Concussions, cuts and cracked bones: A systematic literature review on protective headgear and head injury prevention in Olympic boxing

In 2013, the International Boxing Association (AIBA) prohibited the use of headguards for elite male Olympic boxing competitions. Could the removal of the headguard from elite male boxing competitions potentially cause increased injury risk for boxers? The aim of the literature review is to analyse current knowledge about the use of protective headgear and injury prevention in boxing, in order to determine if there are increased injury risks associated with headguard use. Peer-reviewed studies (language: English, Norwegian, Swedish, Danish and Dutch) published from 1980 and onwards were considered. Five academic databases and grey literature sources were searched, and articles were assessed for methodological quality. Only studies that included boxers as the study population with headguards as a factor were considered. A total of 39 articles were included in the review. The analysis of the reviewed literature indicates that headguards protect well against lacerations and skull fractures, while less is known about the protective effects against concussion and other traumatic brain injuries. Most of the analysed studies however use indirect evidence, obtained through self-report or observational techniques with relatively small non-representative samples. There are almost no randomised control trials, longitudinal research designs or samples from recreational boxing. Therefore, AIBA's decision to remove the headguard has to be seen with caution and injury rates among (male) boxers should be continuously evaluated.

Methods may matter in injury surveillance: "how" may be more important than "what, when or why"

To examine if and how adjustments in injury surveillance recording methodology may have influenced injury rates. Injury and exposure data were collected among professional male players from the Qatar Stars League from the 2008-2009 season to the 2017-2018 season. There have been four iterations of our data collection methods. In the first five seasons, participation in the programme was voluntary. For seasons 6-7, additional dedicated researchers were tasked with contacting the medical teams every month. At the start of season 8, an electronic recording method was instituted. In the final two seasons, injury surveillance participation was further boosted by reinforced encouragement from institutional management. Overall injury incidence increased from season 5 to season 8. Severe injuries have fallen steadily, but slightly over the ten seasons, whereas mild injuries increased dramatically from seasons 5 to 8. The current data suggest that along with the standard metrics (e.g. injury incidence, injury burden) we also need to clearly report the methods by which data were collected and verified in as much detail as possible. We suggest that sports medicine journals should adopt minimum reporting standards and perhaps checklists could be a useful step forward.

Seasonal time-loss match injury rates and burden in South African under-16 rugby teams

OBJECTIVES

Youth rugby union is a popular sport with a high injury incidence density (IID) and burden. This high risk has called for further research into the factors affecting the injuries in youth rugby. The aim of the study was to analyse time-loss IID and burden in multiple schoolboy rugby teams over a season and the potential factors associated with injury.

DESIGN

Prospective cohort METHODS: All time-loss injuries were recorded from three schools for the whole season. Overall IID and injury burden were calculated, as well as for injury event, type, location and the match quarter in which they occurred and Poisson regression analyses were performed to determine differences.

RESULTS

IID was 28.8 (18.9-38.6) injuries per 1000 player hours over the season, with an injury burden of 379.2 (343.6-414.9) days lost per 1000 player hours. The ball-carrier had a significantly higher IID (11.3 (5.2-17.5) per 1000 player hours) compared to other events, and the joint (non-bone)/ligament injuries were the most common (IID of 12.2 (5.8-18.6) per 1000 player hours) and severe type of injury (burden of 172.6 (148.5-196.6) days lost per 1000 player hours).

CONCLUSIONS

The IID was similar to previous youth rugby studies, however the injury burden was much lower. The South African youth cohort showed similar factors associated with injury for inciting event (the tackle) and injury type (joint (non-bone)/ligament) and location (lower limb) as seen in other studies in both youth and senior players.

Shoe drop reduction influences the lower limb biomechanics of children tennis players during an open stance forehand: A longitudinal study

Compared to traditional tennis shoes, using 0-drop shoes was shown to induce an immediate switch from rear- to forefoot strike pattern to perform an open stance tennis forehand for 30% of children tennis players. The purpose of the study was to examine the long-term effects of a gradual reduction in the shoe drop on the biomechanics of children tennis players performing open stance forehands. Thirty children tennis players participated in 2 laboratory biomechanical test sessions (intermediate: +4 months and final: +8 months) after an inclusion visit where they were randomly assigned to control (CON) or experimental (EXP) group. CON received 12-mm-drop shoes twice, whereas EXP received 8 mm then 4-mm-drop shoes. Strike index indicated that all CON were rearfoot strikers in intermediate and final test sessions. All EXP were rearfoot strikers in intermediate test session, but half the group switched towards a forefoot strike pattern in final test session. This switch resulted in a decreased loading rate of the ground reaction force (-73%, p = .005) but increased peak ankle plantarflexors moment (+47%, p = .050) and peak ankle power absorption (+107%, p = .005) for these participants compared with CON. Biomechanical changes associated with the long-term use of partial minimalist shoes suggest a reduction in heel compressive forces but an increase in Achilles tendon tensile forces.

A multifactorial injury prevention intervention reduces injury incidence in Physical Education Teacher Education students

Physical Education Teacher Education (PETE) students are at considerable risk for non-contact sports injuries of the lower extremities. Multifactorial injury prevention interventions including exercises have been successful in sports populations, but no such study has ever been performed in PETE students. This study investigated the efficacy of a multifactorial injury prevention intervention on injury incidence reduction in PETE students. PETE students in the intervention group (n = 154) and in the control group (n = 189) registered sports injuries prospectively. The intervention lasted one academic year and consisted of an injury awareness programme and preventive strategies, implemented by the PETE sports lecturers. Differences in injury incidence between the intervention and control group were tested by Poisson regression Wald tests. There was a trend towards significantly lower incidence rate (2.18 vs. 2.73; p = 0.061) in the intervention group compared with the control group. Students in the intervention group had significantly less acute, first-time and extracurricular injuries. The largest reduction was observed for injuries during unsupervised practice sessions. A multifactorial injury prevention intervention embedded into a regular PETE programme is a promising and feasible strategy to prevent injuries in PETE students. Further research is needed to investigate whether the results may be generalised to other PETE programmes.

Squad management, injury and match performance in a professional soccer team over a championship-winning season

Squad management, injury and physical, tactical and technical match performance were investigated in a professional soccer team across five consecutive league seasons (2008-2013, 190 league games) with specific focus on a championship-winning season (2010/11). For each player, match participation and time-loss injuries were recorded, the latter prospectively diagnosed by the team's physician. Defending and attacking tactical and technical performance indicators investigated included ball possession and possession in opponents' half, passes, forward passes, completed passes and forward passes, crosses and completed crosses, goal attempts and goal attempts on target, successful final third entries, free-kicks and 50/50 duels won/lost. Physical performance measures included total distance and distance covered at high-speeds (≥19.1 km/h). Results showed that during the 2010/11 season, squad utilisation was lowest potentially owing to the observed lower match injury occurrence and working days lost to injury thereby increasing player availability. In 2010/11, the team won both its highest number of points and conceded its lowest number of goals especially over the second half of this season. The team also won its highest number of games directly via a goal from a substitute and scored and conceded a goal first on the highest and lowest number of occasions, respectively. While multivariate analysis of variance (MANOVA) detected a significant difference in some attacking and defensive performance indicators across the five seasons, these were generally not distinguishing factors in 2010/11. Similarly, univariate ANOVAs showed a significant difference in running distances covered across seasons, but the trend was for less activity in 2010/11.