bluuebunny/crossref_metadata_2025 huggingface dataset:
JUMPER'S KNEE: A PROSPECTIVE EVALUATION OF RISK FACTORS IN VOLLEYBALL PLAYERS USING AN OVERUSE MEASURE OF INJURY
Authors: MacDonald Kerry , Palacios-Derflingher Luz , Kenny Sarah , Emery Carolyn , Meeuwisse Willem H.
Published: August 2017

Background

A multitude of risk factors have been reported to increase an athlete's risk of developing jumper's knee. An overuse injury definition has been cited as more sensitive in capturing knee injuries when compared to a time-loss injury definition. To date, risk factors for jumper's knee have not been assessed for the development of knee problems captured by an overuse injury definition.

Objective

To assess a multitude of potential intrinsic risk factors for jumper's knee in volleyball players.

Design

Prospective Cohort.

Setting

Collegiate and national team training facilities.

Patients (or Participants)

Sixty elite adult male volleyball players were recruited from collegiate and national team programs in Canada.

Interventions (or Assessment of Risk Factors)

Participants completed risk factor assessments at the commencement of the season including: vertical jump ability (cm), weight bearing ankle dorsiflexion range (degrees), dynamic balance (cm), dynamic knee alignment (degrees) and landing mechanics (degrees).

Main Outcome Measurements

Self-reporting knee problems utilizing an overuse injury questionnaire collected via short message service (SMS) was completed prospectively over one season. Substantial knee problems were identified and logistic regression was used to estimate odds ratios for each risk factor independently.

Results

The season prevalence of knee problems was 75.0% (95% CI: 62.2 to 84.6) and the incidence proportion of those rated as substantial was 30.0% (95% CI: 19.5 to 43.1). The SMS system of tracking overuse injuries demonstrated 98.2% completeness. No single risk factor was found to predict substantial knee problems. All odds ratios were close to unity with narrow confidence intervals (0.91–1.07) and p>0.05.

Conclusions

A more sensitive capture of overuse knee injuries did not result in the identification of distinct risk factors for the development of jumper's knee. These findings bring question to the utility of field based pre-season risk factor assessment for the identification of at risk athletes.
IS SHOE DROP A KEY FACTOR FOR INJURY PREVENTION IN RUNNING? PART 1: AN RCT ON INJURY RISK
Authors: Malisoux Laurent , Chambon Nicolas , Urhausen Axel , Theisen Daniel
Published: August 2017

Background

Modern running shoes come in variable heel-to-toe drops, but it is currently unknown if this feature plays a role in the prevention of injuries.

Objective

To determine if the drop of conventional cushioned running shoes influences injury risk and whether running regularity (>6 months of regular practice over the previous year) modifies this association.

Design

Double-blind randomised controlled trial, with a 6-month follow-up.

Setting

Leisure-time distance runners.

Participants

Study participants (n=553) were recruited via advertisements in local newspapers. They were required to report any running activity, sport practice and injury using a dedicated internet platform.

Intervention

Running shoes with a drop of 10 mm (D10, n=176), 6 mm (D6, n=190) or 0 mm (D0, n=187). Apart from the shoe drop, the 3 versions were strictly identical. A stratified analysis was conducted according to the participants' running regularity.

Main Outcome Measurements

First running-related injury self-reported by the participants, and systematically verified by email or phone call. Cox regression analyses were used to compare injury risk between exposure groups.

Results

136 of the participants (25%) sustained at least one injury. The proportion of injured participants were 21.6%, 27.4% and 24.6% in the D10, D6 and D0 groups, respectively. The overall injury risk was not different among the participants who had received the D6 version (hazard rate ratios – HR=1.30; 95% confidence intervals −95% CI=0.86–1.98) or the D0 version (HR=1.17; 95% CI=0.76–1.80) when compared to the conventional D10 version. The stratified analysis revealed that low drop shoes (D6 and D0 grouped together) were associated with a lower injury risk in occasional runners (HR=0.48; 95% CI=0.23–0.98), and with a higher injury risk in regular runners (HR=1.67; 95% CI=1.07–2.62).

Conclusions

Overall, injury risk was not influenced by the drop of conventional cushioned running shoes, yet this association may be modified by the runner's profile.
CONGENITAL HEART DISEASES AND SPORT ACTIVITY: AN OBSERVATIONAL STUDY
Authors: Rosselli Martina , Toncelli Loira , Giannelli Chiara , Mascherini Gabriele , Galanti Giorgio
Published: August 2017

Background

Regular physical activity promotes the cardiovascular fitness and the physical and psychological health. However, exercise can acutely increase the cardiovascular risk in athletes with congenital and acquired heart disease. In Italy, pre-participation cardiovascular screening to obtain eligibility is mandatory for both agonistic and non-agonistic sports, whereas in the United States it is not requested.

Objective

In this study, we aimed at investigating the clinical characteristics of subjects with congenital heart diseases who requested the judgment of eligibility to sport practice at the Sport Medicine Center, University of Florence.

Participants

Over the period 2010–2016 approximately 3000 athletes aged 6–50 year-old per year underwent eligibility visits at our Center. We found 227 patients with Congenital Heart Disease.

Interventions

The eligibility visits included an accurate familiar and personal history and physical examination, basal ECG interpretation, Stress Test with treadmill or cycle-ergometer and basal echocardiography. The stress echocardiography can be especially helpful in athletes with cardiovascular disease, evaluating directly the effect of physical effort on heart by ultrasound.

Main Outcome Measurements

We considered age and sex, the presence of cardiovascular risk factors or familiarity for cardiovascular, the type of congenital disease, the type of sport and the ECG/echocardiography findings.

Results

Over the period 2010–2016 we assessed 227 athletes with congenital heart diseases, most of which were Bicuspid aortic valve (n=94), Ventricular Septal Defect (n=43); Atrial Septal Defect (n=27), Pulmonary Stenosis (n=15), Patent Ductus Arteriosus (n=14). The median age was 23.4 years (M/F=176/51).

Conclusions

We found a remarkable amount of patients with congenital heart disease who apply to obtain the judgement of fitness to practice sport. We are evaluating the data and deepening the study to comprehensively assess the demographical and clinical characteristics of these subjects and to evaluate the predictors of eligibility to sport practice in safety.
I WAS AN ACROBAT. AM I IN PAIN?
Authors: Martins Úrsula , Cunha João , França Lourenço , Amaro João , Gomes Joana , Aguiar Branco Catarina
Published: August 2017

Background

Acrobatic Gymnastics is a competitive discipline where gymnasts work together, perform acrobatic moves, dance and tumbling.

Objective

Investigate the prevalence of musculoskeletal (MS) disorders in former gymnasts.

Design

Survey of MS disorders (past and present), sent to former gymnasts.

Setting

This study included former gymnasts.

Participants

Retired gymnasts of national teams (n=200) and clubs (n=390) from all over the world (16 countries, 4 continents); 612 responders, 590 included according to the inclusion criteria.

Interventions

The survey included questions on country, gender, position, years of practice, hours of training/week and competition level, as well as medical information: reason for stopping practice (medical/nonmedical, specify the problem), injuries during practice years, present impact in daily life.

Main Outcome Measurements

Proportion (%) who stopped practicing as a consequence of a serious MS injury. Proportion (%) having any current MS disorder. Pre-specified analysis of relationship between training hours/week, competition level, position and % with current MS disorders in the present.

Results

Of 590 gymnasts, 294 (50%) reported having suffered a training injury, while 166 (28%) reported still having current medical problems as result of these. A total of 131 gymnasts (22%) reported having stopped practicing because of a medical problem and 121 (21%) reported having a current MS disorder. The most common injury was a traumatic fracture (n=125), most commonly affecting the knee (n=74) and ankle/foot (n=73). As a consequence of the training period, the most common current problems were spine pathology (n=43) and tendinopathies(n=38). Concerning actual symptoms, 402 (68%) reported low back pain, 320 (54%) knee and 219 (37%) shoulder disorders.

Conclusions

This is the first study of former gymnasts, allowing us to evaluate the impact of training on the future life quality of the athletes, to identify the most frequent injuries, as well as those with the greatest impact. This may lead to improvements in the treatment of acute injuries, as well as to monitor the level and quality of training, to prevent and also to rehabilitate injuries.
THE RISK FACTORS OF 5TH METATARSAL STRESS FRACTURE IN FOOTBALL PLAYERS
Authors: Matsuda Sho , Hirose Norikazu , Fukubayashi Toru
Published: August 2017

Background

No firm consensus has been established regarding the risk factors for stress fracture of the 5th metatarsal because of a lack of large-scale prospective studies.

Objective

The purpose of this study was to clarify the risk factors for a stress fracture of the 5th metatarsal.

Design

Cohort study.

Setting

Prospective study with well-trained varsity players.

Participants

One hundred and sixty healthy collegiate male football (soccer) players.

Assessment of Risk Factors

The medial lateral arch ratio of the foot, leg-heel alignment with weight-bearing (WLHA), LHA without weight-bearing (NLHA), relative angle of the forefoot to the hindfoot (FA-H), and plantar pressure during the heel raise position were measured. Rearfoot and forefoot alignment were evaluated from images using Image J. The plantar pressure distribution was measured using a plate-type lower limb GP-6000 weighted meter and pressure distribution-measuring MD-1000 device from Anima Co., Ltd.

Main Outcome Measurements

The measurements from players who were diagnosed with a stress fracture of the 5th metatarsal were compared with the measurements from non-injured players.

Results

Four players were diagnosed with a stress fracture of the 5th metatarsal. The arch ratio, WLHA, and FA-R of the injured players were higher than those of the non-injured players (17.8±0.21 vs. 1.68±0.26, −3.79±2.5° vs. −4.24±2.93°, 4.34±3.62° vs. 3.19±5.18°). The NLHA of the injured players was lower than that of the non-injured players (3.08±2.29° vs. 6.03±4.51°). The plantar pressure of the injured players tended to be located in a more lateral position compared with the non-injured players during heel raise (55.41±1.59% vs. 47.93±4.59%).

Conclusions

Stress on the lateral side of the foot during heel raise may cause stress fractures of the 5th metatarsal.
INJURY SURVEILLANCE OF AN ENGLISH PREMIER LEAGUE FOOTBALL CLUB ACADEMY BETWEEN 2012–2014
Authors: Bacon Christopher , Petersen Carl
Published: August 2017

Background

Published research into injury surveillance at English Premier League club (EPL) academies is scarce.

Objective

To investigate the injury incidence rate (IIR) across two EPL U21 seasons.

Design

Retrospective observational epidemiological cohort study.

Setting

An EPL academy.

Participants

Forty-one male professional football players (Age 17.8±1.1 y; Mass 73.7±5.9 kg; Height 178.3±5.3 cm).

Risk factor assessment

Over two seasons, 2012–2014, injuries were diagnosed by a qualified physiotherapist. Each season consisted of 42-weeks, with ∼6×1-hour training sessions plus 1-fixture per week, with an accumulated squad total of 8054 hours on-legs exposure. Injury variables included; site, type, contact/non-contact, activity at onset and severity classification (days lost; £7,38£14,315).

Main Outcome Measurements

IIR was defined as the number of injuries per 1000 hours of training and matches. Inter-season comparisons were completed through X2analysis.

Results

Eighty-three injuries occurred across two seasons; 2012–13 n=27 and 2013–14 n=56 (10.3 IIR). The ankle (n=26, 3.2 IIR) was the highest recorded injury site. Muscular overuse and sprains both had equivalent IIR (n=16, 2.0 IIR). Over half (57%) of all injuries were sustain in matches (n=47, 5.8 IIR). High severity injuries (n=28) had 7 and 12 times the total days lost of Medium (n=22) and Low (n=33) severity injuries, respectively. Injuries classed as non-contact occurred 8% more often than those involving contact (54% vs. 46%). Statistically significant differences resulted between seasons only for muscle strains (1 vs. 11, P=0.02), training (7 vs. 23, P=0.01) and low severity injuries (10 vs. 23, P=0.01).

Conclusions

We recommend cost effective targeted injury prevention programs for ankles, muscular overuse, muscular sprains and high severity injuries.
CAN ULTRASOUND IMAGING PREDICT THE DEVELOPMENT OF ACHILLES AND PATELLAR TENDINOPATHY? A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Auliffe Sean Mc , Creesh Karen Mc , O'Sullivan Kieran , Purtill Helen , Culloty Fiona
Published: August 2017

Background

Ultrasound [US] imaging is commonly used to visualise tendon structure. It is not clear whether the presence of structural abnormalities in asymptomatic tendons predicts the development of future tendon symptoms in the Achilles or patellar tendon. This led to considerable uncertainty in the management of sporting populations with a high prevalence of tendon related injuries.

Objective

To investigate the ability of US imaging to predict future symptoms of patellar or Achilles tendinopathy.

Design

A systematic review and meta-analysis.

Setting

Prospective imaging in a range of clinical settings.

Patients (or Participants)

The majority of the participants involved athletic populations ranging from volleyball, basketball, soccer players, fencing, badminton, ballet dancing, running.

Interventions (or Assessment of Risk Factors)

Prospective studies that performed US imaging of Achilles OR patellar tendon structure among asymptomatic subjects at baseline and a clinical measure of pain and/or function at follow-up were included.

Main Outcome Measurements

Tendon abnormalities were described as any deviation in tendon structure; e.g. hypoechogenicity, increased thickness, or increased vascularity as seen on power doppler US.

Results

The majority of participants in the review were from sporting populations. Meta-analysis revealed tendon abnormalities on US are associated with future symptoms of both patellar and Achilles tendinopathy [RR =4.97, 95% CI: 3.20–7.73]. Subgroup analysis indicated tendon abnormalities at baseline were associated with an increased risk of both Achilles [RR=7.33, 95% CI: 2.95–18.24] and patellar [RR=4.35, 95% CI: 2.62–7.23] tendinopathy.

Conclusions

This review indicates that tendon abnormalities US in asymptomatic tendons are predictive of future tendinopathy and are associated with at least a 4-fold increased risk. Identification of at risk athletes using screening tools such as US may allow preventative programs to be implemented. However, it is clear other factors beyond tissue structure are involved in the development of lower limb tendinopathy.
PADDED HEADGEAR IN CONTACT FOOTBALL – INERTIA OR MOMENTUM?
Authors: McIntosh Andrew , Patton Declan
Published: August 2017

Background

Regarding padded headgear worn in contact football (excluding American football), little has changed in terms of game laws, technical specifications or market supplied models over the last 15 years.

Objective

Assess the impact performance and potential for padded headgear to protect the head.

Design

Biomechanical. Impact energy attenuation drop tests with ISO “M” headform onto a rigid flat anvil and linear impactor tests on a Hybrid III head and neck.

Setting

Australian rules football, rugby union and rugby league.

Patients

None.

Interventions

Laboratory testing of eight padded headgear models – six commercial and two prototypes.

Main Outcome Measurements

The primary study outcome measures include peak headform linear (PLA) and peak angular (PAA) accelerations and the Head Injury Criterion (HIC).

Results

In centre-front 0.2 m drop tests, PLA values ranged from 367 to 592 g and HIC ranged from 780 to 2064 in commercial models. In contrast a prototype “Hexlid” model produced PLA of 53 g in the same tests and 172 in 0.3 m drop tests. In 4 m/s lateral linear impacts the bare headform PLA was 107 g and PAA 7.1 krad/s2. Commercial headgear PLA's ranged from 91 to 100 g and PAA 6.0 to 6.8 krad/s2for the same tests. In contrast the “Hexlid” model produced PLA of 65 g and PAA of 4.8 krad/s2. PLA in 0.2 m drop tests on commercially available headgear ranged from 251 to 538 g compared to 64 to 483 g in eight models tested under equivalent conditions and available in the late 1990s.

Conclusions

There is no indication that the commercially available headgear would be effective in reducing concussion risk. The performance of commercially available headgear has not improved since the 1990s. Prototype headgear show how impact performance can be improved. The test methods provide the basis for technical specifications.
METHODS TO ASSESS WEARABLE HEAD IMPACT RESPONSE DEVICES
Authors: McIntosh Andrew , Willmott Catherine , Mitra Biswadev , Brennan James , Dimech-Betancourt Bleydy , Howard Teresa , Rosenfeld Jeffrey , Patton Declan
Published: August 2017

Background

There is a growing range of wearable non-helmet mounted devices on the market and/or in use that purport to measure head impact responses. There is potential for these devices to be useful tools in research and injury management programs.

Objective

Describe methods for assessing the validity of wearable head impact response devices.

Design

Laboratory and qualitative observational methods. Tests on an exemplar wearable head impact response measurement “device” were undertaken in a laboratory using an instrumented Hybrid III head and neck and linear impactor. Football players in competitive matches wore the device and games were videoed. A qualitative protocol was applied to correlated device head impact events were those observed on video to examine sensitivity and specificity.

Setting

Contact sport.

Participants

Community level Australian football players.

Interventions

None.

Main Outcome Measurements

Head impact responses in vitro (linear and angular accelerations) and vivo (observed head impact characteristics).

Results

Laboratory head impacts were performed at a number of impact sites and velocities. Laboratory tests identified significant correlations (p<0.05) between in-headform measured peak resultant linear and resultant angular accelerations and HIC with the device measured parameters. However, the device estimates of HIC were incorrect by a factor of 2 and angular acceleration by a factor of 0.7. Linear acceleration measurement was more accurate, but lacked precision. Qualitative video analysis showed approximately 60% correlation of device measured >30 g in game head impact events with observed head impacts, but in 18% events were not correlated with any head impact, and there were other errors.

Conclusions

A combination of laboratory and field tests are critical in establishing the validity of wearable head impact response devices and should be performed as the first stage of research with these devices.
ADAPTED EVALUATION PROTOCOLS FOR TEENAGE ATHLETES COMPETING AT YOUTH OLYMPIC GAMES: SAFEGUARDING AND PROTECTING YOUNG CHAMPIONS
Authors: Adami Paolo Emilio , Squeo Maria Rosaria , Quattrini Filippo Maria , Paolo Fernando Maria Di , Pisicchio Cataldo , Ciardo Roberto , Verdile Luisa , Caselli Stefano , Maestrini Viviana , Spataro Antonio , Pelliccia Antonio
Published: August 2017

Background

Currently no clear indication are present for the pre-participation evaluation of adolescent elite athletes.

Objective

Our objective was to assess the efficacy of a tailored pre-participation evaluation protocol to assess health and eligibility of adolescent athletes, shortlisted for participation in the Youth Olympic Games.

Design Setting and Patients

Between 2010 and 2014, 247 adolescent elite athletes (53% females), mean age 16.3±1.01 years, competing in 22 summer and 15 winter sport disciplines, were evaluated through a tailored pre-participation protocol, which included 10 different health specialists.

Main Outcome Measurements

In 36 of the 247 athletes (14.5%), the pre-participation evaluation led to the final diagnosis of a pathological condition, including CV in 17 (6.8%), pulmonary in 11 (4.5%), endocrine in 5 (2.0%), infectious, neurological and psychiatric disorders in 1 each (0.4%). Among CV abnormalities, atrial septal defects were observed in 9 (3.6%), valvular diseases in 5 (2.0%), primary tachyarrhythmias in 2 (0.8%) and hypertension in 1 (0.4%). Pulmonary diseases consisted of allergic asthma, diagnosed in 11. Endocrine diseases included Hashimoto's Thyroiditis in 2, Hypothyroidism in 2 and Androgen Insensitivity Syndrome in the remaining subject. Hepatitis B, Epilepsy Syndrome and Panic Disorder represented the remaining diagnoses, each in one individual.

Results

Based on current National and International Recommendations, none of the athletes was considered at high risk for acute events and all were eligible to compete at the Youth Olympic Games. All athletes with pathological conditions or abnormal findings were required to undergo a periodic follow up.

Conclusions

The specific pre-participation evaluation protocol implemented proved to be effective in identifying a wide range of disorders, in a significant proportion (14.5%) of adolescent Olympic athletes. The presented protocol should be considered for early identification of a wide spectrum of diseases in this population of athletes, allowing prompt treatment and minimising health consequences.
CHARACTERISTICS OF ANKLE MUSCLE ACTIVITY DURING TILTING MOVEMENTS ON A WOBBLE BOARD
Authors: Morita Miho , Urabe Yukio , Fujii Eri , Moriyama Nobuaki , Yamamoto Takahiko , Takeuchi Takuya , Tsutsumi Shogo , Numano Shuhei , Suzuki Yuta , Maeda Noriaki
Published: August 2017

Background

Balance training is a common component of rehabilitation after ankle sprains. A relatively high activity of the peroneus longus (PL) to the activity of the tibialis anterior (TA) (a low TA/PL ratio) is reported as an effective muscle activity pattern during balance training to prevent inversion ankle sprains. To date, no research has investigated ankle muscle activity during tilting movements on a wobble board.

Objective

To assess the magnitude of muscle activity of the ankle while inversion and eversion movements of the ankle joint are performed on a wobble board.

Design

Single-session randomized repeated-measures study design.

Setting

University laboratory.

Participants

Seventeen young adults (11 females and 6 males) with no history of ankle injury.

Interventions

Participants performed tilting movements on a wobble board in a medial and lateral direction while balancing on their non-dominant leg. The frequency of the movement was set at 40 bpm. Muscle activity of the TA and the PL during five cycles of inversion-eversion movements were collected and stored for analysis.

Main Outcome Measurements

Normalized RMS EMG values (percentage of each participant's maximum voluntary isometric contraction; %MVIC) of the TA and PL, along with TA/PL ration in the inversion (wobble board tilted in the lateral direction) and eversion (wobble board tilted in the medial direction) phase.

Results

There was a significant difference in muscle activity of the PL (inversion phase; 41.6±15.3%MVIC, eversion phase; 59.2±21.5% MVIC, p<0.01) and TA/PL ratio (inversion phase; 52.6±22.3%, eversion phase; 34.1±16.3%, p<0.01). There was no significant difference in muscle activity of the TA (p>0.05).

Conclusions

The results of the present study indicate that tilting movements on a wobble board in the medial direction (eversion of the ankle joint) may be favorable as an exercise modality after inversion ankle sprains as a high PL activity and a low TA/PL ratio was acquired.
THE FUNCTIONAL MOVEMENT TEST 9+ IS A POOR SCREENING TEST FOR LOWER EXTREMITY INJURIES IN PROFESSIONAL MALE FOOTBALL
Authors: Bakken Arnhild , Targett Stephen , Bere Tone , Cristiano Eirale , Aziz Farooq , Johannes Tol , Rod Whiteley , Karim Khan , Roald Bahr
Published: August 2017

Background

The Nine Plus screening battery test (9+) is a series of 11 tests, used to assess limitations in fundamental movement patterns assumed to predispose athletes for injury.

Objective

To examine the association of the 9+ with lower extremity injuries, and to identify the optimal cut-off point for risk screening.

Design

Prospective cohort study.

Setting

Professional football league.

Participants

Male professional football players in Qatar.

Interventions

The 9+ test was performed prior to the 2013 and 2014 seasons. Time-loss injuries and exposure in training and matches were registered prospectively by club medical staff during 2 consecutive seasons. Univariate and multivariate regression analyses were used to calculate odds ratios (ORs), risk ratios (RR) and 95% confidence intervals (CIs). Receiver operating characteristics (ROC) curves were calculated to determine sensitivity and specificity, and identify the optimal cut-off point for risk assessment.

Main Outcome Measurement

Lower extremity injuries.

Results

In total, 363 players completed the 9+ and had injury and exposure registration. There were 527 injuries among 204 players (56.2%) during the 2 seasons; injuries to the thigh were most frequent. There was no association between 9+ total score and the risk of lower extremity injuries (OR, 1.02; 95% CI, 0.98–1.06;P=0.44), even when adjusted for exposure (RR, 1.04; 95% CI, 0.98–1.12;P=0.21) or other factors in a multivariate analysis (OR, 1.04; 95% CI, 0.97–1.06; P=0.60). ROC curve analysis revealed an area under the curve of 0.48 for lower extremity injury. No optimal cut-off point to distinguish between injured and non-injured players could be determined.

Conclusions

The 9+ total score was not associated with lower extremity injury. The 9+ total score was no better than chance for classifying injured and non-injured players. Therefore, the 9+ test cannot be recommended as a screening tool in this population.
THE USE AND MODIFICATION OF INJURY PREVENTION EXERCISES BY PROFESSIONAL YOUTH SOCCER TEAMS
Authors: O'Brien James , Young Warrren , Finch Caroline
Published: August 2017

Background

The efficacy of injury prevention exercise programs (IPEPs) for amateur youth soccer has been established, but little is known about their adaptability to other soccer populations.

Objective

This study aimed to assess the use of individual injury prevention exercises by professional youth soccer teams, against the industry-standard, FIFA 11+ program.

Design

Prospective observational study.

Setting

A European professional youth soccer academy.

Participants

Soccer coaches, fitness coaches and physiotherapists (n=18) from four teams.

Data collection

The teams' chosen IPEPs (total 160 sessions) were observed across one season and documented on a standardized form. The use of each FIFA 11+ exercise was coded as “performed” (in its original form), “performed modified” or “not performed”.

Main Outcome Measurements

The primary outcome measure was the proportion of the 160 observed sessions containing each individual exercise in original or modified forms. The secondary outcome measure was the staff members' reasons for using and modifying FIFA 11+ exercises.

Results

On average, individual FIFA 11+ exercises were conducted in original form in 12% of the sessions (range 0–33%), and in modified form in 28% of sessions (range 2–62%). The five most frequently observed exercises, in either original or modified form, were “bench” (72%), “squats” (69%),“running straight” (68%), “single-leg stance” (66%), and “sideways bench” (64%). Staff modified exercises to add variation, progression, and individualization, and to align with specific training formats and goals.

Conclusions

Professional youth soccer teams often use injury prevention exercises similar to those in the FIFA 11+, but tailor them considerably to fit their implementation context. These findings will inform the design and delivery of future, context-specific IPEPs.
CONCUSSIONS IN JAPANESE HIGH SCHOOL RUGBY PLAYERS: RESEARCH ON INJURIES, SYMPTOMS, AND SIGNS
Authors: Otomo Mana , Torii Shun , Yamada Mutsuo , Fukubayashi Toru
Published: August 2017

Background

In Japan, sports-related concussions have been a subject of active research in recent years. Among sports played in Japan, concussions occur most frequently in rugby football.

Objective

The purpose of this study was to investigate the status of concussions in high school rugby players, with the intent of prevention.

Design

Subjects were Japanese high school rugby players.

Setting

The subjects were evaluated at a clinic in Sugadaira, a revered venue for rugby training in Japan, attended by teams from all over the country. Subjects were 178 high school rugby players who were diagnosed with concussion within 2 hours of injury. Information about the concussion was obtained from the injured player and a witness. Symptoms and disturbances of consciousness after concussion were evaluated using the Sport Concussion Assessment Tool 3 (SCAT3), in an interview format.

Results

A total of 93% of subjects has been injured during a match, and 43% had a history of concussion. The contact site was the head in more than 90% of cases, with the forehead in 38%, the side of the head in 30%, the back of the head in 21%, the top in 5%, and an unknown site in 6%. The concussion occurred while performing a tackle in 61% cases, and when being tackled in 30%; the cause was uncertain in 9% cases. Symptoms were present in 94% of the subjects on SCAT3 evaluation. The most common symptom was headache (84%). Loss of consciousness occurred in only 15%, but 72% had some loss of memory.

Conclusions

The most common circumstance of concussion involved head contact was when tackling an opponent. Concussion was associated with subjective symptoms and the loss of memory more often than the loss of consciousness.
SPORTS AND EXERCISE SAFETY IN FINLAND – LIVE: AN IMPLEMENTATION PROGRAM TO SPORT CLUBS AND SCHOOLS
Authors: Parkkari Jari , Pasanen Kati , Jussila Anne-Mari , Oksanen Raija , Ojala Anna , Autio Katariina , Kannus Pekka
Published: August 2017

Background

The number of sports injuries has increased in Finland during the past decades. In 2009 there were 337.000 sport injuries in Finland. Children, youth and especially young men are at high risk.

Objective

The purpose of the LiVE program is to prevent sports injuries in Finland.

Design

Prospective cohort.

Setting

Nationwide injury prevention programme.

Participants

All sports clubs and elementary schools in Finland.

Interventions

Multidisciplinary prevention programme of evidence based methods. Implementation of the national and international study findings are conducted in three main projects; Healthy Athlete (2006–), Safety in School Sports (2010–) and Smart Moves (2014–). The primary target groups are young athletes, their coaches and parents, elementary and vocational school pupils and their teachers. Programs main communication channels are websites: www.terveurheilija.fi, www.tervekoululainen.fi and www.smartmoves.fi.

Main Outcome Measurements

Number of sports injuries in Finland.

Results

The program has educated over 80 tutors and 50 sports nutritionist. The Tutor Network and Sport Nutrition Society share the same education materials and injury prevention strategies. Purposes of networks are to implement preventive strategies against sport injuries among target groups by offering education and counselling by local experts. LiVE program has also introduced itself to projects' target groups in numerous events and organized several seminars. LiVE websites and expert intranet offers a large source of information and practical tools. Nationwide number of injuries will be monitored next time in the beginning of the year 2017.

Conclusions

Successful development and implementation of preventive strategies against sports injuries are likely to reduce athletes' health problems, sport, work and school absenteeism, and medical costs. This study shows the that an implementation program can be introduced nationwide. Future studies will determine the effects of the LiVE programme on the number of injuries.
HELMET FIT IN YOUTH ICE HOCKEY
Authors: Patton Declan , Blackmore Shelby , Hagel Brent , Emery Carolyn
Published: August 2017

Background

Appropriate helmet fit is thought to contribute to the protective effect of helmets in reducing the risk of concussion in sports. Only one previous study has evaluated helmet fit in youth ice hockey; however, inter-rater reliability was not assessed.

Objective

To evaluate helmet fit in youth ice hockey players and assess inter-rater reliability of helmet fit criteria.

Design

Self-report and observational evaluations.

Setting

2016 Hockey Calgary Summer Day Camps.

Participants

Canadian youth (11–18 years) ice hockey players.

Methods

Helmet fit criteria were developed from previously published ice hockey, skiing, snowboarding and motorcycle helmet fit criteria. A total of 60 players underwent self-report and observational helmet fit evaluations by two independent assessors. Inter-rater reliability was assessed using descriptive statistics and Cohen's kappa coefficient.

Results

Most players rated helmet fit (90%) and comfort (87%) as ‘excellent’ or ‘good’. Most helmets (93%) and cages (84%) displayed the Canadian Standards Association (CSA) sticker or stamp. Only 23% of players satisfied all helmet fit criteria for both assessors; however, 70% of players failed three or fewer criteria across the evaluations of both assessors. The most commonly failed helmet fit criterion was ‘crown of helmet is 1–2 fingers above eyebrows’, which was failed by 22% of players. For inter-rater reliability, the most commonly disputed helmet fit criterion was ‘helmet does not cover eyes when pressing down’, which was disagreed upon by the assessors for 33% of players; however, all other criteria were agreed upon for over 80% of players. Substantial agreement (K>0.8) was found for 19% of helmet fit criteria, whereas 50% of criteria had little agreement beyond chance (K<0.2).

Conclusions

The majority of youth ice hockey players did not satisfy all helmet fit criteria for both assessors. The association between helmet fit and concussion needs to be investigated.
INCIDENCE AND RISK FACTORS OF INJURIES IN BRAZILIAN ELITE VOLLEYBALL PLAYERS: A PROSPECTIVE COHORT STUDY
Authors: Pimenta Rafael M , Junior Luiz C Hespanhol , Neto João A Grangeiro , Lopes Alexandre D
Published: August 2017

Background

Volleyball can be considered one of the most popular sports. Prospective studies aimed at investigating the incidence and risk factors of volleyball injuries are scarce.

Objective

To investigate the incidence and risk factors for volleyball injuries among Brazilian elite volleyball players.

Design

20-week prospective cohort study.

Setting

Brazilian elite national league (2015–2016).

Participants

13 Brazilian elite volleyball teams (208 players): 7 male teams (116 players) and 6 female teams (92 players).

Assessment of Risk Factors

Volleyball exposure (hours and sessions of training, strength training and number of matches) and injuries were recorded weekly by the medical team.

Main Outcome Measurements

Injury during the follow-up period.

Results

196 injuries were reported among 96 athletes. The overall injury incidence was 4.8 injuries/1000 hours of training and 18.6 injuries/1000 matches. Overuse injuries (65.3%, n=128) were more common than acute injuries (33.7%, n=66). Knee (28.5%, n=50) and shoulder (9.8%, n=19) were the body regions most affected by overuse injuries. Ankle (6.2%, n=12) and shoulder (5.6%, n=11) were the body regions most affected by acute injuries. Tendinopathy (23.7%, n=46) was the overuse injury type most observed, and ankle sprain (7.2%, n=12) was the acute injury type most observed. Female athletes (OR: 0.50, CI 95%: 0.31–0.80) and additional training sessions (OR: 0.74, CI 95%: 0.60–0.91) were associated with a lower risk of injury. Previous injury (OR: 2.18, CI 95%: 1.40–3.38), and an additional hour of training (OR: 1.18, CI 95%: 1.05–1.32) were associated with a higher risk of injury.

Conclusions

This study showed that male gender, an additional hour of training, and a history of previous injury were the most significant risk factors for developing a new injury. However, additional training session was associated with lower considered risk of injury.
OVERUSE PROBLEMS IN ICELANDIC MALE HANDBALL
Authors: Rafnsson Elis Thor , Myklebust Grethe , Bahr Roald , Frohm Anna , Valdimarsson Ornolfur , Arnason Arni
Published: August 2017

Background

The majority of studies in handball register only time loss injuries. From previous studies and our experience working with handball players we know that playing with overuse problems are common and such symptoms can affect their performance.

Objective

To register the prevalence of overuse problems in low back, knee and dominant shoulder among Icelandic male handball players using questionnaire designed by OSTRC in Oslo, Norway.

Design

Prospective cohort study. Players from the two highest division in Iceland were invited.

Setting

Icelandic elite male handball players.

Patients (or Participants)

Out of 14 elite male handball teams invited, totally 229 players from 13 teams participated. The first questionnaire was answered by 206 players; 137 answered the final one.

Interventions (or Assessment of Risk Factors)

The questionnaire was distributed sixteen times to players via e-mail, every second week from September 25th 2012 to April 22nd 2013.

Main Outcome Measurements

The prevalence of overuse problems (every problems registered) and substantial problems (problems affecting performance or participation) were calculated for knee, low back and dominant shoulder. This was done for each questionnaire by dividing the number of players that reported problems (overuse or substantial overuse) by the total number of respondents.

Results

The response ratio was 71.5%. During the research period 91% of participants reported overuse problems and 61% reported substantial overuse problems. The average prevalence of overuse problems was 34% (31–37 95% CI), varying from 21–47%, highest during the pre-season period (September 25th to October 8th). The average prevalence of substantial overuse problems was 12% (10–14 95% CI), varying from 6–15% over the research period.

Conclusions

Substantial overuse problems are constantly affecting many players during the season. High prevalence in the first two questionnaires raises speculations about the training methods during the pre-season.
A 12MM, IN-SHOE ORTHOTIC HEEL LIFT ADDED TO STANDARD RUNNING SHOES LOWERS ACHILLES TENDON LOADING
Authors: Bartold Simon
Published: August 2017

Background

Orthotic heel lifts are thought to lower tension in the Achilles tendon, but the evidence supporting this is equivocal.

Objective

To investigate the effect of a 12 mm in-shoe orthotic heel lift on Achilles tendon loading using transmission mode ultrasonography.

Design

Controlled study.

Setting

Laboratory.

Patients (or Participants)

12 active males.

Interventions (or Assessment of Risk Factors)

The propagation speed of ultrasound, which is governed by the elastic modulus and density of tendon and proportional to the tensile load to which it is exposed, was measured in 12 recreationally active men, during shod treadmill walking at matched speeds (3.4 +/− 0.7 km/h), with and without the addition of a heel lift. Vertical ground reaction forces and spatiotemporal gait parameters were simultaneously recorded. Data were acquired at 100 Hz during 10 seconds of steady state walking.

Main Outcome Measurements

Ultrasound transmission speed maxima (P1, P2) and minima (M1,M2) in the Achilles tendon, vertical ground reaction force peaks, step length, and cadence.

Results

Ultrasound transmission speed in the Achilles tendon was characterised by 2 maxima (P1,P2) and minima (M1,M2) during walking. Addition of a heel lift to footwear resulted in a 2% increase and a 2% decrease in the first vertical ground reaction force peak and the local minimum respectively (P< 0.05). Ultrasonic velocity in the Achilles tendon (P1, P2, M2) was significantly lower with the addition of an orthotic heel lift (P<0.5).

Conclusions

Peak ultrasound transmission speed in the Achilles tendon was lower with the addition of a 12 mm orthotic heel lift, indicating that the heel lift reduced tensile load in the Achilles tendon, thereby counteracting the effect of footwear observed in previous studies. These findings support the addition of orthotic heel lifts to footwear in the rehabilitation of Achilles tendon disorders where management aims to lower tension within the tendon.
THE EFFICACY OF FIFA 11+OVER A 6-YEAR PERIOD, IN ADOLESCENT FOOTBALL PLAYERS
Authors: Saho Yasuaki , Kato Haruyasu , Chikako Nakahori , Ikeda Hiroshi , Fukubayashi Toru
Published: August 2017

Background

FIFA 11+ program has been shown to reduce the risk of injury in football players, but it has not been evaluated in adolescent Japanese players.

Objective

To investigate the effects of FIFA 11+on the risk of injury in adolescent Japanese football players.

Design

Cohort study.

Setting

Six male and 4 female Japanese Under-18 (age: 16–18 yr.) and Under-15 (age: 13–15 yr.) football teams were followed for six seasons (from 2010 to 2015). The 2010 season was considered as the control season, with the players practicing their usual warm-up techniques. Throughout the seasons from 2011 to 2015, the players exclusively performed FIFA 11+; these 5 seasons were considered the intervention seasons.

Participants

A total of 2,344 athletes (1,815 male, 529 female; age: 12–18 yr.).

Interventions

FIFA 11+program was conducted at least twice per week, throughout the intervention seasons.

Main Outcome Measurements

For each of the three categories: football [matches+trainings], matches, and trainings, the injury rates were reported as the number of injuries per 1000 player-hours (1000PH).

Results

In males, the injury rate during football, the matches, and the trainings were 4.0, 8.9, and 3.4 in the control season, and 2.4, 6.9, and 1.8 in intervention seasons (mean values from 2011 to 2015), respectively. In females, the injury rates during football, the matches, and the trainings were 2.7, 2.2, and 7.5 in the control season, and 3.1, 2.6, and 8.9 in intervention seasons (mean values from 2011 to 2015).The injury rates were reduced significantly in the intervention seasons, compared with the control season in males, but not in females. Non-contact injuries were significantly reduced in both genders.

Conclusions

FIFA 11+program reduced the risk of injury in adolescent Japanese male football players, and reduced non-contact injuries in adolescent Japanese female football players.
RESTRICTION IN HIP INTERNAL ROTATION AND 5TH METATARSAL STRESS FRACTURES (JONES FRACTURE) IN PROFESSIONAL FOOTBALL PLAYERS
Authors: Saita Yoshitomo , Nagao Masashi , Kobayashi Yohei , Kobayashi Keiji , Ikada Hiroshi
Published: August 2017

Background

Fifth metatarsal stress fracture (Jones fracture) is one of the issues of sports-related injuries.

Objective

Exploration of unknown risk factor for developing Jones fractures.

Design

Case control study.

Setting

Retrospective cohort study in male Japanese professional football (soccer) players.

Patients (or Participants)

Case control study conducted between with (n=20) and without (n=40) the history of Jones fractures.

Interventions (or Assessment of Risk Factors)

Reviewed the medical check data regarding the joint and muscle tightness at the time they joined the team, and compared them between two groups.

Main Outcome Measurements

Risk factors to develop developing Jones fracture.

Results

The mean age sustaining Jones fracture was 20.5 years old (95% CI, 19.1–21.8, range 17–28). The fracture occurred in their non-dominant (standing) legs in 60% (12/20) of players. Among the physical examination data, Hip internal rotation (HIR) was significantly restricted in players with history of Jones fracture (25.9 degrees on average) compared with those without Jones fractures (40.4 degrees, p<0.0001). Logistic regression demonstrated that the wider range of HIR was associated with a statistically significantly decreased odds of Jones fracture (OR=0.83, 95% CI=0.75–0.91), while other physical examination data were not significant. A post-estimation analyses demonstrated that a 10-degree reduction in HIR of the right hip significantly increased the odds of Jones fracture in ipsilateral or contralateral foot (OR=3.11, 95% CI=1.35–7.16, and OR=2.24, 95% CI=1.22–4.12, respectively). Similarly, a reduction in HIR of the left hip significantly increased the odds of Jones fracture in ipsilateral or contralateral foot (OR=2.77, 95% CI=1.08–7.08, and OR=4.88, 95% CI=1.56–15.28, respectively).

Conclusions

Restriction of HIR was significantly associated with increased risk of Jones fracture in professional football players in Japan.
NEUROMUSCULAR CONTROL ADAPTATIONS TO BALANCE TRAINING: A SYSTEMATIC REVIEW
Authors: Sato Sheila Miho
Published: August 2017

Background

Balance training (BT) programs seem to be appropriate for non-athletes and athletes, but the use of multi-intervention BT protocols make difficult to observe how balance exercises improve neuromuscular control.

Objective

The purpose of this study is to evaluate the current knowledge regarding the neuromuscular control adaptations in healthy participants following a BT protocol with exclusively balance exercises.

Design

Systematic review.

Setting

Randomised controlled trials and controlled clinical trials.

Patients (or Participants)

Healthy and physically active participants.

Interventions (or Assessment of Risk Factors)

The methodological quality and risk of bias were assessed using a modified Downs and Black checklist.

Main Outcome Measurements

The primary outcome is the measurements of electromyography (EMG) activity, like the rate of muscle activation, H-reflex, and M-wave.

Results

There were inconsistent findings regarding neuromuscular control outcomes. In relation to muscular activity observed by EMG signs, there was no change in the majority of the studies. However, one study reported a decrease in EMG activity for plantar flexors, and two studies observed an increase in muscular activity for soleus, gastrocnemius medialis, and quadriceps muscles after BT. Concerning H-reflex/M-wave ratio of the soleus muscle, two studies observed no change, while three studies reported significant reduction. Also, the reduction observed in the H-reflex/M-wave ratio was associated with a decrease of the maximal H-reflex and no change of the maximal W-wave. Following BT, the rate of force development normalized by maximum voluntary contraction (MVC) had a transient increase for plantar flexors and leg extensors. Although some authors reported a slight enhancement or no improvement on isometric MVC for plantar flexors, leg extensors, quadriceps, and hamstrings muscles.

Conclusions

Despite the moderate level of proof for neuromuscular control enhancement following BT, adaptations in neuromuscular control remain a significant factor to determine an appropriate exercise that would improve specific athletic performance.