bluuebunny/crossref_metadata_2025 huggingface dataset:
Text messaging as a new method for injury registration in sports – a methodological study in elite female football
Authors: Nilstad A , Bahr R , Andersen T E
Published: March 2011

Background

Injury registration is a necessary first step of injury prevention research in sports. However, inconsistencies in injury definitions and recording methods may have contributed to discrepancies in injury rates reported. Previous studies have traditionally been based on injury reporting by team medical staff.

Objective

To evaluate a novel methodology employing text messaging (SMS) by players to record injuries, comparing it to routine injury registration by team medical staff.

Design

Prospective study.

Methods

All teams in the Norwegian elite female football league (N=12, 205 players) reported injuries and exposure in training and matches throughout the 2009 football season (April-November). For the individual registration, we used a new SMS tracking system; all players received three messages once weekly with questions on exposure and injuries. Players reporting time-loss injuries were contacted to complete an injury form through a telephone interview. A designated member of the team medical staff also recorded injuries and team exposure throughout the season.

Results

We compared data from teams with complete registrations (n=9, 159 players). A total of 232 time-loss injuries were reported; 62% were recorded by individual registration only, 28% by both methods, and 10% by medical staff only. Knee injuries dominated (26%), but only 41% were captured through medical staff reports. The most frequent injury type was ligament injuries (22%), of which 38% were reported by the medical staff. Of the severe injuries (absence >28 days), 31 (50%) were identified from medical staff reports.

Discussion

The medical staff reports underestimated the incidence of time-loss injuries by two-thirds in our setting, which emphasises the importance of individual registration to increase the accuracy of injury incidence in team sports.

Conclusion

A new method employing text messaging by players to record injuries gave a more complete picture of injuries to elite female football players than team medical staff registration.
The influence of climate type on injury epidemiology in european professional football
Authors: Waldén M , Hägglund M , Kristenson K , Ekstrand J
Published: March 2011

Background

The influence of different weather conditions on injury risk has only been scarcely investigated.

Objective

The objective was to study the influence of climate type on injury epidemiology in men's professional football in Europe.

Design

Prospective cohort study.

Setting

Men's professional football from nine European football associations.

Participants

24 clubs followed over a varying number of seasons from 2001/2002 to 2008/2009.

Assessment of risk factors

The assessed risk factor was the climate type according to the Köppen-Geiger Climate Classification System. This system is divided into five climate types based on the average monthly temperature and precipitation. The dominating climate types in Europe are the Mediterranean, the Marine West Coast (MWC), the Humid Continental, and the Subarctic types.

Main outcome measurements

The main outcome measure was the difference in time-loss injury incidence between clubs with Mediterranean (MED) and MWC climate types expressed as a rate ratio (RR) with 95% CI.

Results

Excluding one club belonging to the Humid Continental climate type, there were 16 clubs in MWC group (61 team-seasons) and seven clubs in the MED group (40 team-seasons). The MED group had significantly lower incidence of training (3.5 vs 4.4/1000 h, RR 0.79, 95% CI 0.72 to 0.86) and match (25.5 vs 29.1/1000 h, RR 0.88, 95% CI 0.81 to 0.94) injuries. There were no differences for severe injuries (RR 0.95, 95% CI 0.82 to 1.09), strains (RR 1.05, 95% CI 0.95 to 1.15) or sprains (RR 0.89, 95% CI 0.78 to 1.02). However, the incidence of anterior cruciate ligament (ACL) injury was higher (0.087 vs 0.042/1000 h, RR 2.07, 95% CI 1.10 to 3.90) in the MED group, especially for non-contact ACL injuries (0.083 vs 0.012/1000 h, RR 6.72, 95% CI 2.53 to 17.83).

Conclusion

Clubs with a Mediterranean climate type had lower injury risk in general, but a substantially higher risk of non-contact ACL injury.
An overview of interventions designed to reduce risk factors for sport injury
Authors: McBain K , Shrier I , Shultz R , Meeuwisse W H , Klugl M , Garza D , Matheson G O
Published: March 2011

Background

While physical activity is associated with an overall reduction in mortality, morbidity and an improved quality of life, it also increases the risk of injury and illness.

Objective

To identify gaps in the literature with respect to interventions designed to reduce risk factors for sport injury.

Design

Review.

Databases

PubMed, Cinahl, Web of Science, Embase, and Sports Discus were searched.

Setting

All ages, sex, levels of competition and Olympic sports were included.

Main outcome measurement

Pattern of publications over time stratified by study design, intervention type, sport and anatomic site.

Results

Only 144 of 2525 articles retrieved by the search strategy met the inclusion criteria. Cross-over study designs increased by 175% since the late 1980's until 2005 but have declined 32% since. Randomised controlled trial (RCT) study designs increased by 650% since the early 1990's. Protective equipment was the focus of 61.8% of the studies and training the remaining 35.4%. Equipment research studied stability devices (83.1%) and attenuating devices (13.5%) while training research studied balance and coordination (54.9%), strength and power (43.1%) and stretching (15.7%). Almost 92.1% of the studies were of the lower extremity and 78.1% were of the joint (non-bone)-ligament type. 57.5% of the reports studied contact sports, 24.2% collision, and 25.75% non-contact sports.

Conclusion

We were surprised to find only 144 publications examining interventions designed to reduce risk factors for sport injury. The decrease in cross-over study design and increase in RCTs indicate a shift in research focus. Most notable was the finding that studies using equipment interventions have been decreasing since 2000 (35% decline) while those using training interventions have been increasing (213% increase).
Evidence in practice: an overview of effective measures to prevent sports injuries
Authors: Vriend I , Kemler E
Published: March 2011

Background

Many studies have been performed to gain insight into the effectiveness of measures and training programs to prevent sports injuries. An overview of effective measures is essential in order to translate research results into policy recommendations and interventions, together with insight in potential barriers and possibilities for these measures to be used in real-life.

Objective

Gain insight in current scientific knowledge with regard to the effectiveness of sports injury prevention measures and give recommendations for the use by the athletic population on a national level. Results are published in the European database on injury prevention (http://www.eurosafe.eu.com) and made generally known to the Dutch target population.

Design

Literature was searched systematically and reviewed independently by two researchers on methodology and relevance as an update of a previous study performed in 2000. The results were reviewed by 15 (inter)national experts (sport scientists and/or sport physicians). If research was lacking or contradictory, experts' opinion was used as a guideline.

Intervention

20 Primary preventive measures were selected that can be used by sport athletes and trainers, including taping and bracing, personal protective equipment, shoe features, warm-up, stretching, and various training programs. Measures are evaluated as single interventions or part of multifaceted training programs.

Main outcome measurements

Indications of effectiveness to prevent sports injuries and recommendations for practice and further research are given for every measure.

Results

Based on controlled study designs, only six measures have been proven to be effective for the prevention of sports injuries. Implementation of these measures in real-life is strongly recommended. Several measures lack sufficient evidence.

Conclusion

This study emphasises the need of additional research on the efficacy of several measures, and especially to evaluate the effect in real-life on compliance, behaviour and number of injuries. Currently, pilot studies are performed in the Netherlands to evaluate these effects in new interventions.
Radiological evidence of femoroacetabular impingement in asymptomatic athletes
Authors: Abellàn J , Esparza F , Blanco A , Martínez M , Merino G Ruiz , Lisón A
Published: March 2011

Background

Femoroacetabular impingement (FAI) has been stated as one of the main causes of early osteoarthritis in the hip. This is particularly important in young athletes. However, there are no data available about the prevalence of radiological signs of FAI in the asymptomatic population. These data would improve the evaluation of athletes with groin pain to prevent further injuries.

Objective

The aim of this study is to show the prevalence of radiological signs of FAI in non-symptomatic athletes.

Design

Descriptive study.

Setting

Soccer and basketball players enrolled in elite division leagues.

Participants

Players were selected from the teams of the Federation of Soccer and Basketball of Murcia.

Interventions

Participants were clinical and radiologically evaluated. Clinical exam included: range of motion, and anterior and posterior hip impingement tests. Radiological exam included both anteroposterior radiographs of the pelvis and axial (frog-leg) views of both hips.

Main outcome

Radiographs were assessed to detect signs of FAI (both cam and pincer type). These signs were: pistol grip deformity (PG), coxa vara, alfa angle higher than 50°, anterior offset ratio (OR) lower than 0.18, coxa profunda/Protasio acetabuli (CP/PA), acetabular index lower o equal to 0°, cross-over sign (CO), and posterior wall sign (PW).

Results

80 athletes were evaluated (mean (SD) age 24.43 (3.21)). PG was present in the 28.8%, alfa was higher than 50° in the 43.8%, CP/PA was detected in the 41.25%, CO was seen in the 25%, and PW in the 8.8%. Clinical signs of FAI, that is, groin pain with provocative test, were positive in the 13.8% of the patients.

Conclusion

Radiological evaluation shows a high prevalence of signs of FAI in athletic population. However, clinical signs are only present in a few of them.
Injury potential evaluation of the upper extremity and torso of three tennis serve types using a novel markerless motion system
Authors: Abrams G , Sheets A , Corazza S , Andriacchi T , Safran M
Published: March 2011

Background

The tennis serve is the most common stroke in tennis and is the single stroke most associated with musculoskeletal injury in tennis. Previous investigations have utilised marker-based systems which are prone to error and also have not evaluated all three types of serves.

Objective

Utilise a novel markerless video system to determine whether the kick and slice serves produced greater forces/torques about the torso and upper extremity versus the flat serve.

Design

Single recording session.

Setting

Outdoor regulation tennis court.

Participants

Seven NCAA Division I male tennis players.

Interventions

Three successful flat, kick, and slice serves.

Main outcome measurements

Back extension angle; total forces at back, shoulder, elbow, and wrist.

Results

Maximum back extension angle was significantly higher for the kick serve versus the slice (40.5 vs 37.3°; p=0.01) while there was a trend towards significance in the kick compared to the flat serve (40.5 vs 38.6°; p=0.096). Maximum external rotation of the shoulder was not significantly different between flat, kick, and slice serves (89.8 vs 90.1 vs 91.5°; p>0.67). The kick serve showed greater total back force (2974 vs 2138 vs 2568 N; p<0.05) and posterior shoulder force (1370 vs 809 vs 741 N, p<0.05) versus the flat and slice. The slice serve demonstrated lower torques at the elbow (71.1 vs 87.0 vs 89.3 N-m; p<0.05) and wrist (20.9 vs 33.5 vs 27.9 N-m; p<0.05) compared to the flat and kick serves.

Conclusion

The kick serve places higher stresses on the back and shoulder while the slice is the least injurious to the elbow and wrist. This data may help provide guidelines for injury prevention, rehabilitation, and possibly for return to play after injury or surgery.
Can specific treatment prevent progressive tendon degeneration?
Authors: Alfredson H
Published: March 2011

Background

Tendon degeneration is generally believed to be irreversible.

Objective

To use ultrasound to study the Achilles midportion tendon structure and thickness before and after treatment of chronic painful tendinosis.

Design

Prospective study.

Patients and interventions

Middle aged patients on varying activity levels, having midportion chronic Achilles tendinosis, were followed with ultrasound examinations before and after treatment with eccentric training, sclerosing polidocanol injections and surgical scraping.

Outcome measurements

Tendon thickness and structure.

Results

89 patients successfully treated (pain-free during tendon loading) with eccentric training (n=22), sclerosing polidocanol injections (n=38) and surgical scraping (n=29), had a significantly thinner Achilles midportion and a more normal tendon structure, after compared to before, treatment.

Conclusion

For the Achilles midportion, tendon degeneration might not be irreversible. The findings indicate a possible regeneration potential.
Effects of whole body vibration training on dynamic balance in healthy adult volunteers
Authors: Amano H , Nakata K , Mae T , Kohda H , Shimomura K , Satoh M , Shino K , Yoshikawa H
Published: March 2011

Background

Motor performance depends on the integration and utilisation of a range of different abilities, such as muscle strength, flexibility, and balance. Improving these abilities is thus important for improving motor performance. Training using whole body vibration (WBV) comprises one of these new methods.

Objective

The purpose of this study was to clarify the effects of WBV training in comparison with conventional training on knee proprioception and postural stability.

Design

This study was performed using randomisation, single blinding and prospective.

Setting

Healthy volunteers were enrolled in this study by recruitment to the postgraduate students whose sports activity level was recreational.

Patients and Interventions

12 healthy volunteers were randomly divided to undergo 12 sessions of training per 4 weeks with (WBV group) or without (CTL group) WBV training.

Main outcome measurements

Absolute error in joint repositioning at two target angles (30° and 60°) was determined with the Biodex dynamometer system, and static and dynamic postural stability (single-leg standing with eyes closed, forward single-leg drop jump (F-SDJ), and lateral single-leg drop jump (L-SDJ)) with a force plate were measured pre- and post-exercise at sessions 1, 6, and 12, respectively.

Results

The improvement in dynamic postural stability in the WBV group was significantly greater than in the CTL group (p<0.05). In particular, L-SDJ at session 6, F-SDJ and L-SDJ at sessions 6 and 12, and total length of the centroid track improved from pre- to post-exercise. There were no significant differences between the WBV and CTL groups for static postural stability or in the average absolute angular error at 60° and 30°.

Conclusion

WBV was effective in improving balance in healthy volunteers, with more difficult balancing tasks showing greater improvement at earlier stages.
The impact of serious sport and active recreation injuries on physical activity levels
Authors: Andrew N , Gabbe B J , Wolfe R , Cameron P A
Published: March 2011

Background

Sport and active recreation are important avenues for health enhancing physical activity. These health benefits can however be negated by injury. The impact of sport and active recreation injury on long term physical activity levels has yet to be investigated.

Objective

To evaluate the impact of serious sport and active recreation injury on patients' long-term physical activity levels.

Design

Prospective cohort study with 12-month follow-up.

Setting

Two Level 1 trauma centres and one regional hospital in Victoria, Australia.

Participants

Adults admitted to hospital with orthopaedic sport and active recreation injuries and captured by the Victorian Orthopaedic Trauma Outcomes Registry were recruited from the two Level 1 trauma centres and one regional hospital over a 12-month time period. A total of 324 patients entered the study and 98% were followed up at 12-months post-injury.

Assessment of risk factors

Independent variables used in the analyses were sporting group, age, sex, education level, major trauma classification (Injury Severity Score>15), injury patterns and disability at 12-months post-injury.

Main outcome measurement

The International Physical Activity Questionnaire.

Results

At 12-months post-injury participants reported significant reductions in physical activity levels (p<0.001) with median levels reduced by two thirds. Those reporting no disability as measured by the Extended Glasgow Outcomes Scale at 12-months, still reported significant reductions in physical activity (p<0.001) with median levels reduced by more than half and vigorous activity being performed half as frequently. Multivariate regression analysis found no significant predictors of physical activity levels at 12-months.

Conclusion

Sport and active recreation injuries lead to significant reductions in physical activity levels, with potential negative health impacts in the future. The importance of sports injury prevention in maintaining population physical activity and the need to better understand why patients do not return to pre-injury activity levels is highlighted.
The effects of tai chi class on subjective exercise experiences: a preliminary study in community sports centre settings
Authors: Baltsezak S , Dilliway G
Published: March 2011

Background

Exercise Referral Schemes (ERS) are aimed at local residents to encourage them to become physically active. General practitioners use ERS when they feel their patients can benefit from organised physical activity. Subjective psychological states that occur during and after exercise are likely predictors of whether individuals are willing to adopt and maintain lifestyles that include physical activity. Therefore if Tai Chi (TC) class improves psychological affect it could be included in the range of physical activities offered to the scheme participants.

Objective

This study examines short term effects of TC class on subjective well being of patients referred to ERS.

Design

Within subject comparison of changes in a pre-test post-test design.

Interventions

Subjective Exercise Experiences (SEES) were measured by validated questionnaire before and after the TC class. TC class consisted of warm up (10 min), learning TC techniques (25 min), performing Yang style eight steps form (7 min), and cool down (3 min). Brief Physical Activity and rate of perceived exertion (RPE) were also recorded by validated questionnaires.

Setting

Community Sports centre.

Participants

13 TC-naive volunteers (mean age 47) were recruited via ERS.

Results

Mean RPE after TC class was 12.31 with 95% CI 10.7 to 13.8. Mean score for Positive well being improved from 15.1 to 20.5 (P-value 0.004), Mean score for Psychological distress decreased from to 12.7 to 9.4 (P-value 0.080), scores for Fatigue also decreased from 14.4 to 12.2 (P-value 0.21).

Even though mean SEES scores showed improvements in all three categories, only improvements in Positive well being was very statistically significant.

Conclusion

This is the first study in the UK exploring psychological effects of TC on people taking part in ERS. The results demonstrate psychological benefits after participating in a single TC class. TC can be included in the range of physical activities offered by ERS.
From explicit to implicit learning in ACL injury prevention?
Authors: Benjaminse A , Bisschop M , Schoenmakers P , Otten E
Published: March 2011

Background

Despite reported early successes, anterior cruciate ligament (ACL) injury rates have not diminished. Currently explicit learning strategies are mainly used for prevention. However, this may be unsuitable for the control of complex motor skills.

Objective

The purpose was to investigate explicit and implicit learning while keeping balance on a 4 mm narrow ridge. Results can contribute to the development of ACL injury prevention programs.

Design

Randomised controlled trial.

Setting

Laboratory based study with recreational athletes.

Participants

60 healthy subjects between 18 and 24 years were recruited from the university population. Females (n=36) and males (n=24) were equally distributed over three groups; implicit learning, explicit learning and the control group.

Interventions

Balance time on the ridge was investigated where the groups received different types of feedback after each trial; implicit (visual feedback from video of the best trial so far), explicit (instructions) and no feedback. During the retention test after 2 weeks none of the subjects received any feedback. All subjects conducted 25 trials during both measurements. The independent t-test was used in SPSS 16.0 (SPSS Inc., Chicago, IL) where the alpha level was set a priori at p<0.05.

Main outcome

Measures Grow of balance time (based on first grade regression line).

Results

Growth during the intervention for implicit, explicit and control was 2.36 (SD ± 3.21; p=0.009), 1.53 (SD ± 2.09; p=0.001) and 0.84 (SD ± 1.26; p=0.209) respectively. Growth of the implicit group was significantly different from the control group (p=0.03). No other significant differences were found. Growth and group differences were not significant from each other during the retention test (p>0.05).

Conclusion

Before use in the clinical setting, future research is needed to evaluate and improve the learning strategies. SD were high, which could explain the results.
Voice and vocal health in elite sports coaching: considerations for elite football coaching staff
Authors: Buckley K , O'Halloran P , Oates J
Published: March 2011

Background

While voice is integral to sports coaching, currently there is a dearth of research considering coaches' occupational vocal health.

Objective

To investigate football coaches' occupational voice use and vocal health (including the role of voice in coaching and the identification and management of workplace risk factors).

Design

A mixed-methodological approach (interviews, a questionnaire and acoustic voice measurement) using descriptive statistics and thematic analyses.

Setting

On-site at three Australian Football League clubs and one Australian Super 14's Rugby Union club.

Participants

12 male coaches volunteered to participate. Inclusion criteria required participants to be employed full time as elite level football coaches.

Results

Participants perceived their voices as crucial for the frequent verbal communication required while coaching. Acoustic measurements revealed that, across work contexts, participants engaged in heavy vocal loads. Coaches also identified various aspects of their physical and organisational environments that impacted negatively on their voices. These vocal demands appear to be associated with negative health consequences. All participants reported experiencing voice symptoms (such as vocal fatigue and hoarseness) at least some of the time while coaching. Coaches suggested several strategies that reduced these symptoms, but were generally unaware of why these assisted their voices. Furthermore, coaches did not actively contemplate how to address risk factors or promote positive vocal health experiences at work.

Conclusion

This study demonstrates the critical reliance coaches have on their voices. It also suggests that the nature of vocal demands and workplace environments may negatively impact on coaches' vocal health. While participants demonstrated some insight into their voice use, this did not necessarily translate to awareness of vocal health or management of risk factors. A greater understanding of risk factors and their management is required to better support the occupational vocal health of coaches.
The effect of a one-time abdominal muscle training session on the ability to contract the transverse abdominus in low back pain patients
Authors: Burston A , Hammill R R , Beazell J , Saliba S , Hart J M , Ingersoll C D
Published: March 2011

Authors request their Abstract not to be published.
Relationship between training-playing loads and injury risk in elite australian footballers
Authors: Buttifant D , Berry J , Ullah S , Finch C F
Published: March 2011

Background

Training and match loads are important for ensuring optimal performance outcomes and achievements of footballers and also have an impact on injury and illness among the players. There had been no prospective study of the training/playing loads of first year Australian Football League (AFL) players and associated influence on injury rates.

Objectives

To measure the training and match loads and determine the relationship between loads and injury risk in the first year AFL football players and then compare this to mature 3+ years AFL players.

Design

Data was collected through a systematic prospective documentation of the 2009 training-playing loads in all first year AFL players, and a subset of 3+ years players. Data was collected by the club's conditioning or sport science staff weekly for the 2009 competitive season.

Results

64 first year and 58 3+ years players from nine of the 16 AFL clubs were participated in the study. The first year players had significantly higher injury incidence and prevalence rates compared to 3+ years players, leading to both missed matches and missed training sessions. By the end of the 22 matches of the competitive season, the first year players had collectively missed 4.3 times as many matches and 2.6 times as many training sessions as the 3+ years players due to injury. When the number of players available at any competition week was taken into account, the first year players were 14.3 times more likely to miss matches.

Conclusions

There was a significantly increased injury risk for first year players compared to more mature AFL players resulting in more missed matches and training sessions.
The association between runners' lower limb alignment with running-related injuries: a systematic review
Authors: Carvalho A C A , Junior L C Hespanhol , Costa L O P , Lopes A D
Published: March 2011

Background

Although running is one of the most popular sports in the world, there are few studies that describe the relationships between anatomic characteristics of lower limb in this population.

Objective

To systematically review studies aimed at testing the association between lower limb alignment and running-related injuries.

Design

A systematic review.

Setting

The articles are related with long-distance runners without restriction of competitive level.

Interventions

We performed a search on MEDLINE, LILACS and SciELO. The keywords and operands used were: anatomical factors OR alignment OR Q angle OR foot structure OR lower limb injuries AND running. There was no restriction with regards to the year of publication.

Main outcome measurements

The lower limb alignment related with the musculoskeletal injuries in runners.

Results

Of the 1919 studies found, 973 were excluded by the title, 686 were excluded after reading the abstract and 287 were excluded after reading the original text. Eight articles were considered eligible and therefore were included. The main lower limb alignment characteristics related with the musculoskeletal injuries in runners found were: the Q angle greater than 20°, the navicular drop exceeding 5 mm, excessive pronation of the subtalar joint, the length discrepancy between the lower limbs (more than 10 mm), and the height of the medial longitudinal arch (dorsum foot height/truncated foot length ratio, high arch >0.356 and low arch <0.275). These variables as those most associated with the Patellar Tendinitis, Iliotibial Band Syndrome and the Plantar Fasciitis.

Conclusion

The main lower limb alignment characteristics related with running-related injuries found were: the Q angle greater than 20°, the navicular drop exceeding 5 mm, excessive pronation of the subtalar, the length discrepancy between the lower limbs, and the height of the medial longitudinal arch.
Injury prevention methods among athletes: how are they really performed?
Authors: Cerulli G , Caraffa A , Ponteggia F , Potalivo G , Rende R , Conti V , Benvenuti E
Published: March 2011

Background

The effectiveness of prevention programmes in diminishing the incidence of ankle and knee ligament injuries has been established and published in literature but we do not know exactly the real diffusion among athletes.

Objective

To assess the application of prevention methods.

Design

Retrospective Survey.

Setting

Youth sport, amateur, professionals and elite teams.

Material and Method

Coaches of 176 basketball, handball and volleyball teams (in total 2936 players, 1315 males and 1621 females: average age 15.6 years) in the Umbria region (central Italy) answered an anonymous original questionnaire regarding prevention methods (quantitative evaluation, balance training, landing technique, sport specific movements, video analysis, rapid deceleration and cutting manoeuvre).

Results

quantitative evaluations are performed in 26% of the teams; video analysis of sport-specific movements and playing situations are used in 51% of the teams to improve performance but not to prevent injuries (assessing at risk situations or reviewing the injuries); balance training with board is performed by 55% of the teams (an additional 10% use the board only during rehabilitation); sport specific at risk movements like rapid deceleration and crosscut maneouver are reproduced during training respectively in 49% and 42% of the teams while correction of jump landing strategies is not applied; 38% of the trainers declare they are aware of and use prevention methods.

Conclusions

Surveys are a fundamental way to know if the prevention measures are employed. These studies should be performed in every sport and in every country, according also by age, sex and level. The knowledge of basic prevention methods and their use by all the teams is a target that should be rapidly obtained with courses for both trainers and athletes. Moreover these results are helpful in combination with epidemiological data to decide the need of interventions, saving resources.
Investigations of genes encoding proteins within the inflammatory pathway provides insight into the genetic susceptibility of achilles tendinopathy
Authors: September A V , Nell E-M , Connell K O , Cook J , Handley C J , Schwellnus M P , Collins M
Published: March 2011

Background

Achilles tendinopathy (AT) is a multifactorial condition for which genetic risk factors have been identified. The evidence implicating cytokines and inflammatory mediators in the development of tendinopathy is growing.

Objective

The objective of this study was to identify sequence variants within genes encoding proteins involved in the inflammatory pathway which may modulate risk of developing AT.

Methods

A case-control genetic association study was conducted and candidate genes within the inflammatory pathway were explored. Functional polymorphisms within interleukin-1 (IL) (−31T>C and −511C>T), IL-1RN (VNTR) and IL-6 (−172G>C), were investigated for associations with AT in a South African (SA) and Australian (AUS) case-control study. A total of 356 (158 SA and 198 AUS) asymptomatic control participants (CON) and 171 (89 SA and 82 AUS) participants with AT (TEN) were genotyped. Genotype pairs were constructed using the above polymorphisms in combination with the COL5A1BstUI RFLP.

Results

Risk-reducing genotypes were indentified and these genotypes in combination with the COL5A1BstUI CC genotype were found to significantly modulate risk of AT (p<0.025). No associations were observed for IL-1−31T>C, IL-1−511C>T or IL-1RN. The GG genotype (OR=2.1, 95% CI 1.2 to 3.6; p=0.017) and G allele (OR=1.5, 95% CI 1.0 to 2.2; p=0.044) of IL-6-172G>C were significantly over represented in AUS TEN.

Conclusion

Variations within interleukin genes together with the COL5A1BstUI CC genotype are able to modulate risk of AT. This research emphasises that a pathway-based genetic association study may be a more effective approach to capture and understand the genetic risk factors underlying multifactorial conditions, such as AT. Furthermore, this study provides evidence that injury susceptibility is most likely dependent on the cumulative effect of the interactions of sequence variants in multiple genes within biologically significant pathways.
Re-defining normal: bone mineral density in elite female athletes
Authors: Cutti P , Steele R , Shrier I , Garza D , Meeuwisse W , Bacharach L , Matheson G
Published: March 2011

Background

College age female athletes are susceptible to decreased bone mineral density (BMD) which puts them at an elevated risk for poor bone health in the future.

Objective

The primary purpose of this study was to compare site-specific and total body BMD of college-age female athletes across sports of varying impact level. Secondary objectives included (1) evaluating the relationship between BMD and menstrual, family bone health, and personal bone health histories; (2) to determine the best clinical predictors of BMD in this population.

Design

Cross-sectional.

Setting

NCAA Division I female athletes screened at university sports medicine centre.

Participants

265 (20.1±1.19 years, 66.5±10.9 kg, 1.7±0.09 m) college-age female athletes from 14 different sporting teams.

Interventions

Personal and family health questionnaire, Total Body (TB), anteroposterior Spine (APS), Dual Femur (DF) BMD and Body Composition scans using GE Lunar iDXA.

Main outcome measurements

Athletes were separated into three sport impact categories. BMD measurements were compared across the impact levels. Both stepwise regression and classification and regression tree analysis were conducted to determine significant predictors of BMD.

Results

Athletes participating in low and moderate impact sports had significantly lower TB and site-specific BMD values when compared to high impact athletes (TB: High=1.24, Mod=1.18, Low=1.15; APS High=1.33, Mod=1.25, Low=1.21; DF High=1.25, Mod=1.12, Low=1.11). The BMD values for each secondary exposure were lower in those with history of abnormal menses (TB-1.19, APS- 1.24, DF- 1.17), previous stress fracture/reaction (TB-1.19, APS- 1.27, DF- 1.17), and poor family bone health (TB-1.18, APS- 1.26, DF- 1.16). Classification and regression trees (CART) analysis shows highest TB mean BMD was found in high impact athletes with LBM>50.9 kg.

Conclusion

There is an ordinal relationship between sport impact level and BMD. Using CART analysis, gynaecological age, impact level and LBM are the best predictors of mean BMD.
Isokinetics: which value is better to report?
Authors: Mendonça L D , Amaral G M , Marinho H V R , Silva A A , Fonseca S T
Published: March 2011

Background

Isokinetic tests are golden pattern for muscular performance evaluation. Nevertheless, there isn't any uniformity when reporting and analysing results, many authors have taken the peak torque value as major variable to be discussed.

Objective

To verify correlations between values reported in ‘Comprehensive Evaluation’ generated by the Biodex System III pro and to determine the main values related to the total variance.

Design

Data base analysis.

Setting

Results from knee isokinetic evaluations in volleyball and football male players realised in LAPREV.

Participants

117 ‘Comprehensive Evaluation’, only the reports for dominant limb at 60°/s were used.

Results

‘Comprehensive Evaluation’ reports generated 19 different values. Factorial analysis with Varimax Rotation (KMO=0.687; Bartlett's Test of Sphericity p=0.000) grouped all values in four main factors, named respectively:

▶

Muscle Strengthening (eigenvalue=7391)

▶

Performance Rise (eigenvalue=3073)

▶

Muscle Length (eigenvalue=1858)

▶

Performance Decay (eigenvalue=1223)

‘Total Work’ value showed bigger loading (0.949), this result represents its major contribution to total variance. This value represents the Muscle Strengthening Factor better than any other value. Furthermore, the ‘Peak Torque’ value was only the fourth value to contribute to this factor variance (0.889). The factor grouped 9 of 19 values, all of them related to work, torque and power. The Second Factor comprehended ‘Time to peak torque’ (0.904), ‘ROM’ (0.872) and ‘Acceleration time’ (0.576) values. The Muscle Length factor included ‘Peak Torque Angle’ (−0.912) and ‘Torque @25deg’ (0.798) values and the Fourth Factor comprised ‘Work Fatigue’ (0.838) and ‘Maximum work repetition#’ (−0.540) values.

Conclusion

These preliminary results suggested that, during scientific investigation process, to report the appropriate variables is necessary to better define muscular performance. Peak torque should not be the better value to represent Muscle Strengthening and it's necessary to discuss which variable properly answers ours questions.
Correlation between isokinetic profile and shoulder injuries in male volleyball athletes
Authors: Mendonça L D , Bittencourt N F N , Barreto R A , Paiva T F , Porto R F , Silva A A , Fonseca S T
Published: March 2011

Background

There is a high prevalence of shoulder injuries in volleyball and their preventive management is still a challenge. Isokinetic assessment is largely used in sports injury prevention. Few studies investigate the correlation between the isokinetic profile and injuries story, furthermore these studies analyses the agonist/antagonist ratio and do not consider other parameters as fatigue.

Objective

to investigate the differences between injured and non injured dominant shoulder in the lateral/medial rotators ratio and fatigue index in volleyball male athletes.

Setting

all testing took place in the Sports Injury Prevention and Rehabilitation Laboratory-LAPREV in elite volleyball.

Participants

42 athletes (mean+SD age, 21.3+4.1; height, 196.8+0.06 and body mass, 89.9+8.8) were evaluated in this study (28 at injured group). Participants with upper-extremity surgery in the previous 6 months and pain during the isokinetic test were excluded.

Assessment of risk factor: agonist and antagonist ratio at 60°/s and 360°/s and index fatigue at 360°/s in 90° of abduction at dominant shoulder.

Main outcome measurement

trauma and overuse shoulder injuries story provided by questionnaire.

Results

The results showed statistical differences between groups in lateral rotators (p=0.039) and medial rotators fatigue (p=0.024). The mean fatigue of lateral rotators in the injury group was 52.9 and 37.0 for non-injured group and 31.6 and 43.8 respectively for medial rotators. No differences were found in the ratio analysis between groups (p=0.403 for 60°/s and p=0.289 for 360°/s). The means were 71.6 and 67.4 for injured and non-injured groups at 60°/s and 56.9 and 63.9 respectively at 360°/s.

Conclusion

The results show that lateral rotators fatigue was greater in the injured group and no differences were found in the ratio parameters. The fatigue analysis must be incorporated in the athlete's assessment, because seems to be more informative about injury risk.
Analysis of predictor factors in knee valgus in female soccer athletes
Authors: Mendonça L D , Bittencourt N F N , Santos T R T , Assis M , Carvalhais V , Araújo V L , Silva A A , Fonseca S T
Published: March 2011

Background

Knee injuries in soccer are common regardless of age, gender or playing level. The injury that draws most attention is the anterior cruciate ligament tear and adolescent females seem to have the highest risk. Le Gall and associates (2009) reported 12% of incidence in female soccer players. Several potential risk factors, for example anatomical and biomechanical factors, have repeatedly been discussed in the literature, but lack scientific evidence.

Objective

assess the potential predictors of frontal plane knee angle (FPKA) and the interplay between them, through a non-linear statistical model (Classification and Regression Tree-CART).

Design

Observational cross sectional.

Setting

A professional female soccer team was evaluated in Sports Prevention and Rehabilitation Laboratory (LAPREV) at Federal University of Minas Gerais (CENESP-UFMG).

Participants

19 female soccer athletes, mean age 18.27 (2.79) years were included in this study. All participants were healthy, with no current complaints of lower limb injury or pain and no history of previous lower extremity surgery.

Assessment of risk factors

The independent variables were shank-forefoot alignment (SFA), hip abductor torque, hip passive internal rotation (HPIR).

Main outcome measurements

The FPKA during three single leg squat with dominant leg in front of a camera (reflexive marcs were located in ASIS, femoral condyles and in a middle point of the medial and lateral maleolus).

Results

The HPIR was the main predictor of High-FPKA. 15.8% presented high-FPKA with a HPIR <26.55°. Those with HPIR >33.55° and SFA>17.10° also presented High-FPKA (21%). The model's estimate risk was 15% and the sensibility and specificity were 78% and 84% respectively.

Conclusion

The extreme low and great ranges available of HIPR associated with high values of SFA were predictor of knee malalignment in frontal plane. Also the SFA must be considered part of athletes' preseason assessment.
Correlation of age, sex, body mass index and sports modality to patellar rotation in jumping athletes
Authors: Mendonça L D , Bittencourt N F N , Santos T R T , Silva A A , Fonseca S T
Published: March 2011

Background

Patellar malalignment reveals a inappropriate tendon traction and could lead to overuse injuries as patellar tendinopathy. There is two angles that describe the frontal patellar rotation: Arno (A) and McConnell (M). There is lack of evidence about the normative data, especially in jumping athletes.

Objective

analyse the Arno and McConnell's patellar angles profile in jumping athletes.

Design

observational cross-sectional.

Setting

all testing occurred at Minas Tênis Club and at Sports Injury Prevention and Rehabilitation Laboratory – LAPREV.

Participants

171 volleyball, basketball and gymnastics athletes (41 female and 130 male) were assessed. All participants were healthy, with no current complaints of lower limb injury or pain and no history of previous lower extremity surgery. The average+SD age, height and mass of the athletes was 15.7+5.1 years, 178.2+14.5 cm, 68.3+16.5 Kg.

Assessment of risk factors

Age, sex, body mass index (BMI) and sports modality were the independent variables.

Main outcome measurements

frontal plane patellar rotation in stand position with 30° of knee flexion.

Results

The means for M and A angles at dominant and non-dominant limbs were −0.87 (+4.75), −4.1 (+5.2), 4.6 (+7.34) and 1.35 (+8.1) degrees respectively. Statistic significant differences were found in AD and AnD limbs at female and male group (p=0.001), in MD at modalities female volleyball and male basketball (p=0.012), in AnD at ages between >19 and 7 to 10 (p=0.005), 11 to 14 (p=0.000) and 15 to 19 (p=0.006) and in AD between normal and low BMI groups.

Conclusion

This study shows normative data about M and A angles in jumping athletes. Some associations were found between sex, age, sports modality and BMI with A angle and modality with M angle. These variables must be considered part of athletes' preseason assessment.
Normative values of dynamic knee valgus during single leg squat in basketball and volleyball athletes
Authors: Mendonça L D , Murta B A J , Leite M N F , Bittencourt N F N , Castro V , Gonçalves G G P , Silva A A , Fonseca S T
Published: March 2011

Background

Volleyball and basketball are among the sports with a higher incidence of knee injuries. The inability to maintain a proper alignment of the lower limbs during functional activities could create a knee valgus which predisposes to injury. Thus, the quantification of knee valgus is necessary to guide prevention and clinical interventions.

Objective

To establish normative values for dynamic knee valgus during the single leg squat (SLS) in volleyball and basketball athletes.

Design

Observational cross-sectional.

Setting

Minas Tênis Club, Brazil, youth sports.

Participants

151 athletes (108 male and 43 female) were assessed during national championship preseason. All participants were healthy, with no current pain of lower limb injury and no history of previous lower extremity surgery. The mean age, weight and height were 14.21+2.09; 62.75+14.20 and 173.89+13.42, respectively.

Assessment of risk factors

Gender, age and sport.

Main outcome measurements

Knee valgus was measured as frontal plane projection angle of the knee (FPPAK) during SLS up to 60° of knee flexion. The mean of three repetitions of SLS from each limb was used for analysis, using SIMI Motion Twinner software. The FPPAK was defined as the connections between ASIS, midpoint of femoral epicondyles and anterior midpoint of the malleolis.

Results

The mean FPPAK during SLS for right leg was 7.08+4.0 and 8.68+4.2 for left leg. There were no differences between ages and genders. There were significant differences between sides in both modalities (p<0.000).The basketball athletes had lower FPPAK on the left leg when compared with athletes from volleyball (p<0.000).

Conclusion

All athletes showed an inability to maintain proper alignment during dynamic squat. The differences found between modalities may be linked to the specific technique of each sport and are important to guide an intervention focused on injury prevention.
Correlation between isokinetic profile and knee injuries in male volleyball athletes
Authors: Mendonça L D , Bittencourt N F N , Barreto R A , Paiva T F , Porto R F , Silva A A , Fonseca S T
Published: March 2011

Background

Knee injuries are prevalent in elite volleyball and their preventive management is still discussed. Isokinetic assessment is largely use in sports injury prevention; however few studies investigate the differences in the isokinetic profile of injured knees. These studies analyses the agonist/antagonist ratio and do not consider other parameters as fatigue index.

Objective

to investigate the differences between injured and non injured knee in the hamstring/quadriceps ratio and fatigue index in volleyball male athletes.

Setting

all testing took place in the Sports Injury Prevention and Rehabilitation Laboratory- LAPREV in elite volleyball.

Participants

49 male (mean+SD age, 21.96+4.1; height, 196.5+0.06; body mass, 89.1+9.03) athletes were evaluated in this study, being 20 at injured group. Participants with lower-extremity surgery in the previous 6 months and pain during the isokinetic test were excluded.

Assessment of risk factor: hamstring/quadriceps ratio at 60°/s and 300°/s and fatigue at 300°/s at the dominant knee with 90° of hip flexion.

Main outcome measurements

trauma and overuse knee injuries provided by questionnaire.

Results

Differences between groups were found just in hamstring fatigue (p=0.002). The means of this parameter were 63.1 and 55.6 for injured and non-injured group respectively. For quadriceps fatigue the means were 48.4 and 47.3 respectively. No differences were found in the ratio analysis between groups (p=0.403 for 60°/s and p=0.289 for 360°/s). The means were 199.4 and 203.5 for injured and non-injured groups at 60°/s and 157.4 and 168.6 respectively at 300°/s.

Conclusion

The results showed that the injured group has more hamstring fatigue compared to non-injured group. The ratio analysis does not reveal differences between groups. The fatigue analysis must be incorporated in the athlete's assessment, because seems to be more informative about injury risk.