionally, we highlight the importance of an enabling context and effective implementation strategies for the successful integration of evidence-based injury prevention programs into real-world soccer settings. This narrative umbrella review provides guidance to inform future research, practice, and policy towards reducing injuries among soccer players.
Collapse
Affiliation(s)
- Oluwatoyosi B A Owoeye
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Allied Health Professions Building, 3437 Caroline Street, St. Louis, MO, 63104, USA.
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
| | - Mitchell J VanderWey
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, Allied Health Professions Building, 3437 Caroline Street, St. Louis, MO, 63104, USA
| | - Ian Pike
- Department of Paediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, BC, Canada
| |
Collapse
|
23
|
Lee I, Jeong HS, Lee SY. Injury Profiles in Korean Youth Soccer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5125. [PMID: 32708572 PMCID: PMC7400017 DOI: 10.3390/ijerph17145125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 11/24/2022]
Abstract
We aimed to analyze injury profiles and injury severity in Korean youth soccer players. Data on all injuries that occurred in U-15 youth soccer players during the 2019 season were collected from 681 players of 22 teams through a medical questionnaire. The questionnaire was based on injury surveillance procedures of the Federation International de Football Association Medical and Research Centre and International Olympic Committee, and it comprised questions on demographic characteristics, training conditions, and injury information. Among all players, defenders accounted for 33.0%, followed by attackers (30.7%), midfielders (26.8%), and goalkeepers (7.9%). Most players played soccer on artificial grounds (97.4%). Injuries occurred more frequently during training (56.3%) than during matches (43.7%). Recurrent injury rate was 4.4% and average days to return to full activities were 22.58. The ankle (26.6%) and knee joints (14.1%) were the most common injury locations, and ligament sprains (21.0%), contusions (15.6%), and fractures (13.9%) were the most frequent injury types. In conclusion, Korean youth soccer players have a high injury risk. Therefore, researchers and coaching staff need to consider these results as a key to prevent injuries in youth soccer players and injury prevention programs may help decrease injury rate by providing injury management.
Collapse
Affiliation(s)
- Inje Lee
- Department of Physical Education, Yonsei University, Seoul 03722, Korea;
- International Olympic Committee Research Centre KOREA, Yonsei University, Seoul 03722, Korea
| | - Hee Seong Jeong
- Department of Physical Education, Yonsei University, Seoul 03722, Korea;
- International Olympic Committee Research Centre KOREA, Yonsei University, Seoul 03722, Korea
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Seoul 03722, Korea;
- International Olympic Committee Research Centre KOREA, Yonsei University, Seoul 03722, Korea
- Institute of Convergence Science, Yonsei University, Seoul 03722, Korea
| |
Collapse
|