Characteristics and associated factors with sports injuries among children and adolescents

Sports-Related Musculoskeletal Injuries in Medical Students

Background

Little attention is paid to the problem of sports-related injuries in amateur or nonathletes or recreational student athletes. We investigated the prevalence of sports-related musculoskeletal (MSK) injuries in medical students and attempted to identify the risk factors for these injuries.

Methods

We conducted a cross-sectional questionnaire-based observational study on medical students of a tertiary care teaching hospital in central India. A total of 500 medical students were approached; the questionnaire consisted of details, such as age, gender, height, weight, predominant sport played or the sport during which they sustained an injury, estimated time spent playing every week, if they had undergone any formal training for the sport, any preexisting MSK condition, details of the injury and the treatment taken, if any, after joining medical school, and duration from getting injured to return to studies and sports. The odds ratio (OR) and logistic regression were calculated for multiple parameters. Statistical significance was set at P ≤ 0.05.

Results

Seventy-four of the 402 students who responded reported sustaining a sports-related injury; 33 and 41 students reported injury while playing contact and noncontact sports, respectively. Of these, 58 students reported that they had received formal training in sports. Football, volleyball, cricket, and kabaddi were the sports during which most injuries occurred. The injury rate was 3.7 per 1000 playing or practice hours.

Conclusions

Almost one-fifth of the students reported sustaining a sports-related MSK injury after joining medical school. The risk factors identified for these injuries were male gender, participation in team sports, participation in noncontact sports, and lack of adequate preparation or practice.

A world panorama of bruxism in children and adolescents with emphasis on associated sleep features: A bibliometric analysis

BACKGROUND AND OBJECTIVES

To present a world panorama of the published papers on bruxism in children and adolescents, emphasising the characteristics of studies related to the sleep features of these patients.

METHODS

Literature searches were conducted in six databases without language or date restrictions. Data on the titles, types of study, main subjects, countries of origin, keywords, years of publication, authors and their network collaborations, journals and sleep studies were extracted and analysed using VantagePoint™ software.

RESULTS

A total of 725 studies met the eligibility criteria. Most included only children (75.31%), with observational design (66.34%), and risk or aetiology (53.93%) as the main subject. Brazil (18.06%) and Brazilian authors (54.84%) had the largest number of studies, with a low amount of network collaboration. The Journal of Oral Rehabilitation published most of the studies (6.2%); publications in this field have grown considerably from 2000 to 2020. Of the studies, 123 (16.96%) included sleep studies; night sweating, restless sleep, sleep talking, mouth breathing, snoring, obstructive sleep apnoea syndrome, sleep-disordered breathing, nightmares, poor sleep quality and duration, and daytime naps were significantly associated with bruxism in most.

CONCLUSION

Studies on bruxism in children and adolescents have increased in the past 20 years, with most being observational, and risk or aetiology as the main subject. Brazil and the Journal of Oral Rehabilitation have published most in the field. Sleep studies have shown some features associated with bruxism, such as night sweating, restless sleep, somniloquy, snoring, breathing problems, nightmares, daytime naps, and poor sleep quality and duration.

Influence of Size and Maturity on Injury in Young Elite Soccer Players

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.

Risk assessment in different Judo techniques for children and adolescent athletes

Judo is a combat sport that involves throwing the opponent onto the back. When being thrown, head biomechanics may be related to head injury risk. This study aimed to assess head injury risks associated with four Judo techniques in children and adolescents with different experience levels. Twenty children (<12 years) and 20 adolescents (≥ 12 years) judoka were recruited. Each group was divided into non-expert and expert. Two inertial sensors were fixed on fallers' head and torso. Two backward (o-soto-gari and o-uchi-gari) and two forward (ippon-seoi-nage and tai-otoshi) techniques were performed. Peak of linear and angular head acceleration magnitude, impact time duration, neck angle, and the Gadd Severity Index were assessed. Children did not show differences between techniques or experience levels. In contrast, adolescents showed greater linear acceleration peak in o-soto-gari than tai-otoshi (p = 0.03), greater angular acceleration peak in o-soto-gari and o-uchi-gari than ippon-seoi-nage (p < 0.05), and greater neck flexion in o-uchi-gari than ippon-seoi-nage (p = 0.004). Compared to expert adolescents, non-expert adolescents showed greater angular acceleration peak, impact duration, and the Gadd Severity Index in o-soto-gari (p < 0.05) and greater neck extension in o-uchi-gari (p = 0.02). Current results pointed out higher risks for adolescents judoka while being thrown with backward techniques, especially for non-expert participants. This study highlights the need of training athletes in controlling head and neck during back falls from a young age to become expert judoka in adulthood.

Rates and Patterns of Lower Extremity Sports Injuries in All Gender-Comparable US High School Sports

Background:

High school athletes with lower extremity sports injuries (LESIs) frequently present to the emergency department in the United States. Previous epidemiological studies have presented rates and mechanisms of LESIs in these athletes. No studies, however, have looked at LESIs in gender-comparable sports in an attempt to evaluate what differences exist between LESIs in boys and girls.

Purpose:

To describe the epidemiology of LESIs among US high school athletes using a large national database of athletes in sports that could be considered gender comparable, given the rules of play and protective equipment.

Study Design:

Descriptive epidemiology study.

Methods:

Descriptive data from 2005 to 2016 were collected using the internet-based High School Reporting Information Online (High School RIO), a national high school sports injury surveillance system, for athletes participating in 8 gender-comparable sports (soccer, volleyball, basketball, baseball/softball, swimming and diving, track and field, cross-country, and tennis). Rates and patterns of injury were evaluated, with injury rates calculated as ratio of injuries per 10,000 athlete-exposures. Rate ratios (RRs) were calculated to compare the LESI rates in girls and boys.

Results:

In both genders, LESI rates (per 10,000 athlete-exposures) were highest in soccer (girls, 15.87; boys, 11.68) followed by basketball (girls, 11.51; boys, 9.35), and were lowest in swimming and diving (girls, 0.70; boys, 0.39). Although injury rates were significantly higher in girls compared with boys in all sports, only in tennis was the RR greater than 2 (RR, 2.03; 95% CI, 1.17-3.54). Girls had a greater proportion of severe LESIs and injuries that received radiographic evaluation, such as magnetic resonance imaging, compared with boys for all sports except volleyball. Consistency in the mechanism of injury was demonstrated between genders within each sport.

Conclusion:

This study demonstrated that LESIs are common among high school athletes and disproportionately affect girls more than boys, especially when looking at severe injuries and resource utilization. Further studies are needed to elucidate the cause of these findings. We hope that the awareness of gender-based differences in LESIs will lead to improvements in targeted efforts to decrease injury rates and injury severity.

Sports injuries aligned to predicted mature height in highly trained Middle-Eastern youth athletes: a cohort study

OBJECTIVES

To investigate the association of maturity status with injury incidence in Middle-Eastern youth athletes.

DESIGN

Prospective cohort study.

SETTING

Four consecutive seasons (2010-2014), Aspire Academy, Qatar.

PARTICIPANTS

Male athletes (age range: 11-18 years) representing four disciplines enrolled and grouped into two categories: individual sports and racquet sports.

OUTCOME MEASURES

Injury data collected over four seasons. Athletes' anthropometric characteristics assessed to calculate age at peak height velocity. Predicted mature heights (PMHs) collected and categorised into four quartiles. Athletes had wrist and hand radiographs for assessment of skeletal age (SA). Early and late maturers with an SA of >1 year older or younger than their chronological age (CA).

RESULTS

For the sample (n=67) across all groups, 43 (64%) athletes had one or more injuries: total of 212 injuries, 4.9 injuries per athlete across study. Survival analysis of maturity status using SA found early maturing athletes had two-fold greater injury risk compared with late maturers (HR 2.04, 95% CI 1.15 to 3.61, p=0.015). PMH associated with injury risk (HR 1.05, 95% CI 1.01 to 1.08, p=0.006).Athletes in fourth quartile (≥184 cm) had up to two-fold injury risk (HR 2.41, 95% CI 1.42 to 4.08, p=0.001). Racquet and individual sports involved similar injury risk (HR 1.14, 95% CI 0.86 to 1.52, p=0.37).

CONCLUSION

SA early maturity and PMH gradient were significant predictors of injury in youths.

Structural differences in the lower extremities in children aged 7-9 years, caused by playing football: A cross-sectional study

BACKGROUND

Physical activity during childhood can be beneficial in the long term. However, this practice can influence the child's physiological development. The aim of this study was to determine whether the practice of soccer, in moderation, could be a risk factor for the inadequate development of the lower limb.

METHODS

The study group was composed of 115 children, of whom 59 (mean age 8.03±0.89years) practised soccer 3 times a week and had a positive Physical Activity Questionnaire for Adolescents (PAQ-A) score, while a further 56 (mean age 7.96±0.87years) did not perform any additional physical activity and had a negative PAQ-A score. A foot posture analysis, based on the foot posture index (FPI), the valgus index, the orientation of the subtalar joint (STJ) and the Q angle of the knee, was carried out.

RESULTS

For the group of soccer players, the following results were obtained: FPI 4.79±2.38 (R) and 3.95±2.31 (L); valgus index 13.56°±1.66° (R) and 13.42°±1.48° (L); STJ test 79% pronated; Q angle 13.13°±2.06° (R) and 13.18°±1.93° (L). For the non-players, the corresponding values were: FPI 3.62±2.82 (R) and 3.74±2.77 (L); valgus index 12.76°±1.71° (R) and 12.84°±1.72° (L); STJ test 50% pronated; Q angle 13.87°±3.01° (R) and 13.86°±2.94° (L).

CONCLUSION

There is a degree of difference between the two groups, but the values do not vary greatly from those considered normal for this age group. Any alterations in this respect can be assumed to be caused at older ages than those analysed.

Lesões musculoesqueléticas em praticantes de judô

RESUMO A prática de judô integra situações variadas de contato físico e exigências específicas, tornando-o uma modalidade competitiva e com alto índice de lesões musculoesqueléticas (LME). Este estudo transversal teve por objetivo descrever a epidemiologia de LME e analisar a relação entre diferentes características e a ocorrência de lesão em judocas. A casuística integrou 111 participantes de ambos os sexos. Para tomar informações sobre lesões, utilizou-se um inquérito de morbidade referida. Para análise estatística, foi empregado o teste de Goodman de proporções multinomiais. A relação entre fatores associados com LME foi avaliada por meio de regressão logística. Foram relatados 135 LME, com prevalência de 65% (72 esportistas), totalizando 1,22 LME/atleta. A maioria dos relatos foi constituída por lesões articulares decorrentes de traumas (n=50 casos, 37%), sendo que entorse de tornozelo (25,2%) e luxação de ombro (17,8%) foram os casos com maior frequência. Entre as lesões ósseas, verificou-se maior proporção de casos graves (25 casos; 18,5%). Sexo e carga horária semanal constituíram-se como as principais características preditivas para ocorrência de LME no judô (p<0,001). Conclui-se que as lesões articulares traumáticas em tornozelo e ombro foram as principais LME no judô. Sexo masculino e maior carga horária semanal constituíram-se como as principais características preditivas de lesão entre judocas.

Shoulder pain in adolescent athletes: prevalence, associated factors and its influence on upper limb function

BACKGROUND

Sports that require the constant use of an upper limb demand the maximum kinetic chain efficiency in this segment. Immaturity of the musculoskeletal system, followed by failure in motor skills can expose adolescents to major reports of pain complaints, particularly for the shoulder.

OBJECTIVE

To evaluate the prevalence of shoulder pain in adolescent athletes and identify possible factors associated with the complaint.

METHOD

A total of 310 athletes, of both sexes and aged between 10 and 19 years old participated on this study. The subjects filled out a questionnaire with personal, sports and upper limb function (Quick-DASH) questions. We evaluated the height, body mass, shoulder rotation range and stability of the upper limb using the CKCUES-test. The association between pain and the variables was analyzed using multilevel modeling logistic regression. We used the Mann-Whitney test for comparing between pain and function.

RESULTS

The prevalence of shoulder pain was 43.5%. Athletes between 15 and 19 years, handball and judo practitioners, are 1.86, 2.14 and 3.07 more likely to report shoulder pain, respectively, when compared with other sports and ages. Shoulder pain reduced function scores (p<0.001) and increased changes in the range of motion (p<0.04).

CONCLUSION

Shoulder pain is highly prevalent and is associated especially with older adolescent athletes of handball and judo, and affects the levels of function and the range of the shoulder.

Impact sports and bone fractures among adolescents

The objective of the present study was to investigate the effects of different sports on stress fractures among adolescents during a 9-month follow-up period. The sample was composed of 184 adolescents divided into three groups (impact sports [n = 102]; swimming [n = 35]; non-sports [n = 47]). The occurrence of stress fracture was reported by participants and coaches. As potential confounders we considered age, sex, resistance training, body composition variables and age at peak of height velocity. There were 13 adolescents who reported fractures during the 9-month period. Bone mineral density values were higher in adolescents engaged in impact sports (P-value = 0.002). Independently of confounders, the risk of stress fracture was lower in adolescents engaged in impact sports than in non-active adolescents (hazard ratio [HR] = 0.23 [95% confidence interval (CI) = 0.05 to 0.98]), while swimming practice was not associated to lower risk of fracture (HR = 0.49 [95% CI = 0.09 to 2.55]). In conclusion, the findings from this study indicate the importance of sports participation among adolescents in the reduction of stress fracture risk, especially with impact sports. More importantly, these results could be relevant for recognising adolescents in danger of not reaching their potential for peak bone mass and later an increased risk of fractures.