Prevention of Patellar and Achilles Tendinopathies in Youth Basketball
Condition: Injury, Knee; Injury, Ankle; Tendinopathy; Sports Injuries in Children
MeSH terms: Tendinopathy; Wounds and Injuries; Athletic Injuries; Knee Injuries; Ankle Injuries
Study type: Interventional

Summary: 
      This study seeks to determine the prevalence of knee and ankle tendinopathies in youth
      basketball players, as well as determine the efficacy of a Basketball specific Neuromuscular
      training warm-up in reducing injuries.
    

Detailed description: 
      1. BACKGROUND & RATIONALE Basketball is one of the most popular youth sports in the United
           States and Canada. Knee and ankle injuries are the most common injuries in youth
           basketball (40%). Patellar and Achilles tendinopathies (PATs) are of particular concern
           in elite level basketball with a prevalence of 32% for patellar tendinopathy in elite
           male athletes (60% career prevalence). The risk for injury may be initiated in youth
           basketball where overuse injury incidence increases with age. Previously reported PAT
           injury rates likely underestimate the burden of overuse injury in youth basketball as
           current surveillance guidelines are optimized for acute injury and there are no
           guidelines on appropriate tendinopathy diagnosis in youth athletes. Current knowledge on
           basketball-related injuries (acute and overuse) in adolescent athletic community is
           sparse. Jump loads, landing mechanics, joint morphology and tendon structure changes may
           be predictive of tendinopathy. However, their consequences on PAT risk in basketball
           remain to be investigated using prospective cohort study methodologies. Encouragingly,
           the potential for mediating injury risk in youth sport through neuromuscular training
           programs has been demonstrated. A basketball specific neuromuscular training program
           (BSpecNMT) in turn may be efficacious for primary PAT prevention. Clearly, there is an
           urgent need to advance the current state of injury surveillance, prevention programs,
           sport-specific risk factors for PATs and structural consequences of PATs in youth
           basketball.

        2. RESEARCH OBJECTIVES Primary Objectives 1) To quantify the prevalence and severity of
           patellar and Achilles tendinopathies and assess associated risk factors in youth
           basketball (Year 1); and 2) To evaluate the efficacy of a BSpecNMT program in reducing
           patellar and Achilles tendinopathies and all injuries in youth basketball players (Year
           2 and 3).

        3. METHODS A Hybrid (effectiveness-implementation) Type 2 RCT design will be conducted.
           Teams will be randomized into either a comprehensive or standard intervention delivery
           group. All coaches will attend one pre-season coach workshop for the basketball specific
           neuromuscular (BSpecNMT) warm-up program. The workshop was led by a physiotherapist,
           athletic trainer, or strength and conditioning coach before the start of the season.
           During the pre-season coach workshop, coaches will take part in a theoretical and
           practical session about basketball injury prevention and warm-up exercises. Coaches in
           the both study groups will be instructed to carry out the 10-minute warm-up program at
           the beginning of all training sessions.

      In addition, the comprehensive intervention group will receive weekly visits at team
      practices from a research physiotherapist, athletic trainer, or strength and conditioning
      coach. These visits will provide the team guidance with the BSpecNMT warm-up to facilitate
      proper technique and appropriate progression of the BSpecNMT warm-up exercises.

      All teams will have their adherence to the BSpecNMT recorded on a weekly basis by a Team
      Designate. In addition, injuries will be prospectively monitored through a weekly self-report
      questionnaire, a post-season questionnaire (completed by players) and injury report form
      (completed by team designates). Also, Coaches' knowledge and attitudes to injury prevention
      will be registered by surveys during the pre-season, post-workshop, post-season, 6-month
      post-season, and 12-month post-season timepoints.
    

Intervention name(s): Comprehensive Follow-up; Standard Follow-up
Intervention type(s): Other; Other
Intervention description(s): Trained research staff members will provide weekly support to coaches on the NMT warm-up.; Research staff will monitor teams weekly, however no additional support for warm-up will be provided.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A Hybrid (effectiveness-implementation) Type 2 RCT design will be conducted. Teams will be randomized into either a comprehensive or standard intervention delivery group.
Masking: Double (Participant, Investigator)
Primary purpose: Prevention