bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrinsic risk factors and the effects of prophylactic bracing on the development of patellofemoral pain in male subjects
Authors: Van Tiggelen D , Cowan S , Thijs Y , Coorevits P , Witvrouw E
Published: March 2011

Background

The aetiology of patellofemoral pain (PFP) is multifactorial. Patellofemoral bracing can be used as a preventative method in subjects undergoing strenuous training.

Objective

Individuals with intrinsic risk factors for PFP could be identified to provide them with patellofemoral braces as preventative method.

Setting

Military cadets undergo a strenuous basic military training (BMT) of 6 weeks.

Design

A prospective cohort study.

Participants

169 male officer cadets volunteered for the study.

Intervention 43 subjects were randomly assigned to the intervention group wearing patellofemoral braces during the BMT.

Main outcome measurements

Peak torque of the knee extensor and flexors, the onset of the VMO and VL, the joint position sense (JPS) of the knee, the range of motion and anthropometrical characteristics were measured. A military physical fitness test (MPFT) was assessed prior to the start of their BMT.

Results

After BMT less recruits in the brace group developed PFP compared to the control subjects (16.3% vs 33.7%; p=0.042). A delayed onset of the VMO-VL, poor JPS, lower peak torque of the knee extensors and a low score on the MPFT were predictive variables in the development of PFP.

Conclusion

The incidence of PFP in predisposed individuals could be downsised using patellofemoral bracing if intrinsic risk factors are identified. Physical intrinsic risk factors predict the development of PFP during strenuous training sessions. The use of the logistic regression model could identify individuals who could derive benefit from patellofemoral bracing during exacting training sessions.
Beijing 2008 olympic games meant danger for the health of athletes? Monitoring of air pollution during games of XXIX olympiade by PM10
Authors: Vetvicka J , Handl M
Published: March 2011

There has been extensive debate about the impact of air pollution before Olympic games 2008 in Beijing and its influence on health and/or performance of athletes. BOCOG and Chinese authorities give this issue a lot of effort. Also, the IOC and NOCs monitor the situation, communicate with the BOCOG and implement preventive measures. Czech NOC in addition to prevention, decided to own direct measurement of air pollution. Based on the measurement results can then decide about the scheme and selection of athletes training funds, or preventive precautions.

Ambient temperature, relative humidity and particulate matter with aerodynamic diameter below 10 ìm (PM10) were measured during and shortly before the Games between August 3 and 24, 2008 in Beijing Olympic Village in Block B3 where devices were placed on the balcony in rooms of the Czech Olympic team. Continuous temperature and relative humidity values were monitored datalogging thermo-hygrometer, and PM10 were made fast to respond DustTrak nephelometer. For comparison, similar measurements were carried out at the same time, also in Prague.

Temperature and PM10 concentrations were significantly higher in the week preceding Olympic Games. During the Games, however, these parameters decreased significantly. Relative humidity was a lower one during pre-Games than during Games.

Announced drastic measures to reduce emissions from industry, transport and construction are likely to bring their positive influence. Significant effects were also favourable climatic conditions, which decreased ambient temperature and frequent rains are likely to have contributed to an unprecedented improvement of pollution conditions.

According to our results we can conclude that athletes in Beijing were significantly fewer health risk due to air quality than expected pessimistic assumptions.
Jumping ability and change of jumping ability as a risk factor for developing jumper's knee? Data from the patellar tendinopathy cohort 2006–2010
Authors: Visnes H , Bahr R
Published: March 2011

Background

Previous studies on high level athletes has shown that players with jumper's knee jumps as high and perhaps even higher than the symptom-free athletes. The reason for this difference is unknown, and we know little about when this difference occurs.

Objective

Assess the Jumping ability and change of this ability as a risk factor for developing jumper's knee.

Design

Prospective cohort study.

Participants

Elite volleyball players at junior high school (Top Volley Norway) at Sand, Norway.

Method

Standardised jumping on the power platform (Boscotest). Standing jump (SJ) and countermovement jump (CMJ) were tested at baseline and then twice a year. The jumper's knee diagnosis was based on a standardised clinical examination.

Results

A total of 113 symptom-free students were included, with a mean observation time of 1.8 years. 19 of these developed jumper's knee (16 boys and three girls). The three symptomatic women these were excluded in the analysis. The groups were equal at baseline; asymptomatic athletes had SJ of mean 27.5 cm and CMJ at 35.0 cm, while the jumper's knee group had SJ at 28.0 cm (p=0.67 vs asymptomatic) and CMJ (37.2 cm (p=0.10). Jumping ability changed in both groups. For the asymptomatic it was SJ: 5.5 cm (95% CI 1.9 to 9.1) for and CMJ: 6.0 cm (4.1–7.9) while the corresponding results in jumper's knee group was SJ: 3.7 cm (−1.8 to 9.3) (ANOVA, p=0.003) and CMJ: 4.5 cm (0.3 to 8.8) (ANOVA, p=0.001).

Conclusion

There is no difference at baseline between the men who developed jumper's knee with those who remained asymptomatic. Those who remained asymptomatic, however, increased their jumping ability more than those who developed a finding that conflict with data from previous cross-sectional studies.
Cross-training and injury risk in british olympic distance triathletes
Authors: Vleck V , Alves F Bessone
Published: March 2011

Background

Triathlon injury research is in its early stages- with no consensus on injury definition and recording methods having been reached, and few prospective data yet available. Levyet al., (1986) suggested that less injury may occur within this sport than in its component disciplines. Massiminoet al., (1988) proposed the opposite.

Objective

To determine whether swim, cycle and or run training exert a cumulative stress effect on triathlon overuse injury (OU) risk.

Design

Seven month prospective longitudinal training diary based survey, from the endurance base period up to World Championships.

Setting

British Olympic distance specialists.

Participants

Top 50 finishers at their non-drafting National Championships in the year of, or year prior to, the study.

Assessment of risk factors

Both absolute (ie, duration) and derived training variables were assessed. Derived variables included both training that was weighted for each of five intensity levels it comprised, and combined training for more than one discipline. Log values (% difference from the previous week) and (difference from the previous week) for training variables for 1, 2, 3, and 4 weeks prior to injury were used.

Main outcome measurements

‘New OU’ was used as the dependant variable in a binary logistic regression analysis, involving combinations of 1–4 training related variables. Anatomical location, discipline(s) that OU was attributed to (on first and subsequent occurrence(s), and performance decrement (PD) were also assessed.

Results

Return rates were 43, 38, 33, 26, 21, 14 and 11 for each consecutive month. 60% of athletes reported OU with concomitant PD at least once. New OU was associated with an increase in the log of combined weighted cycle and run training in levels 3, 4 and 5 two weeks prior to onset (p<0.05).

Conclusion

The extent to which cycle and run training have a cumulative effect on triathlon injury risk deserves further investigation.
Effects of olympic style taekwondo kicks on an instrumented head-form and resultant head injury measures
Authors: Fife G , Pieter W , O'sullivan D , Cook D , Kaminski T
Published: March 2011

Background

In taekwondo (TKD), concussion incidence is four times greater than in American football. Biomechanical investigations on concussion in TKD is sparse.

Objective

To examine differences in TKD kicks on resultant head linear acceleration (RLA), head injury criterion (HIC15) and peak head velocity (HVEL).

Design

Between-groups.

Setting

Biomechanics laboratory.

Participants

12 elite male TKD athletes (22.5+3.5 years, 176.9+7.3 cm, 70.9+8.6 kg).

Interventions

Five head kicks (round kick (RK), front leg axe kick, clench-axe kick (CA), jump spin back kick, jump spin hook kick (JH)) were randomly performed five times each. A Hybrid II Crash Dummy head (H2D) was instrumented with a tri-axial accelerometer (PCB Piezotronics-356A66) mounted inside the H2D head. The H2D was fixed to a height adjustable frame and fitted with a protective TKD helmet. Acceleration data were captured using Qualisys Track Manager (Gothenburg, Sweden) and processed in accordance with SAE J211-1.

Main outcome measurements

RLA, HIC and HVEL.

Results

The RK (130.11±51.67 g) produced a higher RLA than the CA (54.95±20.08 g, p<0.001, d=1.84) and a higher HIC15 than the JH (672.74±540.89 vs 300.19±144.35, p<0.001, ES=0.97). The range of the RLA by the RK was 60.50–217.33 g, while the CA was 26.34–99.02 g. The HIC15 range for the RK was 128.40–1608.70 and the JH, 63.90–573.00. There was no difference in HVEL of the RK (4.73±1.67 m/s, range: 3.36–9.52 m/s) and that of the JH (4.43±0.78 m/s, range: 3.00–5.54 m/s) (p=0.977, ES<0.01).

Conclusion

Our investigations are the first to identify the high-magnitude head impacts in TKD. A previous report suggests an HIC15 concussion threshold of >200. The RK is of concern because it is the most common technique and most common cause of concussion in TKD and has a high RLA and HIC15. Prevention of concussion in TKD should focus on employing qualified medical personnel, injury monitoring, and safer equipment.
The impact of fitness level on self-report of concussion symptoms
Authors: Lebrun C , Mrazik M , Naidu D , Matthews-White J , Game A
Published: March 2011

Background

The diagnosis and management of concussion in sport rely heavily on self-report of symptoms by the athlete. However, many symptoms commonly reported after a concussion (headache, nausea, fatigue, etc.) may be influenced by other factors. Fatigue is a frequent complaint, but may actually be a function of level of physical fitness.

Objective

To evaluate the role of physical fitness on self-report of concussion symptoms in collegiate athletes and students, during baseline testing.

Design

Prospective repeated measures.

Participants

125 subjects were recruited, including 95 collegiate athletes and 30 undergraduate students (83 males and 42 females). Athletes were screened for medical and psychological conditions. No athlete had a recent history of concussion.

Intervention

Subjects completed the Standardised Concussion Assessment Tool (SCAT1) at three time periods: prior to a Leger (Beep) test, within 10 min of test completion, and within 24 h. The Leger test has established validity and reliability to estimate an athlete's V02 maximum and overall fitness levels.

Main outcome measures

Estimated V02 max (Leger test) and symptom scores on the SCAT1.

Results

Subjects were grouped into three levels of fitness according to criteria established by the American College of Sports Medicine (2010). A 3×3 repeated-measures ANOVA was not significant for the overall model but showed a significant interaction between time and fitness level (F (2, 121)=3.50, p=0.02). Post-hoc analysis revealed significant differences in report of symptoms among the three fitness groups at baseline and immediately post-activity, but not at 24 h.

Conclusion

Results provide evidence of a moderating effect of fitness level on report of concussion symptoms at baseline, even in healthy adults. Specifically, exercise can induce symptom reporting, and may a function of an athlete's level of conditioning. Sport medicine professionals making decisions following concussion need to consider an athlete's level of fitness when evaluating post-concussion symptoms.
Are pre-season reports of neck pain, dizziness and/or headaches risk factors for concussion in male youth ice hockey players?
Authors: Schneider K , Emery C , Kang J , Schneider G , Meeuwisse W
Published: March 2011

Background

Concussion is a commonly encountered injury associated with potential long-term sequelae. No previous studies have evaluated dizziness, neck pain and headache as potential risk factors for concussion.

Objective

The objective of this study is to determine the risk of concussion in male youth hockey players with preseason reports of neck pain, headaches and dizziness.

Design

This study is a secondary data analysis of a prospective cohort study examining the risk of injury associated with body checking among paediatric ice hockey players.

Setting

Youth ice hockey in Alberta and Quebec, Canada.

Participants

A total of 3902 11–14 year old males from 282 teams participated.

Assessment of risk factors

Each participant completed a pre-season baseline demographic and injury history questionnaire. Preseason reports of neck pain, headache or dizziness were documented on the Sport Concussion Assessment Tool.

Main outcome measurements

Diagnosed concussions were recorded during the season of play via a previously validated, prospective injury surveillance system.

Results

A total of 178 concussions occurred during the studies, with 11 players sustaining two concussions. Incidence rate ratios were calculated using Poisson regression, adjusted for exposure hours, cluster by team and potential covariates. Dizziness was not a significant predictor of concussion. Individuals reporting a headache or neck pain at the start of the season were 1.48 (95% CI 1.02 to 2.14) and 1.69 (95% CI 1.16 to 2.44) times more likely to suffer a concussion during the season than those not reporting these symptoms. Individuals reporting any two of dizziness, headache and neck pain were 1.99 (95% CI 1.20 to 3.32) times more likely to sustain a concussion.

Conclusion

Male youth athletes reporting headache or neck pain at baseline were at an increased risk of concussion during the season. From an injury prevention perspective, baseline testing may aid in identifying individuals at a higher risk for concussion.
Effectiveness of cervical spine stabilisation techniques
Authors: Boissy P , Shrier I , Mellete J , Fecteau L , Matheson G O , Garza D , Meeuwisse W H , Segal E , Boulay J , Steele R
Published: March 2011

Background

Proper stabilisation of suspected unstable spine injuries is necessary to prevent (worsen) spinal cord damage. Although the lift-and-slide (L&S) technique has been shown superior to the log-roll (LR) technique to place the body on the spinal board, no studies have yet compared different techniques of manual stabilisation of the c-spine itself.

Objective

To compare cervical motions that occur when trained professionals perform the Head Squeeze (HS) and Trap Squeeze (TS) c-spine stabilisation techniques.

Design

Cross-over.

Setting and participants

12 experienced therapists.

Assessment

HS and TS during lift-and-slide (L&S) and LR placement on spinal board, and agitated patient trying to trying to sit up (AGIT-Sit) or rotate his head (AGIT-Rot).

Main outcome measurements

Peak head motion with respect to initial conditions using inertial measurement units attached to the forehead and trunk of the simulated patient. Comparisons between HS and TS with a priori minimal important difference (MID) of 5° for flexion or extension, and 3° for rotation or lateral flexion.

Results

Overall, the L&S technique was statistically superior to the LR technique. The only differences to exceed the MID were extension and rotation during LR (HS>TS). In the AGIT-Sit test scenario, differences in motion exceeded MID (HS>TS) for flexion, rotation and lateral flexion. In the AGIT-Rot scenario, differences in motion exceeded MID for rotation only (HS>TS). There was similar inter-trial variability of motion for HS and TS during L&S and LR, but significantly more variability with HS compared to TS in the agitated patient.

Conclusion

The L&S is preferable to the LR when possible for minimizing unwanted c-spine motion. There is little overall difference between HS and TS in a cooperative patient. When a patient is confused and trying to move, the HS is much worse than the TS at minimizing c-spine motion.
Matrix metalloproteinase genes on chromosome 11q22 and the risk of anterior cruciate ligament (ACL) rupture
Authors: Posthumus M , Collins M , Van Der Merwe L , O'Cuinneagain D , Van Der Merwe W , Ribbans W J , Schwellnus M P , Raleigh S M
Published: March 2011

Background

Anterior cruciate ligament (ACL) rupture is a complex disorder for which several risk factors, including genetic factors, have been established.

Objective

As matrix metalloproteinases (MMPs) are critical to ligament homeostasis and integrity, the primary aim of this study was to investigate if four selected polymorphisms within four MMP genes, which cluster on chromosome 11q22, associate with risk of ACL ruptures.

Methods

343 (138 individuals with ACL ruptures (ACL group) and 215 asymptomatic controls (CON group)) unrelated Caucasians were recruited for this case-control genetic association study. The ACL group included 54 participants with a non-contact mechanism of ACL rupture (NON- subgroup). All participants were genotyped using fluorescence-based assays, for the four selected functional polymorphisms; namely the MMP10 C/T rs486055, MMP1 1G/2G rs1799750, MMP3 G/A rs679620 and MMP12 A/G rs2276109 variants.

Results

When adjusted for sex, age and weight, the AG and GG genotypes of the MMP12 rs2276109 variant were significantly (p=0.030) under-represented among the NON-subgroups (14%), when compared to the CON group (26%). No other variants were significantly different between groups. In addition, when adjusted for the same confounders, the four variant haplotypes T-1G-A-A (CON 14%, ACL 9%, p=0.033) and C-2G-G-G (CON 14%, NON 5%, p=0.021) were significantly different between the CON group and the ACL group, as well as the CON and NON sub-group, respectively.

Conclusion

This study reports for the first time that the chromosomal region 11q22 is associated with risk of ACL rupture. The genetic risk profile reported in this study, together with genetic risk factors previously associated, and those yet to be identified, should in the future be included in multifactorial models designed to reduce the incidence of ACL rupture within ‘at-risk’ populations. Further research is required to replicate these findings in an independent population.
Screening of asymptomatic elite youth hockey players: clinical and MRI exam
Authors: Philippon M J , LaPrade R F , Briggs K K , Stull J D
Published: March 2011

Background

Ice hockey players are reportedly at increased risk to suffer hip injuries. This may be due to repetitive hip positions during the ice hockey skate stride.

Objective

To determine if specific tests used during a screening program can identify youth hockey players who are at risk of acetabular labral tears due to femoroacetabular impingement (FAI).

Design

Prospective screening study.

Setting

Clinical centre screened elite youth hockey players.

Participants

20 asymptomatic male (average age of 17.6 SD=0.5) ice hockey players who had signed IRB approved consent.

Assessment of risk factors

Participants underwent impingement testing, Flexion Abduction External Rotation (FABER) test, and range of motion and hip strength assessment prior to an MRI (3T) to determine hip alpha angle (AA) and labral pathology.

Main outcome measurements

Positive clinical findings of impingement correlate with the presence of labral pathology and high AA.

Results

14 players had a positive clinical exam (+impingement test or+FABER test or decreased hip internal rotation). Players with a positive clinical exam had a significantly higher AA compared to those with no positive signs (68° vs 61°; p<0.025). Players with a positive clinical exam were 12.5 times (95% CI 1.1 to 143) more likely to have an AA 65° or greater. 12 of the 14 participants with a positive clinical exam also had partial acetabular labral tears.

Conclusion

With this screening protocol, we were able to identify those patients with higher AA, which are considered at high risk. These players also demonstrated labral tears on MRI. We recommend that hip screening utilizing the impingement test, FABER test, and assessment of hip internal rotation be conducted as the initial screening of athletes with hip pain to assess for symptomatic FAI.
Injuries and terrain park feature use among snowboarders in alberta
Authors: Russell K , Meeuwisse W H , Nettel-Aguirre A , Emery C A , Ruest N , Wishart J , Rowe B H , Goulet C , Hagel B E
Published: March 2011

Background

Snowboarding is a popular and risky winter sport. Snowboarders perform tricks on man-made features in terrain parks, which may introduce additional risk.

Objective

To determine snowboard terrain park feature-specific injury rates and risk factors.

Design

Case-control study with exposure estimation.

Setting

A terrain park at a resort in Alberta, Canada, used for recreational and competitive snowboarding.

Participants

Cases were snowboarders injured in the terrain park who presented to the ski patrol or local emergency department (ED) (n=334). Controls were non-injured snowboarders using the terrain park (n=1262). The number of snowboarder-runs in the terrain park was recorded. Participants were recruited for two winter seasons.

Assessment of risk factors

Cases were identified from resort patient care records (PCRs) and ED logs. The PCRs captured demographic and environmental risk factors and injury assessment. Injured snowboarders were telephoned to determine exposure (feature used), listening to music and drugs/alcohol. Randomly selected controls were interviewed.

Main outcome measurements

Overall and feature-specific injury rates (per 1000 runs) were calculated. Cases and controls were compared for risk factor prevalence using multiple logistic regressions to estimate adjusted OR (aOR) and 95% CI.

Results

The overall injury rate was 0.75 injuries/1000 runs. Injury rates were highest on jumps (2.56/1000 runs), the half-pipe (2.56/1000 runs) and kickers (0.61/1000 runs). Compared with rails, the adjusted odds of injury were significantly higher on the half-pipe (aOR=9.6; 95% CI 4.8 to 19.3), jumps (aOR=4.3; 95% CI 2.7 to 6.8), mushroom (aOR=2.3; 95% CI 1.1 to 4.4) and kickers (aOR=2.0; 95% CI 1.3 to 3.1). The odds of severe injury (present to ED) versus minor injury did not differ by feature.

Conclusions

The injury rates and odds of injury were highest on features that facilitate aerial maneouvers. Resorts may consider marking all features to indicate difficulty and associated injury risk.
Training volume as a risk factor for the development of jumper's knee? data from the patellar tendinopathy cohort 2006–2010
Authors: Visnes H , Bahr R
Published: March 2011

Background

Previous studies on players with jumper's knee (cross-sectional studies and case-control studies) have found that symptomatic athletes were training more strength and more workouts per week compared with healthy asymptomatic players. Registration of training volume as risk factor for the development of jumper's knee is to our knowledge not previously done.

Aim

Study training volume as a risk factor for the developing jumper's knee.

Design

Cohort study.

Participants

Elite volleyball players at junior high school (Top Volley Norway) at Sand, Norway.

Method

Registration of training volume through weekly training diary on the internet, and interviews with the player and the coach. The jumper's knee diagnosis was based on a standardised clinical examination.

Results

A total of 140 symptom-free students were included (69 boys and 71 girls), with an mean observation time of 1.8 years. Of these, 28 developed jumper (22 boys and 6 girls). The jumper's knee group trained 20.1 ± 6.9 (SD) h per week, compared with the asymptomatic athletes 16.9 ± 6.9 h (p<0.001). The difference in the training workload was primarily related to indoor volleyball training, where the jumper's knee group trained 15.0 ± 3.0 h and the asymptomatic players 11.9 ± 3.8 h (p<0.001). The volume for other forms of training (volleyball, strength training, flexibility training and other training) were similar. For further analysis, the total training exposure (average hours per week) were divided into four groups. The training group 4 (21–28 h per week) have a significantly increased risk of developing jumper's knee. χ2test=8.57 gives p=0.01.

Conclusion

We find that athletes who developed jumper's knee significantly trained more than athletes who remain asymptomatic. High training loads in the form of indoor volleyball training will therefore be an important risk factor for the developing jumper's knee.
Comparison of the effects of valgus loading and internal axial tibial torque on ACL strain during a simulated jump landing
Authors: Oh Y , Ashton-Miller J , Wojtys E
Published: March 2011

Background

Little is known about how much Anterior cruciate ligament (ACL) strain is increased by a valgus moment versus an internal axial tibial torque loading during a unipedal jump landing.

Objective

To test the (null) hypothesis that the anteromedial (AM) bundle ACL relative strain would not be significantly different under a simulated one-foot jump landing imposing an internally-directed tibial torque versus one imposing a valgus knee moment.

Design

12 cadaveric knees (mean (SD) age: 65.0 (10.5) years) were tested to study the effect of internally-directed tibial torque on the AM-ACL relative strain. Pretensioned quadriceps, hamstring and gastrocnemius muscle-tendon unit forces maintained an initial knee flexion angle. A compound impulsive test load (2*BW compression, flexion moment and internal tibial torque or valgus knee moment) was applied to the tibia while recording the 3-D knee loads and tibofemoral kinematics. AM-ACL relative strain was measured using a 3 mm DVRT. Each loading condition (ie, ‘internal’ or ‘valgus’ loading) was compared against ‘baseline’ loading condition under compression and flexion moment. Results were compared with those from Withrowet al. (2005) for 11 cadaveric knees of similar age tested on the same apparatus to investigate the effect of valgus knee loading on AM-ACL relative strain. The Wilcoxon Signed-Rank test was used to test the null hypotheses (p<0.05 being considered significant).

Setting

A cross-sectional, repeated measures, in vitro laboratory study.

Assessment of risk factors

Independent variables included the magnitude of the impulsive compressive force, flexion moment, and internal tibial torque or valgus knee moment.

Main outcome measurement

AM-ACL relative strain.

Results

Normalised peak AM-ACL relative strain increased 117% under internally-directed tibial torque (17 ± 4 N-m), whereas the corresponding value increased 30% under valgus knee loading (133 ± 29 N-m) (p=0.016).

Conclusion

Internal axial tibial torque increases AM-ACL relative strain more than a valgus load under a simulated jump landing.
No relationship between running related injuries and kinetic variables
Authors: Bredeweg S , Buist I
Published: March 2011

Background

Although the benefits of running are well known, 19–79% of the runners get injured every year. Many risk factors are associated with the aetiology of running-related injuries, but still there is no consensus on the exact cause of running injuries. Kinetic variables, such as impact peak force, active peak force and the impact loading rate are scarcely studied in novice runners. Studies on the aetiology of stress fractures of the tibia showed conflicting results between kinetic factors and the development of stress fractures of the tibia.

Objective

To examine the effects of running kinetics on the incidence of running related injuries in novice recreational runners.

Design

Prospective cohort study. Kinetic variables were acquired from an instrumented treadmill with three force measuring transducers. Female participants ran at 2.2 m/s and 2.5 m/s and male participants at 2.5 m/s and 2.78 m/s. At each velocity the vertical ground reaction forces were measured, from which the kinetic variables were calculated.

Setting

Novice recreational runners.

Participants

98 male and 100 novice female runners, mean age 39.8 years and a body mass index of 25.4 were included in the study and were followed for 9 weeks during the training program.

Intervention

The occurrence of a running related injury in a 9 week training program.

Main outcome measurement

A running related injury.

Results

The incidence of running related injuries was 20.4%. Injured runners showed higher values on the active force peak (2.24 BW vs 2.11 BW) and higher values on the loading rate (92.5 BW/s vs 86.4 BW/s) compared to the non-injured runners. These differences however were not significant.

Conclusion

This study showed no significant differences in kinetic variables between injured and non-injured novice recreational runners during a 9 week training program.
An analysis of impact forces in an active shoulder tackle in rugby
Authors: Usman J , McIntosh A S , Fréchède B
Published: March 2011

Background

The incidence of shoulder injury resulting from the tackle in rugby union football is high and the tackle is as well the main cause of injury. Little is known about the magnitude of tackle forces and influencing factors.

Objective

To measure the force applied to the shoulder in the tackle, the effect of shoulder padding, skill level, side of body, and player size.

Design

Repeated measures design. In counterbalanced order, participants tackled a 45 kg tackle bag five times in the four conditions: dominant versus non-dominant sides; with and without shoulder pads.

Setting

Community level rugby football. The selection criteria were: (1) age 18–25 years old, (2) played at least 3 years of rugby, and (3) played at least a season of rugby within the last 3 years.

Participants

35 participants were recruited.

Interventions

IRB approved shoulder pads.

Main outcome measurements

Maximum impact force was measured with a custom built forceplate incorporated into a 45 kg tackle bag.

Results

The overall average shoulder force was 1660 N. The average impact force for tackling without shoulder pads was 1684 N compared to 1635 N for wearers. Shoulder pads reduced the peak impact forces by 3% (p>0.05). There was a 6% difference in the average impact force between the dominant (1708 N) and non-dominant sides (1611 N). Tackle repetition was found to be a statistically significant factor as the impact forces reduced from the first tackle (1743 N) to the fifth tackle (1571 N) (p<0.05). No relationship was observed between player skill level and size.

Conclusion

Shoulder pad performance needs to be improved. Although the shoulder force in the tackle is normally tolerated without injury, its magnitude is within the reported tolerance threshold range for sternoclavicular joint and glenohumeral joint. Fatigue may be an injury risk factor in the tackle.
Kinematics and kinetics of accidental ankle sprain in 3D motion analysis lab
Authors: Kristianslund E , Bahr R , Krosshaug T
Published: March 2011

Background

Ankle sprain is among the most frequent sports injuries and a significant contributor to time lost from sports participation. The injury mechanism is traditionally described as an inversion trauma, but a detailed description including joint kinetics is lacking.

Objective

To provide an accurate description of an ankle sprain.

Design

Case study.

Setting

Sidestep cutting in 240 Hz motion analysis lab.

Patient

Elite female team handball player (1.73 m, 63.7 kg, 22 years). Accidental grade 1 ankle sprain confirmed by orthopaedic surgeon.

Assessment and outcome

Ankle kinetics and kinematics and ground reaction forces were compared between two normal trials and the injury trial.

Results

In the injury trial we observed a sudden increase in ankle inversion (15° vs 4.9° and 4.8°) and ankle internal rotation (6.9° vs −1.2° and −3.6°) the first 50 ms. The injury trial centre of pressure had an increased lateral excursion after 50 ms (8.4 cm vs 3.3 and 3.0 cm). From 80 ms there was an increasing ankle inversion moment, reaching a peak of 72 Nm at 138 ms. At this time the ankle inversion angle had reached 33.1°, the ankle internal rotation angle was 53.7° and the ankle dorsiflexion was 26.5°. In the same period there appeared to be an attempted unloading of the foot, with a dorsiflexion of the ankle and reduced ground reaction force. The control trials displayed mainly eversion moment of the ankle throughout the stance phase, and joint angular deflections less than 6°.

Conclusion

This study provides the most accurate and detailed description of ankle sprain dynamics to date. The injury involved inversion and internal rotation combined with an unloading of the foot that was initiated after approx 80 ms. The inversion moment likely caused the injury in the time period between 120 and 150 ms.
Injury risk for goalkeepers in norwegian male professional football
Authors: Strand E , Krosshaug T , Andersen T E
Published: March 2011

Background

The role of goalkeepers differs considerably from that of outfield players, but there are no previous studies specifically investigating their injury risk.

Objective

To investigate injury patterns, identify high-risk situations and describe injury mechanism for goalies.

Design

Prospective cohort study.

Participants

12 male goalkeepers from five of 14 teams in the Norwegian male professional league.

Methods

Injury information and exposure data were collected for one competitive season, from April until mid-November 2008. Video recordings from 178 of 182 matches were analyzed to identify high-risk injury situations and to describe injury mechanisms.

Results

A total of 43 injuries were registered. The injury incidence was 27.9 per 1000 playing hours (95% CI 25.8 to 30.4) during matches, 23.6 (21.2 to 26.7) for specific goalkeeper training and 9.1 (8.3 to 10.1) during other football training (RR: 2.6, 95% CI 1.2 to 5.3 specific goalkeeper training compared to football training). Injuries to the upper extremities accounted for 36% of all injuries. The most frequent overuse injury location was the shoulder. Video analysis identified two high-risk situations during matches: 1) Duel in the airspace in front of goal after a cross pass, where the goalkeeper was hit in the stomach/chest by the opponent's shoulder/upper arm. 2) Duel where the goalkeeper collided with the opponent when coming out to save a backroom pass and the goalkeeper was hit in stomach/chest or the knee by the opponent's foot or knee. Video analysis did not reveal any typical mechanism of injury.

Conclusion

This study provides novel information about injuries and high-risk situations for goalkeepers. Football goalies have higher injury risk during specific goalkeeper training compared to football training. Two high-risk situations for goalkeepers in matches were identified.
Evaluation of a national campaign in snow sports
Authors: Bianchi G , Brügger O , Niemann S , Furrer C
Published: March 2011

Background

Around 15% of the 100 000 injuries that occur on ski slopes in Switzerland affect the head. Protective helmets can reduce the incidence of head injuries. Bfu and national partners carried out the campaign ‘1000 injuries per day. Protect yourself with a helmet’ to motivate skiers and snowboarders to use a snow-sport helmet.

Objective

To evaluate the success of the campaign objectives.

Setting

Skiers and snowboarders at 20 ski resorts in Switzerland.

Participants

Before, during and after the campaign, 19 740 skiers and snowboarders were observed; 8820 were interviewed.

Intervention

Quantitative surveys: observations and interviews. Qualitative surveys: document analysis, qualitative interviews, analysis of the media, group discussion.

Main outcome measurements

A concept, process, impact and outcome evaluation was done by an external specialised evaluation agency.

Results

The measures are appropriate to the target of increasing the rate of helmet use. The main elements (posters, television advertisement, helmet testing days) of the campaign were implemented as planned. Hazard awareness and consciousness of vulnerability improved between the 2007 and 2010 winter seasons. The target value of the criterion ‘lacking comfort’ couldn't be obtained. The helmet wearing rate has greatly increased. The results show a small correlation between campaign recognition and helmet use.

Conclusion

The rate of helmet use, hazard awareness and consciousness of vulnerability increased considerably. However, the impact of the campaign on the increases is unclear. First, the rate of helmet use had already risen after the first year of campaigning. Second, studies have shown that campaigns may raise awareness but not achieve behavioural change. Third, there is only a small correlation between campaign recognition and helmet use. The campaign has supported and strengthened the effect of various factors that have promoted helmet use. However, the reasons for the increase in helmet use are unknown.
The swedish athletics study: various prevalence measures of musculoskeletal injury in élite athletics athletes
Authors: Jacobsson J , Timpka T , Ekberg J , Kowalski J , Nilsson S , Renström P
Published: March 2011

Background

Athletics is one of the most popular global sports, but little is known of injury patterns among élite athletic athletes. Injury prevalence has been proposed to be the most valid measure of injury burden in sports where athletes practice long hours and are at risk for overuse problems.

Objective

To compare two different indicators of injury prevalence in athletics as measures of the injury burden among adult and youth élite athletics athletes.

Design

Cross-sectional epidemiological study using web-based data collection.

Setting

Swedish élite youth (U17) and adult athletics athletes. Data were collected in April 2009.

Participants

278 youth and adult athletes (91%) submitted a web-based questionnaire from an eligible study population of 301 athletes.

Assessment of risk factors

Athlete's sex, age and anatomical body regions were assessed as risk factors.

Main outcome measures

1-year prevalence of musculoskeletal injuries causing at least 3 weeks of partial or complete absence from practice and competition; point prevalence of musculoskeletal injury.

Results

The 1-year injury prevalence was 43.6%. Among the age groups, the prevalence was 48.1% for adult and 37.1% for youth athletes. The point prevalence of injury was 36.2%, 38% among adult athletes and 33% among youth athletes. Female youth athletes had a tendency towards higher 1-year (p=0.06) and point (p=0.025) injury prevalence than male youth athletes. There was no sex difference in injury prevalence among the senior athletes. A majority of the injuries (74% 1-year prevalence; 78% point prevalence) reported by the athletes were located to the lower extremities.

Conclusion

Using either the point or 1-year retrospective window definition of prevalence, currently approximately 4 out of 10 Swedish élite athletic athletes have injuries that interfere with their performance of sports activities. Most injuries are located to the lower extremities. Prospective epidemiological studies investigating individual risk factors for athletic injuries are warranted.
Twelve-month health related quality of life and functional outcomes of hospitalised orthopaedic sport and active recreation injuries
Authors: Andrew N , Gabbe B J , Wolfe R , Cameron P A
Published: March 2011

Background

Serious sport and active recreation injuries are common with the potential for grave long-term consequences. Despite this few studies have examined the long-term outcomes of these injuries.

Objective

To establish if patients hospitalised with orthopaedic sport and active recreation injuries have returned to their pre-injury levels of health and function 12-months post-injury and to identify predictors of poor outcomes.

Design

Prospective cohort study with 12-month follow-up.

Setting

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

Participants

Adults with orthopaedic sport and active recreation injuries who were admitted to either Level 1 trauma centre between March 2008 and March 2009 or the regional hospital between June 2008 and June 2009 and captured by the Victorian Orthopaedic Trauma Outcomes Registry. There were 324 participants recruited to the study of which 98% were successfully followed up at 12-months post-injury.

Assessment of risk factors

Independent variables assessed for predictors of outcome were sporting group, age, sex, education level, major trauma classification (injury severity score>15) and injury patterns.

Main outcome measurements

The 36-item Short Form Health Survey (SF-36) and the Glasgow Outcome Scale Extended.

Results

At 12-months post-injury 58.1% of participants reported reduced function and a significant reduction in physical health (p<0.001) and mental health (p<0.001). Multivariate analysis identified injury due to motor sports (p=0.001) or equestrian sports (p=0.015) and being classified as a major trauma (p=0.043), as predictors of a poor physical health outcome. Low education level (p=0.040) and having a major trauma injury (p=0.047) were predictors of a poor mental health outcome.

Conclusion

The findings of our study highlight that at 12-month post-injury, most patients injured during sport and active recreation had not returned to their pre-injury status. This information is useful for setting priorities for treatment and for the progression of sports injury prevention.
Risk of injury in norwegian male professional football
Authors: Bjørneboe J , Bahr R , Andersen T E
Published: March 2011

Background

Only one previous injury surveillance study (Ekstrandet al., 2010) has been carried out for several seasons. Ekstrandet al. (2010) found that the injury incidence and pattern were stable during seven Champions League seasons.

Objective

To monitor trends in injury incidence and pattern in Norwegian male professional football over six seasons.

Design

Prospective cohort study where injuries and exposure were registered by team medical staff using the league injury surveillance system for six seasons (2002–2007). An injury was recorded when a player was unable to fully take part in football training or match play.

Setting

Tippeligaen, the top 14 male Norwegian professional teams.

Main outcome measurement

Injury incidence (injuries/1000 player-hours).

Results

A total of 2365 injuries were recorded; 1664 (70.4%) acute injuries and 701 (29.6%) overuse injuries. The overall incidence of acute injuries was 16.1 per 1000 match hours (95% CI 15.1 to 17.1) and 1.9 (95% CI 1.7 to 2.0) per 1000 h of football training. The incidence of overuse injuries was 1.4 (95% CI 1.3 to 1.5).The incidence of overuse injuries and acute training injuries was consistent during the six-year study period. However, the risk of acute match injury increased (p=0.004). We could not detect any shifts in injury type, location, severity or re-injuries. No significant difference in the risk of acute match injuries (rate ratio (RR): 0.92, 95% CI 0.78 to 1.08), acute training injuries (RR: 1.16, 95% CI 0.99 to 1.36) or overuse injuries (RR: 1.07, 95% CI 0.91 to 1.25) was observed between preseason (January-March) and competitive season (April-October).

Conclusion

The risk of acute match injuries in Norwegian male professional football increased during the six-season study period. However, we detected no change in the risk of training or overuse injuries or any difference between the preseason and competitive season.
An information resource linking performance to prevention of sports injuries – a preliminary inquiry
Authors: Broughton H , Cromie S , Trimble T
Published: March 2011

Background

A review by Chalmers et al. (2004), rugby coaches have a role in preventing injuries and a perspective by Bahr et al. (2005), understanding the mechanisms of injury in sport identified a number of factors.

Objective

To design an information resource for coaching sport.

Design

An information resource develops modules of learning, retrospective injury data are reviewed and ethical approval is sought. The inquiry is based on rugby union.

Setting

Structured interviews are held with senior level coaches.

Participants

Five qualified senior grade coaches in rugby union.

Intervention

The coaches remarked that safety is practicable, athlete conditioning beneficial and technique is important. Injury data linked to game events illustrated the relevance of Newtonian Physics.

Results

Qualitative data highlights safety as being practicable but game rules had less certainty.

From the injury data the total consults: n=367 (08/09), n=377 (09/10) shoulder 39, 42; 81 due to the tackle (inertia & interaction), low back 104, 41; 145 due to scrum, tackle (interaction), hamstring 38, 42; 80 due to running (inertia) and the ankle 52, 59;111 due to running, tackle (inertia).

Conclusion

Safety in coaching sport is practicable, but the game rules need more recognition. Applying Newtonian Physics to injury events enabled an understanding of game actions. Integrating into the modules of learning; the game rules, the applications of Newtonian Physics and attention to safety, injuries can be prevented.
Rugby players and whiplash where are all the cases?
Authors: Clough A , Clough P J , Kelly I , Earle F
Published: March 2011

Background

Despite efforts to provide a comprehensive diagnosis of whiplash (eg, The Quebec Classification system, 1995; Soderlund & Dennison) it is an ill defined and poorly understood injury. Its occurrence seems to be dependent on a number of contextual variables.

Objective

The primary objective of this study was to identify the number of cases of whiplash reported in one complete season by professional rugby players.

Design

A longitudinal design was adopted. The assessment of whiplash was carried out independently of the assessment of the number of incidents that could potentially lead to WAD. The two assessments were blinded to each other.

Setting

The study was undertaken within a professional rugby club in the north of England.

Participants

The full first team squad (n=32) were included in the study.

Assessment of risk

The main independent variables was the number of potential whiplash inducing incidents over the entire season.

Main outcome measurements

The main outcome measure was the number of whiplash related injuries reported.

Results

There were six cases of whiplash reported during the entire season. Five followed an on field assessment during the game and the players were deemed fit to continue with play. They needed treatment post injury in readiness for the next game, however in all five cases the injuries were not sufficiently serious to rule the player concerned out of contention for selection and all have missed no matches as a result of their injury. The minimum number of collisions that would have been expected to produce whiplash was found to be three per game.

Conclusion

It is clear that the number of reported/diagnosed whiplash injuries in this sample is much lower than would be expected if you were to use data from the non-sporting domain. Further investigation into why this discrepancy happens is underway, using physiological, psychological and biomechanical markers.