Body Asymmetries in Athletes and Injury Risk
Condition: Musculoskeletal Injury
MeSH terms: Wounds and Injuries
Study type: Observational

Summary: 
      The study will assess the associations between various asymmetries (strength, flexibility,
      balance, etc.) in different athletes. After the measurements, injury occurrence will be
      tracked prospectively for 1 year, and retrospective analysis will be performed as well. The
      main aim of the study is to determine the asymmetries that impose the biggest injury risk for
      athletes.
    

Detailed description: 
      So far, the studies in the area of sport science have not thoroughly investigated the
      interrelations between different types or levels of body asymmetries, or determined the
      predictive power of asymmetries regarding injury risk. The conduction of this study will
      produce several original outputs. In short, the participants will be assessed for body
      asymmetries, and injury occurrence will be tracked both retrospectively and prospectively.

      Participants:

        -  athletes of different sports (not predefined)

        -  not currently injured

        -  no non-communicable diseases

        -  participates in sport for at least 2 years

        -  participates in competitive play / matches

      Test battery:

      The first part of our test battery will include the measurements of the structural
      irregularities. We will place a special emphasis on potential limb length discrepancy and
      pelvic alignment in frontal plane. When a noticeable deviations are seen, additional
      measurements of anthropometric characteristics will ensue.

      The second part of the tests will be designed to assess the asymmetries in motor abilities
      and function. The flexibility will be evaluated by assessing the passive range of motion in
      individual joints, using an electronic goniometer. We will include all motions that are
      performed in each joint (all major lower limb joints and trunk will be included). Each test
      will be repeated three times, with the best result (highest range of motion) taken as a final
      result.

      The ability to maintain a still single-leg stance with open eyes will be measured to evaluate
      static stability (main outcome parameters: velocity, amplitude and frequency of the centre of
      pressure). The dynamic stability will be assessed using similar parameters, captured after
      the landing on the force plate.

      Maximal strength and explosive strength will be measured in isometric conditions on purposely
      designed dynamometers. Maximal force and rates of force development on different time
      intervals will be recorded. The measurements will include the ankle (flexion and extension),
      the knee (flexion and extension), the hip (flexion, extension, abduction and abduction) and
      the trunk (flexion, extension, lateral flexion). Additionally, the eccentric strength of the
      knee flexors will be assessed.

      The last part of the measurements will include kinematic and kinetic evaluation of complex
      cyclic (cycling, running) and acyclic (jumps, landings) movement patterns. Lateral
      asymmetries during cycling will be measured using a diagnostic tool that records the forces
      and torques on the pedal, and by kinematics systems for tracking the motion of body regions.
      The pedals record the behaviour of the pressure exerted on the pedals during cycling,
      enabling us to evaluate the technique of the pedalling (mechanical efficiency) and amplitude
      (power). The kinematic analysis track the motion of the body. Dynamic and kinematic
      parameters are interrelated and often change simultaneously. Biomechanical properties
      (kinematic and dynamic) of running and jumps/landings will be recorded with a full-body
      motion capture solution that allows unconstrained movement of the subject and wireless
      transmission of measured quantities. Based on the measured motion and the acquired ground
      reaction forces, and the dynamic model of the human body, we will be able to calculate joint
      torques.

      Injury tracking:

        -  purpose-made questionnaires, including type, severity and recurrence of injury

        -  built based on previous questionnaires used in Sports Medicine

      Main outcomes:

        -  Injury rates in 1-year follow up and 1-year history

        -  Odds ratios between groups, based on presence of asymmetries
    

Intervention name(s): Asymmetry measurement
Intervention type(s): Other
Intervention description(s): There is no intervention, the study will prospectively assess associations between asymmetries and injury risk. Asymmetry measurement will be conducted, then injuries will be tracked.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Athletes at a competitive level, coming from different sports.
      
Keywords: asymmetry; pain; sport; injury; risk factor