Effectiveness of Warm-Up Intervention Programs to Prevent Sports Injuries among Children and Adolescents: A Systematic Review and Meta-Analysis

Golfers' Performance Is Improved More by Combining Foam Rolling and Dynamic Stretch to the Lead Hip Than Practice Golf Swinging

ABSTRACT

Hamada, Y, Akasaka, K, Otsudo, T, Sawada, Y, Hattori, H, Kikuchi, Y, and Hall, T. Golfers' performance is improved more by combining foam rolling and dynamic stretch to the lead hip than practice golf swinging. J Strength Cond Res 38(7): e391-e397, 2024-Warming up is considered effective in improving performance and preventing injury. Despite this, there have been few studies investigating warm-up programs in golf and whether specific factors contribute to improved performance. The purpose of this study was to examine the immediate effects of combined foam rolling and dynamic stretch (FR + DS) to the lead hip on golf swing performance, hip range of motion (ROM), and muscle strength in amateur golfers using a randomized crossover design. The study sample comprised 22 men (mean ± SD ; age, 32.6 ± 8.5 years, body mass index (BMI), 23.4 ± 2.7 kg·m -2 ). Subjects were assigned to receive either FR + DS or repetitive golf swing practice (SW) before crossing over to the other intervention for another day. Measurements included golf swing performance (ball speed, club head speed, flight distance ["carry"], spin rate, and launch angle), hip internal rotation (IR), and external rotation (ER) ROM, as well as hip IR and ER muscle strength. Comparisons between groups were made before and after each intervention. For golf swing performance, FR + DS improved "carry" significantly more than SW ( p < 0.05). No significant differences in golf swing performance other than "carry" were found. In addition, IR ROM and IR muscle strength of the lead hip were significantly increased in the FR + DS group ( p < 0.05). FR + DS has effects on improving lead hip IR ROM and IR muscle strength, which may facilitate golfers' swing and "carry." FR + DS shows promise as a warm-up method for amateur golfers who want to improve golf performance.

Effectiveness of exercise-based sports injury prevention programmes in reducing injury rates in adolescents and their implementation in the community: a mixed-methods systematic review

OBJECTIVE

Despite evidence supporting the efficacy of sport injury prevention programmes (SIPPs) in adolescents, implementation of SIPPs in community settings is low. This review aims to synthesise and integrate evidence on the efficacy of exercise-based SIPPs in reducing injury rates in adolescents with implementation strategies for such programmes in the community.

DESIGN

A systematic review with meta-analysis, narrative synthesis and meta-aggregation was conducted, followed by a convergent segregated approach to integrate the findings. Sensitivity and subgroup analyses were conducted. Study appraisal was performed using Joanna Briggs Institute Critical Appraisal Checklists and Mixed Methods Appraisal Tool.

DATA SOURCES

Literature search of nine databases was carried out to identify studies in English from January 2012 to December 2022.

ELIGIBILITY CRITERIA

Included were randomised controlled trials (RCTs), qualitative or mixed-methods studies. Population included adolescents (10-19 years). Interventions included SIPPs. Outcomes were injury rate and rate ratio (IRR). Phenomena of interest were facilitators and barriers to the implementation of SIPPs.

RESULTS

23 studies were included for analysis. Meta-analysis for 16 RCTs showed a protective effect of SIPP (IRR 0.63, 95% CI 0.53 to 0.74, p<0.00001) in adolescents. Meta-aggregation of seven qualitative/mixed-method studies revealed four sets of synthesised findings that impact implementation namely players' perceptions and beliefs, coaches as key facilitators, organisational support and characteristics of the SIPP.

CONCLUSION

Implementation of SIPPs provides a 37% risk reduction in adolescents but requires targeting key stakeholders through a top-down multifaceted approach for its efficacy to be translated. Future research should investigate the effectiveness of SIPPs and implementation strategies in adolescents in community settings.

Efficacy of a Neuromuscular Warm-up Program in Reducing the Risk of School Sports Injury among Chinese Children: A Cluster Randomized Controlled Trial

Background

Children who participate in sports have reduced cardiovascular risk, obesity, and type 2 diabetes. However, sports participation also comes with an inherent risk of sports-related injuries.

Purpose

To examine the efficacy of a school-based neuromuscular warm-up program (NWP) in reducing the risk of school sports injury (SSI) in children and the impact of different levels of compliance on the effectiveness of the program.

Study Design

Randomized controlled trial; Level of evidence, 1.

Methods

A total of 421 students from grades 4 to 6 at a single school (age range, 9-14 years) were randomized by grade to an intervention group and a control group. The intervention group participated in a 13-week simplified (8-minute) NWP designed to reduce SSI risk. The control group participated in a standard warm-up of the same length and duration. Exposure, compliance, and injury data were collected via a weekly form. The primary injury outcome was all SSIs. Secondary outcomes included injuries from physical education (PE) and non-PE class, upper and lower extremity injuries, other location injuries, and time-loss injuries. A Poisson regression model using an intent-to-treat analysis was performed to estimate the incidence rate ratio (IRR) for all injuries in the intervention group compared with the control group. To examine the influence of level of compliance, we divided the intervention group into low compliance (participation 1-2 times/wk) and high compliance (participation >2 times/wk) then compared the difference on injury rates (IRs) between these groups and the control group.

Results

There were significant differences between the intervention and control groups regarding all SSIs (IRR, 0.47; 95% CI, 0.23-0.96; P = .038), PE class injuries (IRR, 0.37; 95% CI, 0.14-0.99; P = .048), and other location injuries (IRR, 0.20; 95% CI, 0.05-0.82; P = .025). The compliance analysis revealed that although the low-compliance group was able to reduce the risk of SSIs (IR, 4.43; 95% CI, 2.49-6.37) compared with the control group (IR, 7.60; 95% CI, 5.61-9.59), the high-compliance group produced a better effect in reducing the SSI risk (IR, 1.80; 95% CI, 0.04-3.56).

Conclusion

The simplified NWP used in this study was efficacious in the reduction of SSIs in children.

Registration

ChiCTR2100043875 (Chinese Clinical Trial Registry; http://www.chictr.org.cn).

Evaluating the impact of injury prevention interventions in child and adolescent sports using the RE-AIM framework and CERT: A systematic review

BACKGROUND

Participation in sport is a popular pastime for children and adolescents that improves their physical health, mental health and motor skills. Musculoskeletal injuries are a relatively common downside of sports participation and can have negative long-term consequences. Injury prevention programmes have demonstrated effectiveness in child and adolescent sports, provided compliance is adequate. However, little is known about the factors which relate to their impact on the wider community and whether the prevention programmes have been adopted and maintained in the long-term. The objective of this review was to assess the current literature on exercise-based injury prevention interventions in child and adolescent sports (aged under 19 years) against the 'Reach', 'Effectiveness', 'Adoption', 'Implementation', 'Maintenance' (RE-AIM) framework and Consensus of Exercise Reporting Template (CERT), to ascertain level of reporting for the components which relate to external validity.

METHODS

Seven electronic databases; PubMed, Medline, SPORTDiscus, PsycINFO, CINAHL, Scopus and The Cochrane Library, were searched from date of inception to July 2022 using the themes of: 'Child and Adolescent', 'Sport', 'Injury' and 'Prevention'. Eligibility criteria included: Experimental trial design, exercise-based intervention programmes, primary outcome of injury incidence and participants aged under 19 years. Two reviewers assessed each trial independently against the RE-AIM model dimension items checklist (RE-AIM MDIC) and Consensus on Exercise Reporting Template (CERT) before reaching a consensus on reporting.

RESULTS

Forty-five unique trials met the eligibility criteria. Mean reporting level for all studies across the whole RE-AIM MDIC was 31% (SD ± 16.2%, Range 7-77%). The domain of 'effectiveness' was the most comprehensively reported (60%), followed by 'implementation' (48%), 'reach' (38%), 'adoption' (26%) and 'maintenance' (7%). The mean reporting score for the CERT was 50% (SD ± 20.8, range 0-81%).

CONCLUSION

Published data on injury prevention in child and adolescent sports is highly focussed on the effectiveness of the intervention, with little consideration given to how it will be adopted and maintained in the long-term. This has led to considerable gaps in knowledge regarding optimal programme implementation, with a lack of data on adoption and maintenance contributing to the gap between research and practice. Future research needs to place greater focus on external validity and consider incorporating the study of implementation and feasibility as part of effectiveness trial design. This approach should provide the data that will help narrow the considerable gap between science and practice.

TRIAL REGISTRATION

PROSPERO Registration number CRD42021272847.

Effects of half-time re-warm-up implemented during a simulated match in U14 female basketball players

Re-warm-up activities are recommended in team sports due to loss of muscle temperature during half-time. This study aimed to evaluate the effects of a half-time re-warm-up strategy on female basketball players. Ten players U14, separated into two teams of five players, performed either a passive rest condition or repeated sprints (5×14 m) plus 2 min of a shooting wheel (re-warm-up condition), during the half-time break (10 min) of a simulated basketball match, where only the first three quarters were played. The re-warm-up did not elicit significant effects on jump performance and locomotory responses during the match, except for the distance covered at a very light speed, which was significantly higher than in the passive rest condition (1767 ± 206 vs 1529 ± 142 m; p < 0.05). Mean heart rate (74 ± 4 vs 70 ± 5%) and rate of perceived exertion (4.5 ± 1.5 vs 3.1 ± 1.44 a.u.) were higher in the re-warm-up condition during half-time (p < 0.05). In conclusion, performing re-warm-up activities based on sprints could be a valuable strategy to avoid the reduction of sport performance during prolonged breaks, but given the limitations of the study, these relationships need to be further explored in official competitions.

Relationship of Training Factors and Resilience with Injuries in Ski Mountaineers

Ski mountaineering is an increasingly popular sport with a relatively high risk of injury. Therefore, several studies have analyzed factors related to the likelihood of injury, including athlete characteristics, training, resilience and equipment. Thus, the aim of this study was to identify factors that may influence injury risk. A 15-minute online survey was sent to various ski mountaineering groups of different ages and levels. Both the Mann-Whitney U test and odds ratio analysis were performed in order to analyze the data. Results from 104 skiers showed that most injuries occurred in the lower extremities, especially in the knee (29.6%). The findings indicated that skiers who had suffered an injury performed in more competitions per year (p = 0.046), more ski mountaineering sessions per week (p = 0.022) and fewer core training sessions per week (0.029), although core training and competition were not statistically significant factors. Likewise, non-injured athletes had fewer pairs of skis (p = 0.019), which were also wider (p = 0.04). However, no difference was found for warm up and resilience between both groups (p = 0.275). In conclusion, it is important to implement preventive measures based on these factors, even if more research is needed.

Intention for Warm-Up among Children and Adolescents Scale: Development and Initial Validation

The purpose of this study was to develop and validate the Intention for Warm-up among Children and Adolescents Scale (IWCAS). There were four phases and four sets of participants in the development of the IWCAS. In the first phase, the domains of intention were defined, and related components were developed, organized, and validated. In the second phase, 446 elementary and middle school students participated in a pilot study for the first version of the scale, which was revised based on the information obtained. In the third phase, 12 graduates in sports pedagogy served on an expert panel and organized the items into domain areas and developed a second version of the IWCAS. In the final phase, 1322 elementary and middle school students from three k-12 schools completed the revised version of the IWCAS, and exploratory and confirmatory factor analyses were conducted. Based on the results, the IWCAS was shortened by deleting some items in two domains; this resulted in 11 items of the final version with 3 domains: (1) attitude toward warm-up, (2) subjective norm, and (3) perceived behavioral control that, according to the indices, generate reliable and structurally valid scores. The composite internal consistency for the three domains ranged from 0.74 to 0.85. The researchers hypothesized the IWCAS is a valid and reliable scale, which can be used by P.E. teachers or coaches to evaluate the intention of primary and secondary school students to perform warm-ups.