bluuebunny/crossref_metadata_2025 huggingface dataset:
VIDEO ANALYSIS OF MATCH INJURIES IN GERMAN MEN'S PROFESSIONAL FOOTBALL
Authors: Klein Christian , Luig Patrick , Bloch Hendrik , Henke Thomas , Platen Petra
Published: August 2017

Background

After description of injury epidemiology the description of injury etiology is the next step to identify relevant preventive approaches.

Objective

What are common injury situations, mechanisms and characteristics?

Design

Prospective video-based analysis of match injuries.

Setting

Two highest German professional leagues in men's football.

Participants

All first and second division football players who played at least one competitive club match (n=3,747) within the seasons 2010/11, 11/12, 12/13 and 14/15 were included.

Interventions

Analysis of all moderate and severe match injuries (time-loss>7 days) that were registered by clubs or physicians with the VBG (German statutory accident insurance for the administrative sector) as part of the occupational accident reporting.

Main Outcome Measurements

A surveillance sheet was evaluated containing six categories and 31 items describing general match and injury information (e.g. date, teams, name of injured player, position on pitch), match situation in moment of injury (e.g. ball possession, movement of injured player, type and direction of possible tackling), mechanism of injury (e.g. type of contact, trigger of injury) and referee's decision.

Results

217 moderate or severe match injuries were identified in the video footage. 52.4% of injuries were contact injuries, 20.4% indirect contact and 27.2% non-contact injuries. 17.2% of injuries result from opponent's and 14.3% from own foul play. Injuries mainly occurred during defending actions (sliding 22.1%, tackling 10.6%), shooting (18.6%), heading (13.3), dribbling (11.5%) or passing (11.5%). Moreover, six typical injury situations for thigh, knee, ankle, lower leg and foot injuries were recognized.

Conclusions

Video analysis of injuries sustained in competition show that the share of injuries effected by irregular actions of the opponents is low. Thus there seems to be a high preventive potential to reduce number and severity of injuries in football. Thus particularly individual intrinsic risk factors needs to be identified within routinely screening measures.
PREVENTION OF ACL INJURIES IN OLYMPIC SPORTS – FIRST STEPS FOR A NATIONAL "ACL REGISTRY IN FOOTBALL"
Authors: Krutsch Werner , Gündisch Christian , Nerlich Michael , Angele Peter
Published: August 2017

Background

Prevention strategies for ACL injuries in Olympic sports are mandatory and the collection of data about risk factors and injury characteristics have highest priority.

Objective

What are the main risk and influencing factors on ACL injuries and safe return to play in different sports, beginning with worl's number one sport football?

Design

A prospective analysis of ACL injuries in German amateur and professional football.

Setting

ACL injury registration over two football seasons and investigation of ACL injured player by 2 questionnaire after injury and after one year.

Patients

Players of German football divisions were investigated, including all divisions, both gender and all age levels.

Interventions

Beside typical influencing and risk factors for ACL injuries, circumstances for a return to play decision were investigated.

Main Outcome Measurements

Investigated variables are anthropometric data, football exposure data, training and warm up data, regeneration data and return to play decision-making.

Results

512 ACL injuries in football were registered in the first season with 71.1% non-contact injuries, 85.5% match injuries, younger female players and 93.5% surgical treatment rate. 68% of ACL injuries occurred in the preseason period, 60% of 1st division players were internationals and the first professional division revealed a higher ACL rate than the 2nd and 3rd division. Balancing exercises (<40%) or trunk stability exercises (<20%) were rare. Small pre-injuries were seen in 30% of all players directly before ACL injury. Over 50% had directly before the ACL injury changes of the training program or football level. Changing of football shoes before ACL injury was seen in 33.3%. A mean of 9.2 months for return to competition was seen in the male professional football players, which was earlier than in amateurs.

Conclusions

To improve injury prevention strategies for ACL injuries, a detailed knowledge about injury characteristics is necessary in all sports.
IMPACT OF AN ULTRA-MARATHON OF 330 KM ON PLASMA LEVELS OF CARDIAC BIOMARKERS
Authors: Goff Caroline Le , Kaux Jean-François , Gergelé Laurent , Millet Grégoire P , Giardini Guido , Viallon Magalie , Croisille Pierre , Cavalier Etienne
Published: August 2017

Background

While a moderate exercise benefits on the cardiovascular system, consequences of a supraphysiological effort are not yet clear.

Objective

The aim of our study was to evaluate the consequences of an ultra-marathon on cardiac and muscles markers (CK, myoglobin, hsTnT, NT-proBNP, copeptin, H-FABP) but also markers of inflammation CRP DFO, GB) and of renal function (urinary NGAL and plasma and urinary creatinine). This project also studied the evolution of new cardiac fibrosis biomarkers: ST2 and Gal-3.

Design

Longitudinal, cohort study.

Setting

The Tor des Geants (TdG), a 330 km long ultra distance trail running, with +24,000 m elevation changes in the Valley of Aosta (Italy), is considered as one of the most difficult mountain marathon race in the world. The maximum time allowed to complete the race is 150 h.

Patients (or Participants)

51 participants attending the TdG have been followed and the study was conducted on 33 subjects having reached at least half of the race (148.7 km).

Interventions (or Assessment of Risk Factors)

Repeated blood and urine samples collection were carried out at four key time points: before, during (mid-point) and after the race (less than 1 h) and 3 days after the end of the race.

Main Outcome Measurements

Biological samples were collected at these four different times. Several biomarkers were assayed on different analyzers such COBAS®, KRYPTOR®, VIDAS® and ETIMAX®, meanwhile, the ST2 and Gal-3 were measured manually.

Results

During the TdG, the plasma levels of cardiac markers, muscle and inflammation have increased significantly to halfway. Meanwhile, the markers of renal function have only slightly varied, excepting plasma creatinine.

Conclusions

The study suggests that there is no permanent structural damage at the myocardium level. However, the low pace adopted by the tired runners caused an inflammatory response as well as muscle damage less important than a shorter race.
INVESTIGATION OF THE LOWER EXTREMITY STATIC POSTURES PREDICTING VALGUS COLLAPSE DURING DROP LANDING IN KOREAN MALE AND FEMALE – LOGICAL ANALYSIS OF DATA (LAD) APPROACH
Authors: Lee Sae Yong , Lee Seok Gi , Kang Yuncheol , Chun Young Min , Kim Chang-Young , Kong In Deok
Published: August 2017

Background

The result of 2002∼2012 National Health Insurance Sharing Service (NHISS) data analysis demonstrated that the gender's odds ratio of ACL was as low as 1.06, which is different from other studies. The static posture measures (SPM) of Asian may not be strongly associated with valgus collapse during landing.

Objective

To investigate SPMs that account for valgus collapse in Korean male and female using the LAD approach.

Design

Cross-sectional study.

Setting

Controlled laboratory.

Patients (or Participants)

Forty-four active male (age: 22.2±3.6 yrs; Height: 176±6.6 cm; Weight: 73.3±9.7 kg) and 43 female (age: 21.9±2.5 yrs; Height: 163±5.3 cm; Weight: 56.5±5.1 kg) with no history of lower extremity injury were recruited.

Interventions (or Assessment of Risk Factors)

Gender.

Main Outcome Measurements

Joint kinematics associated with valgus collapse during drop landing were extracted (Vicon Inc, Oxford, UK) during drop landing task. Thirteen lower extremity SPMs were collected. LAD was implemented using the machine learning software, Weka 3.7.10 (U of Waikato, Hamilton, New Zealand) to generate male and female patterns that characterize features of SPM and its association with valgus collapse.

Results

A total of eight and 33 distinct male and female patterns respectively could be generated (>10% relative prevalence (RP)). Interestingly, Joint kinematics associated with valgus collapse were not shown in patterns, but only six SPMs were included. The most relevant pattern that represents male (RP 25.00%) was tibiofemoral angle less than or equal to 9.5° and leg length discrepancy greater than −3.5 cm. The most relevant pattern that represents female (RP 34.88%) was Q-angle greater than 17.5°, genu recurvatum greater than −1.5°, femoral anteversion greater than 5.5°, and leg length discrepancy less than or equal to 2.5 cm.

Conclusions

SPMs of Korean male and female were not associated with valgus collapse during drop jump. It seemed that the Korean female demonstrated similar neuromuscular control characteristics as male to avoid valgus collapse.
LANDING WITH LESS HIP FLEXION IS ASSOCIATED WITH INCREASED RISK OF ACL INJURIES IN YOUNG FEMALE TEAM SPORTS PLAYERS
Authors: Leppänen Mari , Pasanen Kati , Krosshaug Tron , Kannus Pekka , Vasankari Tommi , Parkkari Jari
Published: August 2017

Background

Stiff landings with less knee flexion and high vertical ground reaction force have shown to be associated with increased risk of ACL injuries (Leppänenet al. 2016). The association between other sagittal plane measures and the risk of ACL injuries is less studied in prospective study designs.

Objective

To investigate the relationship between selected sagittal plane hip, knee, and ankle biomechanics and the risk of ACL injuries in young female team sport players.

Design

Prospective cohort study.

Setting

Female youth team sports.

Participants

A total of 171 female basketball and floorball players (aged 12–21) participated in a VDJ test using 3D motion analysis. All new ACL injuries, as well as match and training exposure, were recorded for 1 to 3 years.

Assessment of Risk Factors

The following biomechanical variables were analysed: 1) peak knee extension moment, 2) peak hip flexion angle, 3) peak hip extension moment, and 4) peak ankle dorsiflexion angle. Cox regression models were used to calculate hazard ratios (HRs, adjusted for 10 unit change) and 95% confidence intervals (CIs).

Main Outcome Measurements

Non-contact ACL injuries.

Results

Subjects suffered a total of 15 ACL injuries during the follow-up (0.2 injuries per 1 000 player hours). Of the investigated variables, landing with decreased hip flexion was significantly associated with increased risk of ACL injury (HR 0.60; 95% CI 0.37 to 0.97,P=0.038). Peak knee extension moment (HR 1.13; 95% CI 0.79 to 1.62,P=0.490), peak hip extension moment (HR 0.88; 95% CI 0.77 to 1.01,P=0.065), and peak ankle dorsiflexion angle (HR 0.70; 95% CI 0.33 to 1.51,P=0.360) were not significantly associated with ACL injuries.

Conclusions

Landing with less hip flexion may increase the risk of ACL injury in young female team sport players. More studies with large study populations are needed to confirm these findings.
ALTERATIONS IN REDOX HOMEOSTASIS IN ELITE ENDURANCE ATHLETES DIAGNOSED WITH UNEXPLAINED UNDER-PERFORMANCE SYNDROME (OVERTRAINING SYNDROME)
Authors: Lewis Nathan , Rogers John , Towey Colin , Howatson Glyn , Moore Brian , Pedlar Charlie
Published: August 2017

Background

Alterations in redox homeostasis (ARH) have been implicated in the pathophysiology of Unexplained Under-Performance Syndrome (UUPS). No studies have investigated alterations in ARH in elite athletes with UUPS.

Objective

To investigate concentrations of antioxidant nutrients and enzymes in world-class endurance athletes diagnosed with UUPS.

Design

Prospective observational case-control study.

Setting

UUPS was diagnosed by a sports medicine physician and referred to sports science and nutrition science practitioners for an exercise test, blood work, nutritional history, and an interview involving a questionnaire. Control athletes were required, not to have suffered with any fatigue associated training restrictions for the past four years (Olympic cycle); and tested in the competitive season to ensure performing successfully.

Patients (or Participants)

Elite endurance athletes from Track & Field and Triathlon (n=16, of which 9 were UUPS and 7 were controls). The athletes were competing at national and international standard, including World and European Championship, Commonwealth and Olympic Games medallists.

Main Outcome Measurements

Redox biomarkers (α- and β-carotene, lutein, α- and γ-tocopherol, red blood cell superoxide dismutase, total glutathione, and co-enzyme Q10) were measured at rest.

Results

Resting hydroperoxides (FORT) were significantly higher in controls vs. UUPS athletes (1.40±0.12 vs. 1.89±0.20 mmolŸL−1H2O2; p<0.001,g=2.87). Controls had higher concentrations of total carotenoids (1.49±.052 µmol•L−1vs. 3.16±1.07 µmol•L−1, p=0.006, g=2.07) and α-tocopherol than UUPS athletes (22.78±8.54 µmol•L−1vs. 31.71±5.80 µmol•L−1, p=0.039,g=1.19). No between-group differences were identified for RBC GSH, SOD, co-enzyme Q10 and γ-tocopherol.

Conclusions

UUPS athletes have lower concentrations of antioxidant nutrients than healthy elite athletes. We speculate that the measurement of antioxidant nutrients and subsequent dietary interventions may reduce the risk of UUPS in elite endurance athletes.
US RUGBY-7S: THE AMERICAN EXPERIENCE WITH A GROWING AMATEUR COLLISION SPORT
Authors: Lopez Victor , Ma Richard , Weinstein Meryle , Hume Patria , Cantu Robert , Victoria Christian , Marcano Erica , Answorth Allen
Published: August 2017

Background

There are limited data on Rugby-7s, an emerging sport in the United States (US), which debuted in the 2016 Olympics.

Objective

To report incidence and causes for US Rugby-7s. We hypothesized that match injuries would be frequent and patterns of injuries would be similar in the US population to international cohorts.

Design

Prospective descriptive epidemiology study.

Setting

The study encompassed U19 to elite players in USA Rugby tournaments (2010–2013).

Participants

A total of 13,644 US players (Men=9,768; Women=3,876; age: 13–49 years) were included over 28 tournaments (37 days) of 2,688 matches (Men=1,886; Women=802) in 1,137 sides/teams (Men=814; Women=323).

Assessment of Risk Factors

Intrinsic and extrinsic risk factors in Rugby-7s match injuries.

Main measurement outcome

Injury incidence (per 1000 player-hour (ph)) and mechanism captured using the Rugby Injury Survey & Evaluation (RISE) Report methodology. Time-loss injuries were defined as players who did not return to play the day of their injury. Injury severity was defined as days absent before return to training/competition (including post tournament).

Results

Overall incidence of time-loss injuries was 50.6/1000 ph. Time-loss injuries were highest among sub-elite level players (69.5/1000 ph) (P<0.001). Fifty percent of all injuries occurred in 20–25 year olds which was consistent with the age distribution of the participants. The average injury severity was 44 days (CI 37.7–49.4) for the 97% of players with follow-up data. Most tournament match injuries were new acute injuries (95%), occurred during tackling (68%), were ligament sprains (35%), and in the lower extremity (52%). Head/face (22.6%) and upper extremity (24.7%) injuries were also frequent.

Conclusions

Compared to international elite cohorts, the US amateur population had lower overall injury incidence, however, they had a higher frequency of upper extremity and head/face injuries. Injury prevention protocols in the US should focus on tackling techniques, which may reduce incidence of tournament match injuries.
INJURIES IN AMERICAN YOUTH RUGBY-7S: AN EMERGING ADOLESCENT COLLISION SPORT
Authors: Lopez Victor , Ma Richard , Weinstein Meryle , Hume Patria , Cantu Robert , Victoria Christian , Queler Sophie , Answorth Allen
Published: August 2017

Background

Rugby-7s growth in the United States predominantly seen in the amateur population, has very little youth rugby injury data.

Objective

To report incidence and causes for US youth Rugby-7s match injuries.

Design

Prospective descriptive epidemiology study.

Setting

The study encompassed Under-19 players in USA Rugby sanctioned tournaments (2010–2014).

Participants

A total of 3,804 US players (13–19 years old) were included over 24 tournaments, of 643 youth-division matches (140=female; 515=male) in 317 sides/teams (61=females; 256=males).

Assessment of Risk Factors

Causes in youth Rugby-7s injuries.

Main measurement outcome

Injury incidence (per 1000 player-hour (ph)) and mechanism, captured using Rugby Injury Survey & Evaluation (RISE) Report methodology. Time-loss injuries=players who did not return to play the day of their injury. Medical attention injuries=players who had injuries evaluated with no absence from play. Severity=days absent before return to training/competition (including post tournament).

Results

Injuries combined were found at 81.9/1000 ph (n=172) (time-loss injuries=33.3/1000 ph; n=70; medical attention injuries=48.6/1000 ph; n=102;P=0.013). Males among positions, experienced higher rates of injuries (backs 81.8/1000 ph, n=77; forwards 56.7/1000 ph, n=40; RR: 1.16,P=0.053) than females (backs 65.6/1000 ph, n=17; forwards 77.1/1000 ph, n=15; RR: 0.93, P=0.642) (RR: 0.96,P=0.332). Time-loss injuries resulted in a mean severity of 35.4 days (females, 29.6 days; males, 37.6 days). Most injuries were acute (93%; RR: 2.3,P<0.001) during tackling (80.3%; RR: 1.6,P<0.001). Injuries most commonly involved the joints or ligaments (40%) and the lower extremities (39%). High incidences of head and neck injuries including concussions (overall 26%) and upper extremity injuries (29%) were seen among the youth.

Conclusions

US Rugby-7s youth had lower time-loss injury rates (33.3/1000 ph) than US amateur adult Rugby-7s (49.2–55.4/1000 ph) and international boys' Rugby-15s (35–57.2/1000 ph). Due to tackling injuries among head, neck and upper extremity, US youth would benefit from injury prevention in a tackling technique evaluation.
VIDEO-ANALYSIS OF MODERATE AND SEVERE MATCH INJURIES IN GERMAN MEN'S PROFESSIONAL HANDBALL
Authors: Luig Patrick , Bloch Hendrik , Henke Thomas , Klein Christian
Published: August 2017

Background

There is little knowledge about the causes of injuries in men's professional handball, in particular with a view to the specificity of regular league play.

Objective

To identify and describe typical injury situations, mechanisms and characteristics in German men's professional handball.

Design

Prospective video-based analysis of match injuries.

Setting

Two highest German professional leagues in men's handball.

Participants

All first and second league handball players who played at least one competitive club match (n=1,194) were included in the study and observed over a period of three consecutive seasons (2010–2013).

Interventions (or Assessment of Risk Factors)

Analysis of all moderate and severe match injuries (time-loss>7 days) that were registered by clubs or physicians with the VBG (German statutory accident insurance for the administrative sector) as part of the occupational accident reporting.

Main Outcome Measurements

The video observation form contained 27 variables including data on injury location, time of injury, injury situation, injury mechanism.

Results

560 moderate or severe match injuries were recorded during 2,227 competitive matches. 243 injuries (43.4%) were identified on video. 56.8% of injuries were contact injuries, 25.1% indirect contact injuries and 18.1% non-contact injuries. 63.8% of injuries occurred during attacking play. While pivots most often injured themselves in a defensive position and through contact, injuries in backcourt players were more often the result of indirect contact and in an attacking position. Injuries in field players were significantly overrepresented during the final thirds of each half, specifically in the last ten minutes of the game. Moreover, 7 typical injury situations for knee, ankle, shoulder and head injuries in were recognized.

Conclusions

Video-analysis of match injuries made it clear that not only sport-specific, but also position- and injury-specific aspects must be taken into account in order to derive targeted, multidisciplinary preventive measures.
THE RELATION BETWEEN LOAD AND PATELLAR TENDON STRUCTURE DURING PRESEASON IN VOLLEYBALL PLAYERS
Authors: Rabello Lucas Maciel , Ijtsma Ruth , Zwerver Johannes , Brink Michel S
Published: August 2017

Background

Patellar tendinopathy is a common overuse injury in jumping sports, with higher prevalence in volleyball players. Different risk factors are associated with patellar tendon problems, including training load. Despite different treatment options, rates of chronicity and recurrence are high. Therefore, the high prevalence and the challenging treatment underlines the importance of prevention.

Objective

Investigate the relation between tendon load and the response of patellar tendon structure of volleyball players.

Design

Observational prospective study.

Setting

The study was performed with elite volleyball players during the preseason.

Patients (or Participants)

A total of 17 elite male volleyball players from Dutch volleyball league.

Interventions (or Assessment of Risk Factors)

Training load, including jump frequency and Rating or Perceived Exertion (RPE), were measured every training and match during 7 weeks.

Main Outcome Measurements

Tendon structure was measured using the Ultrasound Tissue Characterization (UTC), which quantifies the structure of the tendon (percentages of four echo-types).

Results

On average, players spent 624±215 minutes on training and matches per week with a RPE of 13.9±2.1 indicating 'somewhat hard' intensity. Jump frequency was 278±122 per week. Higher load parameters (volume, intensity and load) resulted all in a higher decrease of echo-type I (p<0.05). Higher volume and load resulted in a higher decrease of echo-type II (p<0.05). Higher cumulative weekly volume and cumulative weekly loads between the first and the last UTC were related to significant higher decreases in echo-type I (p<0.05), but not related for echo-type II. No significant relations were found for jump frequency. None of the load parameters were related to echo-type III and IV.

Conclusions

The present study showed that load was related to changes in echo-types over a 7 week preseason in elite volleyball players. A higher amount of load was related to greater echo pattern changes.
THE EFFECT OF BODY CHECKING POLICY CHANGE ON CONTACT MECHANISMS IN 13 AND 14 YEAR OLD YOUTH ICE HOCKEY PLAYERS
Authors: Martinez German , Janzen Leticia , Krolikowski Maciej , Romanow Nicole , Palacios-Derflingher Luz , Goulet Claude , Nadeau Luc , Emery Carolyn
Published: August 2017

Background

A 2015, Hockey Calgary body checking (BC) policy change disallowed BC from non-elite Bantam (ages 13–14, lower 60% of divisions). This was informed by evidence that disallowing BC in Pee Wee (ages 11–12) reduced the risk of injury, specifically concussion, by >3-fold.

Objective

To compare the frequency of type and intensity of player-to-player contacts (PC) and head contact in non-elite Bantam ice hockey games in leagues allowing BC (2014–15) compared with leagues disallowing BC (2015–16).

Design

Cohort study.

Setting

Ice-hockey arenas in Calgary, Canada.

Participants

Non-elite Bantam players in 2014–15 (n=348 players) and 2015–16 (n=309 players) seasons.

Interventions

In the 2014–15 season, non-elite Bantam leagues allowed BC. In 2015–2016, BC was disallowed.

Main Outcome Measurements

Thirteen games pre-policy change (2014–2015) and 13 post-policy change were video recorded. Analysis using validated methodology was used to compare the frequency, type (i.e., trunk, head and other types of PC with limb/head/stick), and intensity (trunk contacts level 1–5 with increasing intensity) of PCs. Incidence rate ratios (IRR) were estimated using Poisson regression (controlling for cluster by team, offset by player minutes).

Results

There were a total of 3485 trunk contacts and 1395 other contacts in 26 games. The overall risk of trunk PCs was lower post-policy change (IRR=0.50, 95% CI; 0.45–0.56). Post-policy change, high intensity (body checking - level 4,5) contacts decreased (IRR4=0.19, 95% CI; 0.13–0.26 IRR5=0.11, 95% CI; 0.03–0.51), lower intensity (level 2,3) PCs were less frequent (IRR2=0.45, 95% CI; 0.40–0.50 and IRR3=0.47, 95% CI; 0.35–0.63), and other contacts made with the limb/stick also decreased (IRR=0.60, 95% CI; 0.48–0.73). Head contact decreased (IRR=0.40, 95% CI; 0.25–0.61).

Conclusions

Post-policy change disallowing BC in non-elite Bantam, incidence of high intensity (level 4,5) PCs decreased 82%. Head contact decreased 60% and stick/limbs contact decreased 40%. These findings inform the mechanisms of injury explaining concussion risk reduction post-BC policy change.
A CASE-CONTROL STUDY INVESTIGATING THE RELATIONSHIP BETWEEN 3-T MRI FINDINGS, BONY MORPHOLOGY, AND HIP PAIN AND FUNCTION IN PROFESSIONAL BALLET DANCERS AND NON-DANCING ATHLETES
Authors: Mayes Susan , Smith Peter , Ferris April-Rose , Cook Jill
Published: August 2017

Background

Ballet loads the hip joint in extreme ranges of movement (ROM). Abnormal bony morphology and joint laxity may enable this movement, but predispose dancers to hip injury.

Objective

To compare hip injury and bony morphology between ballet dancers and non-dancing athletes, and to investigate relationships between these factors and clinical features.

Design

Blinded, case-control study.

Participants

49 professional ballet dancers and 49 age- and sex-matched non-dancing athletes.

Setting

Professional ballet company and sporting clubs.

Assessment of Risk Factors

Lateral centre edge angles, anterior and superior alpha angles, femoral neck-shaft angles and acetabular version angles measured with 3.0-Tesla magnetic resonance imaging (3-T MRI), ROM and hypermobility testing.

Main Outcome Measurements

Cartilage, labral, ligamentum teres (LT) lesions and effusion scored on MRI, and HAGOS (Copenhagen Hip and Groin Outcome Score).

Results

Cartilage defect and labral tear prevalence was similar in dancers and athletes (p>0.05); LT tears were more prevalent in dancers compared to athletes (p=0.001). Dancers had higher neck-shaft angles (p=0.002); lower acetabular version angles (p=0.003); lower superior alpha angles (p<0.001); similar anterior alpha angles (p=0.2); and similar lateral acetabular coverage (p=0.07), compared to athletes. There was no significant association between the morphological parameters and cartilage, labral, LT injury or effusion (p>0.01 for all). All 6 dancers with cam morphology (α angle >50°) measured anteriorly had cartilage defects, and 5 had labral tears; a trend not observed in athletes. Joint effusions were larger in dancers compared to athletes (p=0.009), and the only factor related to lower HAGOS pain and sports/recreation scores in female dancers (p=0.001 for both).

Conclusions

Professional ballet dancers had a high incidence of LT tear, and hip bony morphology that may allow extreme motion. Dancers with cam morphology had cartilage defects, but joint effusion was the only correlate with symptoms. Longitudinal studies are required to determine the clinical sequelae.
USING NATIONAL CORONIAL DATA TO IDENTIFY PRIORITIES FOR PREVENTING DEATH IN SPORT/RECREATION
Authors: McIntosh Andrew , Fortington Lauren , Patton Declan , Finch Caroline
Published: August 2017

Background

Deaths relating to sport/recreation are thought to be rare. However, in Australia, a lack of published data has limited our understanding of the number of deaths in different sports and settings.

Objective

To gain a first understanding of the number/cause of deaths across different sports/recreation activities in Australia.

Design

A case-series analysis was undertaken using the National Coronial Information System (NCIS) in Australia.

Setting

All sport and physical recreation activities in Australia as coded in the NCIS, including recreational and professional participants.

Patients

Cases are ‘closed’ NCIS cases of all ages who died in the period 2000 to 2016 as a result of participating in sport and physical recreation. Cases were selected from NCIS activity level one categories – Sport and Exercise During Leisure Time, Education, Leisure or Play and Paid Work.

Interventions

None.

Main Outcome Measurements

The number of deaths by sport/recreation activity and associated demographic data (e.g. sex, age). The cause, mechanism of injury and contributing factors are explored.

Results

5060 cases were included. The three most frequent activities were “Individual water sports” (42%), “Individual athletic activities” (9%) and “wheeled non-motor sports” (7%). Combined, team bat/stick and team ball sports contributed 7% of cases. Males accounted for 88% of cases. The proportion of deaths by age increased from 4% in 5–14 year olds, peaked at 19% in 45–54 year olds, before declining. The most common causes were identified as cardiac-related (39%), drowning (34%) and blunt force trauma (19%.)

Conclusions

There is demonstrable evidence from other injury settings for data to inform safety measures that can prevent fatalities. These results provide a first understanding of the people/activities most often impacted by death in different sports settings across Australia. With this information, leading activity contexts and causes will be explored to identify common mechanisms and potential prevention priorities and strategies.
EXTREME SPORTS, EXTREME RISKS. FATALITIES IN EXTREME SPORTS IN AUSTRALIA
Authors: McIntosh Andrew , Fortington Lauren , Patton Declan , Finch Caroline
Published: August 2017

Background

Extreme sports are popular and include motorised and non-motorised vehicle sports, e.g. motocross, mountain biking and water skiing, as well as non-vehicle sports, e.g. rock climbing. The causes of death, contributing factors and potential to prevent deaths in extreme sports are poorly understood.

Objective

To understand the causes of death and contributing factors in extreme sports in Australia.

Design

A case-series analysis was undertaken using the National Coronial Information System (NCIS) in Australia.

Setting

Extreme sports, including recreational and professional participants.

Patients

Cases are ‘closed’ NCIS fatal cases aged 15 to 64 years who died in the period 2000 to 2016 while participating in an extreme sport.

Interventions

None.

Main Outcome Measurements

Theses include the cause of death, mechanism of injury, contributing factors, demographic data, case narratives, and sport participation.

Results

Using a narrow definition of extreme sports (i.e. including sports such as kayaking, paragliding, rock climbing, snow sports and mountain biking) there were 693 deaths. Using a broader definition of extreme sports, e.g. including sports such as diving, horse racing, motor racing and quad bike use, there were 995 deaths during the same period. Approximately 88% of cases in either analysis (broad or narrow) were males, with age distributed relatively evenly from 15 to 54 years. The largest two broad sports categories were individual water sports (including surfing/boogie board 120/693) and wheeled motor sports (including motorcycling 192/693), combined accounting for over half of all cases in either analysis. There were over 50 deaths in skydiving/paragliding/parasailing. Blunt force trauma was the main cause of death, 65% of 693, followed by drowning 20% and cardiac 11%.

Conclusions

The potential for preventing a proportion of blunt force trauma and drowning deaths through controls, such as event planning, individual preparation and equipment, will be examined based on the case narratives.
DEATHS IN ORGANISED SPORTS IN AUSTRALIA: A CASE SERIES REVIEW OF THE NATIONAL CORONIAL INFORMATION SYSTEM
Authors: McIntosh Andrew , Fortington Lauren , Patton Declan , Finch Caroline
Published: August 2017

Background

Organised sports include individual water sports and athletic activities, team ball sports, team bat/stick sports and racquet sports. The causes of death, contributing factors and potential to prevent deaths in organised sports are poorly understood.

Objective

To understand the causes of death and contributing factors in organised sports in Australia.

Design

A case-series analysis was undertaken using the National Coronial Information System (NCIS) in Australia.

Setting

Organised sports, including recreational and professional participants.

Patients

Cases are ‘closed’ NCIS fatal cases aged 15 to 74 years who died in the period 2000 to 2016 as a result of participating in an organised sport.

Interventions

No interventions were assessed.

Main Outcome Measurements

These include the cause of death, mechanism of injury, contributing factors, demographic data, and sport participation.

Results

There were 913 deaths in organised sports, with 89% being male. The largest group was 45–54 year olds (23%) and the smallest was 65 to 74 year olds (15%). The three sports groups accounting for the highest proportion of deaths were team ball sports (23%), wheeled motor sports (12%) and individual water sports (11%). Within team ball sports there were 98 deaths in organised football (Australian Rules, Rugby Union and Rugby League). Overall, the cause of death was cardiac, e.g. congestive cardiac failure and acute coronary syndrome, in 56% of cases, blunt force trauma in 29% and drowning in 7%. Cardiac deaths increased with age while blunt force trauma deaths reduced with age.

Conclusions

There are age related differences in sport participation at time of death and cause of death that need consideration in planning for life long active participation in organised sport. Organised sports are governed by organisations with responsibility for setting player safety standards – informing these organisations of risks is critical for injury prevention, medical emergency policy and planning.
PREVALENCE OF PATELLAR TENDON PAIN HISTORY IN BRAZILIAN VOLLEYBALL AND BASKETBALL ATHLETES
Authors: Mendonça Luciana , Bittencourt Natália , Ocarino Juliana , Fonseca Sérgio
Published: August 2017

Background

Patellar tendinopathy is a clinically identified overload injury associated to jumping activities. The symptoms may last for years, affect sports participation and even lead to the end of a sport career. Therefore, is necessary to understand the profile of injury/complain in a sports team in order to plan preventive strategies.

Objective

The purpose of this study was to identify the prevalence of patellar tendon pain history in Brazilian volleyball and basketball athletes.

Design

Cross-sectional.

Setting

Sports Science Laboratory in the Universidade Federal de Minas Gerais.

Patients (or Participants)

One-hundred and ninety and one volleyball and basketball athletes with a mean age of 18.29 (+4.9) years, body mass of 76.50 (+13.8) kilograms and height of 1.85 (0,11) meters participated in this study.

Interventions (or Assessment of Risk Factors)

The athletes were questioned by the examiner about patellar tendon pain history related to sports practice. If the athlete had history of other knee complains (as patellofemoral pain and bursitis) and/or Osgood-Schlatter, he/she was excluded.

Main Outcome Measurements

History of pain, in the last 6 months, localized at the patellar tendon, which compromised the sports participation and/or sports performance.

Results

The prevalence of patellar tendon pain history was 22.5% (n=43) in the athletes participating in this study. Fifteen were female and 28 male, 25 were juvenile and 18 adult and 34 practiced volleyball and 9 basketball. Ten athletes reported patellar tendon pain in left lower limb, 14 in right lower limb and 19 bilaterally. Therefore, 147 athletes did not had patellar tendon pain history in the last 6 months.

Conclusions

The prevalence of patellar tendon pain history in this study was 22.5%. The major occurrence was bilateral pain history and the results suggest that male volleyball athletes had higher prevalence.
CATASTROPHIC INJURY INCIDENCE RATES IN SOUTH AFRICAN RUGBY UNION: ARE THERE REGIONAL DIFFERENCES?
Authors: Badenhorst Marelise , Verhagen Evert , van Mechelen Willem , Lambert Mike , Viljoen Wayne , Readhead Clint , Baerecke Gail , Brown James
Published: August 2017

Background

South Africa has 14 Provincial Rugby regions ('Unions'). Although rugby-related catastrophic injuries have been reported at 2.0 per 100 000 players per year, the comparative risk between each of these SA Unions has not yet been quantified. Understanding the difference in injury risk between Unions is important for potential intervention modifications.

Objective

The objective of this study was to compare the catastrophic injury incidence rates between the 14 SA Unions.

Design

A prospective, population-based study was conducted across all SA Unions between 2008–2014.

Setting

The number of verified players (males and females; under-seven age group to adult; amateur and professional) in each Union was obtained from SA Rugby's 2013 Census.

Patients (or Participants)

Catastrophic injuries were analysed using BokSmart's serious injury database.

Interventions (or Assessment of Risk Factors)

Union-specific injury incidence rates with 95% Confidence Intervals were calculated. Catastrophic injuries (Acute Spinal Cord Injuries (ASCI) and Traumatic Brain Injuries (TBI)) within Unions were compared statistically using a Poisson regression with Incidence Rate Ratios (IRR) and a 95% level of confidence (p<0.05).

Results

Catastrophic injury incidence rates per Union ranged from 1.8 per 100 000 players (95% CI: 0.0 to 6.5) to 7.9 (95%CI: 0.0 to 28.5). The Union with the highest incidence rate of permanent outcome ASCIs was reported at 7.1 per 100 000 players (95% CI: 0.0 to 17.6). Compared to this Union, five (n=5/14, 36%) of the Unions had significantly lower injury incidence rates of ASCI.

Conclusions

Regional differences in catastrophic injury incidence rates exist in SA and interventions should be tailored accordingly. Future studies should investigate the underlying reasons contributing to these regional differences.
ECCENTRIC KNEE FLEXOR STRENGTH AND HAMSTRING INJURY RISK IN ATHLETES WITH HISTORY OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Authors: Messer Daniel , Bourne Matthew , Timmins Ryan , Opar David , Williams Morgan , Shield Anthony
Published: August 2017

Background

Hamstring strain injuries (HSIs) are the most common cause of time loss from training and competition in elite football. Anterior cruciate ligament (ACL) ruptures are also prevalent and typically require surgery from hamstring grafts, which often results in chronic deficits in eccentric knee flexor strength, a known risk factor for HSI.

Objective

We aimed to determine the effect of prior ACL reconstruction (ACLR) on 1) eccentric knee flexor strength during the Nordic hamstring exercise (NHE) and; 2) the risk of future HSI. We hypothesised that athletes with a prior ACLR would display 1) lower levels of eccentric knee flexor strength than athletes without such history and; 2) an increased risk of future HSI.

Design

Prospective study.

Setting

Secondary analysis of 3 studies previously completed in Australian sport.

Patients (or Participants)

541 elite to sub-elite male footballers had their eccentric knee flexor strength assessed using the NHE. Reports of HSIs and any history of ACL injuries were obtained. All participants were categorized into injury history groups.

Interventions (or Assessment of Risk Factors)

Injury history, eccentric strength.

Main Outcome Measurements

Prospective HSI occurrence.

Results

Athletes with history of ACLR were 39N (95% CI, 14.2–67.1; P<0.005) weaker in the injured limb compared to the contralateral limb. Athletes with history of ACLR had a 3.18-fold (95% CI, 1.9–5.2; P<0.001) greater risk of subsequent HSI than athletes without such history and was augmented to 5.69 (95% CI, 3.2–9.5; P<0.001) if they had suffered HSI in the previous 12 months.

Conclusions

ACLR injured limbs are significantly weaker than uninjured limbs. Athletes with prior ACLR are significantly more likely to suffer future HSI, particularly if they have a recent history of HSI. This is the first adequately powered study to have assessed the effect of prior ACLR on future HSI risk.
EFFECTS OF ADDITIONAL PERTURBATION ON NEUROMUSCULAR TRUNK ACTIVATION PATTERN DURING CORE-SPECIFIC SENSORIMOTOR EXERCISE
Authors: Mueller Juliane , Baritello Omar , Stoll Josefine , Mueller Steffen , Mayer Frank
Published: August 2017

Background

Sensorimotor exercises (SE) are evident to enhance neuromuscular activity of the trunk muscles (TM). However, it is unclear if an additional unexpected perturbation leads to higher muscular activity and therefore enhances training efficacy.

Objective

To analyse effects of additional unexpected perturbations on trunk neuromuscular activation pattern during SE.

Design

Cross-sectional design.

Setting

University Outpatient Clinic, Sports Medicine Centre.

Participants

Ten healthy, normal active participants (5 m/5 f; 29±2 yrs; 177±7 cm, 74±12 kg) were included.

Assessment of Risk Factors

All participants were prepared with a bilateral 12-lead trunk EMG (Mm. rectus abdominis (RA), external obliquus (EO), internal obliquus (IO), latissimus dorsi (LD), thoracic (UES) and lumbar erector spinae (LES)). Warm-up on an isokinetic dynamometer (extension/flexion; 30 rep; 60°sec) was followed by maximum voluntary isometric contraction measurements (MVC, 5 sec). Next, a (right-armed) side plank on stable surface (SP; 30 sec) and 2 different instable conditions were randomly assigned (SP plus pad under the elbow (SPP), SPP plus perturbation (SPP+P)).

Main Outcome Measurements

Root mean square (RMS) normalized to MVC (%MVC) was calculated during the whole exercise. Muscles were grouped to ventral right/left (VR;VL=mean of RA, IO, EO), and dorsal right/left (DR;DL=mean of LD, UES, LES). Differences between conditions were calculated for muscle groups, Ventral:Dorsal (V:D) and Side-Right/Side-Left ratio (SR;SL) (repeated-measures ANOVA; α=0.05).

Results

SPP+P showed highest EMG-RMS (e.g,VR: 81±9%; DR: 55±12%) for all muscle groups except DL with significant differences (p<0.05) between conditions SP and SPP+P in VR, VL and DR muscle groups. No differences were found between SPP (e.g.,VR: 71±11%) and SPP+P (e.g.,VR: 81±9%)(p>0.05). Statistically significant higher V:D ratios was found in SPP+P compared to SP (p<0.05). SR:SLratio did not show any differences (p>0.05).

Conclusions

The use of additional perturbations during core stability training is superior to enhance trunk neuromuscular activity and should be implemented into sensorimotor exercises addressing the trunk.
A LARGE WEEKLY INCREASE IN HANDBALL PARTICIPATION INCREASES THE SHOULDER INJURY RATE IN DANISH YOUTH HANDBALL
Authors: Møller Merete , Nielsen Rasmus , Attermann Jørn , Wedderkopp Niels , Lind Martin , Sørensen Henrik , Myklebust Grethe
Published: August 2017

Background

Knowledge of injury patterns, an integral step towards injury prevention, is lacking in youth handball.

Objective

To investigate if an increase in weekly handball participation is associated with increased shoulder injury rates compared with decrease or a minor increase, and if a potential association is influenced by scapular control, isometric shoulder strength, or glenohumeral range of motion (ROM).

Design

Prospective cohort study with weekly reports on shoulder injury, and handball participation over 31 weeks using the SMS, Phone and Medical Examination system. Assessment of shoulder isometric rotational and abduction strength, ROM and scapular control was performed at baseline and mid-season.

Setting

Danish elite youth handball.

Participants

686 players were enrolled. Seven players were excluded, and data from 36 players were censored.

Assessment of Risk Factors

Weekly change in handball participation categorised into (1) <20% increase or decrease (reference), (2) increase between 20–60%, (3) increase >60% relative to the weekly average amount of handball participation the preceding four weeks. Scapular control, isometric shoulder strength and ROM were included as effect measure modifiers.

Main Outcome Measurements

Any handball-related shoulder problem irrespective of the need for time loss or medical attention.

Results

An increase in handball participation by >60% was associated with greater shoulder injury rate (Hazard Ratio (HR):1.91; 95% Confidence Interval (CI) 1.00; 3.70, p=0.05) compared with the reference group. The effect of an increase in handball participation between 20% to 60% was exacerbated amongst players with reduced external rotation strength (HR:4.0; 95% CI 1.1; 15.2, p=0.04) or scapular dyskinesis (HR 4.8; 95% CI 1.3; 18.3, p=0.02). Reduced external strength also exacerbated the effect of an increase above 60% (HR: 4.2; 95% CI 1.4; 12.8, p=0.01).

Conclusions

A large increase in weekly handball participation increases the shoulder injury rate in elite youth handball players; particularly in the presence of reduced external rotational strength or scapular dyskinesis.
THE EFFECT OF AN IRONMAN TRIATHLON ON ACHILLES TENDON STRUCTURE:A CASE REPORT
Authors: O'Neill Seth , Simon Barry
Published: August 2017

Background

Transient changes in Achilles tendon structure are known to occur post exercise, it is unknown whether completing an ironman affects tendon structure.

Objective

Assess the effect of an ironman on Achilles tendon structure.

Design

Case study of a subject completing an ironman triathlon. The study utilised Ultrasound tissue characterization (UTC) scanning to quantify tendon structure pre and post activity. The UTC scan was completed 1 day prior to the Ironman and on day 2 by one examiner. The quantification of the UTC scan was completed by two experienced users who were blinded to the scan order.

Setting

UK University.

Patients (or Participants)

49 year old male subject.

Interventions (or Assessment of Risk Factors)

An ironman triathlon involves 3.86 km swim, 180.25 km bicycle ride and a marathon (42.20 km).

Main Outcome Measurements

UTC quantification of Achilles tendon using percentage volume of each of the four echo types, tendon volume and mean cross-sectional area (mCSA).

Results

Data is presented as the mean of the two examiners results. The mCSA increased by 10.7 mm2and 5.4 mm2on the right and left Achilles respectively. Tendon volume of the right Achilles tendon increased by 321.8 mm3and whilst the left increased by 162.9 mm3. Data for the right and left leg were combined with the mean change in percentage of the different echo types presented post intervention. Echo type I increased by 1.7%, echo type II increased by 0.6% whilst echo type III and IV reduced by 1.7% and 0.6% respectively.

Conclusions

The results indicate a change in Achilles tendon volume, mCSA and percentage of the different echo types post ironman. This preliminary study suggests that further work is required to assess alterations in Achilles tendon post ironman, specifically this work should determine if this change is observable in a larger group of athletes and whether this change is transient in nature.