bluuebunny/crossref_metadata_2025 huggingface dataset:
The epidemiology and prevention of injuries in American Flag Football (AFF)
Authors: Kaplan Y
Published: March 2011

Background

Although AFF is considered a non-tackle sport, many moderate-serious contact-type injuries have been reported. There are no studies describing neither the epidemiology nor the prevention of injuries in this international sporting activity.

Objective

To conduct a 2- season prospective injury-exploratory study in the AFF league, followed by a 2-season prevention trial.

Design

All time-loss injuries sustained in game sessions were recorded by the off-the-field medical personnel. This was followed up by a more detailed phone questionnaire by the author, 7–14 days following the injury.

Setting

American Flag Football league in Israel.

Participants

Male and female amateur league players.

Main outcome measurements

Epidemiological data.

Results

1791 players participated in 1005 games over the two seasons. Athlete-exposures=1799955. There were 179 injuries recorded, with an injury rate=0.099 per 1000 athlete-exposures (95% CI 0.08 to 0.11). 98% of the injuries were traumatic in nature. Over 75% of injuries were caused by contact with the ground. 30% of the contact injuries were to the fingers, thumb and wrist. Many of the finger injuries occurred as a direct result of the player's fingers being caught in the pockets of the opposing player. 20% of the injuries were to the knee, 16% to the head and face and 12% to the ankle.

Conclusion

As a result of the epidemiological study, a two- season (2010–2012) prospective, longitudinal, randomised controlled injury prevention trial will be conducted, where the players will be randomly divided into those teams that will make up the experimental group (n=+180) and those in the control group (n=+180). The experimental group will be instructed to wear mouth guards and air casts. The control group will be instructed to wear pocket less pants. Following the data collection, the results will be analyzed, conclusions drawn and recommendations suggested for inclusion in future league games.
Risk factors for injuries in a high-altitude ultramarathon
Authors: Khodaee M , Myers R , Spittler J , Lee J A , Hill J C , Yeakel D
Published: March 2011

Background

Risk factors for ultramarathon injuries are poorly understood.

Objective

Effects of human and environmental factors on predicting injuries.

Design

Observational study using electronic surveys prior and 10-days post-race.

Setting

Leadville-100 is a difficult high-altitude trail ultramarathon (160.9 km) with a course elevation of 2804–3840 m in Leadville, Colorado.

Participants

All runners completed the pre-race survey and half (n=308, 48%) completed the post-race survey.

Assessment of risk factors

The dependent variable was visiting a physician/health care provider for injuries due to the race. The independent variables were age, gender, prior completion of the race, foot type (normal, flat feet, high arch), Body Mass Index (BMI), height, weight, wearing orthotics, shoe type, changing shoes during the race.

Main outcome measurements

The primary outcome measure was whether stability running shoes are correlated with fewer injuries compared to other types of shoes.

Results

Out of 646 participants, 361 (55.9%) runners finished the race under the 30-h time cut-off. Majority (n=676, 84.9%) were male with average age of 41 years (range 21–73). Majority were first time participants (n=468, 73%). Among those who completed the post-race survey, 109 (35%) visited the aid stations during the race and 37 (12%) sought medical attention after the race. Runners primarily visited aid stations for musculoskeletal, gastrointestinal, and respiratory complaints. Half (n=171, 55%) were able to walk without assistance and majority (n=216, 72%) return to work after 1 day of rest. Runners with cushion shoes were more likely to seek medical attention compared to those with instability shoes (p<0.005; OR=3.59; CI 1.33 to 9.66). There were no correlations between gender, foot type, BMI, height, weight, having orthotics, and prior race completion and seeking medical attention post-race.

Conclusion

Compared to other running shoes, the stability type is correlated with fewer injuries requiring medical visits among participants in a high-altitude ultramarathon.
Are young female athletes at risk of amenorrhoea? analysis of body composition, nutritional and endocrine factors
Authors: Lagowska K , Jeszka J
Published: March 2011

Background

Specific type and amount of high intensity training in athletes especially beginning before puberty, reduced body weight and lower percentage of fat mass have been put forward as potential factors responsible for female athlete triad.

Objective

Estimation risk of amenorrhoea in female athletes with menstrual irregularity basis of results of body composition, nutritional and endocrine factors.

Patients

58 athletes with menstrual irregularity aged 18.0 ± 2.2 years participated in the study.

Design

The nutritional status was evaluated based on the analysis of body composition using the bioelectrical impedance analysis method – percentage of adipose tissue (FM), fat free mass. Nutritional value was estimated by dietary records for seven consecutive days. Moreover, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E), progesterone (P) and serum leptin levels were measured.

Results

The first group included athletes from endurance disciplines emergency department (ED) while the other comprised female from weight category (WC) disciplines. Second classification was also used. In the first group athletes with LH/FSH <0.6, diagnosed as a insufficiency of hypothalamus pituitary IH were included, while the other included female with LH/FSH>0.6, diagnosed as a good results (GR). In case of hormones significant differences between groups with different disciplines in level of LH (ED: 4.0 ± 2.5 mlU/ml, WC: 5.6 ± 2.4.mlU/ml, p<0.05) and FSH (ED: 4.8 ± 1.8 mlU/ml, WC: 6.3 ± 1.5 mlU/ml, p<0.05) were found. What is more, IH athletes has significantly lower LH level compared with GR athletes (IH: 2.9 ± 1.0 mlU/ml, GR: 6.0 ± 2.6 mlU/ml, p<0.05). FSH, LH, LH/FSH and leptin levels was positively correlated with energy and most of nutrients intake.

Conclusion

Diets of athletes with menstrual disorders were not properly balanced. Furthermore, athletes were characterised by low fat mass, low leptin level and inadequate relationship between level of gonadotrophins. Those factors can intensify menstrual disorders and lead to amenorrhoea.
Altered molecular metabolism of knee joint tissues in a botox induced quadriceps muscle weakness model in the rabbit
Authors: Leumann A , Fortuna R , Longino D , Leonard T , Hart D , Valderrabano V , Herzog W
Published: March 2011

Background

Muscle weakness due to joint injuries (eg, anterior cruciate ligament rupture) or muscle injuries (eg, muscle strain) are very frequent in sports.

Objective

To analyze changes to knee joint ligaments and menisci induced by quadriceps muscle weakness by measuring molecular metabolism.

Design

Prospective randomised controlled trial.

Setting

Laboratory study.

Interventions

Chronic quadriceps muscle weakness was induced in six 1-year old New Zealand White rabbits through monthly injections of Botox (botulinum toxin A) for six months. Five age- and sex-matched rabbits served as controls.

Main outcome measurements

Muscle weakness was assessed by measuring muscle weight, isometric quadriceps force, and histologic muscle degeneration. Molecular metabolism was measured in the patellar tendon, medial and lateral collateral ligaments, and medial and lateral menisci by measuring total RNA yields, and nine tissue specific RNA yields (eg, Collagen I, MMP-III).

Results

Muscle weights were decreased by 46.6%, muscle forces by 58.6 to 61.3% depending on the knee flexion angle, and cross sectional areas of the contractile apparatus by 54.7% (all results p<0.001) for the test—compared to the control group animals. Molecular analysis showed significantly decreased overall turnover (MMP-I), and significantly decreased metabolism for anabolic factors (Collagen I, MMP-III, MMP-XIII, TGFâ) and reduced injury response (Collagen III, MMP-XIII).

Discussion

Quadriceps muscle weakness leads to adaptive changes in knee joint structures by adjusting specific RNA activities while overall cell metabolism remains unchanged. In the concept of the joint as an organ, this may reflect a new functional steady-state. Muscular unloading of the knee might impair the biomechanical function of the knee joint and its component structures. This could describe an underlying pathomechanism of the fact, that injured athletes are more susceptible to additional overuse injuries than healthy athletes. Therefore, we suggest that weaknesses of muscles and component joint structures being considered in injury treatment and rehabilitation.
Gender difference in jumping and landing among 15–18-year old icelandic national youth soccer players
Authors: Magnúsdóttir H , Sveinsson T , Árnason Á
Published: March 2011

Background

After puberty female athletes are in 2–7 times higher risk of tearing the anterior cruciate ligament as compared to males.

Objective

To compare following factors between 15 and 18 years boys and girls participating in soccer: 1) Vertical jump height. 2) Jump- and landing technique in drop jump. 3) EMG activity around the knee during jumping and landing.

Design

Observational, cross-sectional study.

Setting

National youth soccer teams in Iceland.

Participants

20 boys and 17 girls, 15–18 years, from three soccer teams and also participating in Icelandic national youth soccer teams were invited to participate. Of these, 10 boys and 10 girls accepted participation and showed up for testing.

Main outcome measurement (1) Jump height in counter movement jumps. (2) Degree of knee valgus during drop jumps. (3) EMG onset latency for five different muscles in each thigh during drop jumps.

Results

Boys jumped significantly higher than girls in countermovement jump (30.3±2.6 cm vs 22.6±3.8 cm, p<0.001). In the drop jump, girls had significantly increased knee valgus compared to boys in three of five test points: when toes touch the floor (165.1±4.0° vs 168.7±4.1°, p=0.05), at 25% of the height from lowest position (163.3±6.4° vs 169.2±9.0°, p=0.013) and at toe off, when jumping up again (162.5±4.2° vs 167.2±4.4°, p=0.01). No difference was found for the lowest position or for 25% of the height from the lowest position to toe off. No gender difference was found for onset latencies of the leg muscles, except for right biceps femoris, where girls activated this muscle earlier before landing than boys (−0.31±0.39 vs −0.12±0.13, p<0.001).

Conclusion

Boys jumped higher than girls. Girls had more knee valgus during landing, at 25% from the lowest position on the way down and, during toe off. No gender differences were found for muscle onset latencies except for one thigh muscle.
Dynamic postural stability in gaelic football players during a single leg drop-landing, a comparison of ankle tape and lace-up brace
Authors: Persson U McCarthy , Arthurs C
Published: March 2011

Background

Ankle inversion injuries commonly occur during landing from a jump. Both ankle braces and taping are methods used to prevent ankle injuries during sport.

Objective

To determine whether an ankle tape or ankle lace-up brace improves dynamic postural stability when compared without support on landing from a jump. The null hypothesis was that there would be no difference in Dynamic Postural Stability Index (DPSI) between the conditions.

Design

This was an experimental randomised intervention study.

Setting

University setting including club level Gaelic football players.

Participants

15 subjects, all male (age=21.3 ± 1.6 years, height=182.2 ± 5.2 cm, mass=81.4 ± 8.2 kg, (mean ± SD)), without lower extremity injury or previous history of ankle injury.

Interventions

The subjects performed a jump protocol consisting of a single leg drop-landing from a 40 cm high step, under three randomised conditions: tape, ankle brace and control (neither tape nor brace).

Main outcome measurements

The Dynamic Postural Stability Index (DPSI) was analyzed after a single leg drop-landing on to a force plate.

Results

The application of an ankle tape increased the DPSI score (1365.04 ± 13.02) significantly when compared to the control (1354.9 ± 14.79), and brace (1359.6 ± 13.77) conditions (p<0.02). This increase in DPSI indicates that the tape application decreased the dynamic stability on the force plate. There was no difference between the ankle brace and the control condition.

Conclusion

Application of an ankle tape decreased the ability to maintain dynamic balance during a jump landing in Gaelic football players without ankle injury. Further study needs to assess the effect of tape and brace application on athletes with ankle instability during jump landings. The possible causes of this decrease in stability will be discussed.
Injury and safety in junior rugby union football
Authors: McIntosh A , Dutfied R , Grimison M
Published: March 2011

Background

Little is known about the injury incidence and risk factors in junior rugby union football. In particular, the timing of the introduction of the tackle, the skill associated with the highest incidence of injury, must be considered in the development pathway.

Objective

To measure the incidence of injury in junior rugby and assess risk factors.

Design

A prospective cohort study.

Setting

Community level junior male rugby union football.

Participants

312 rugby players aged between 6 and 14 years were recruited over two seasons.

Assessment of risk factors

Age, number of players, and introduction of the tackle were assessed.

Main outcome measurements

Game and training participations, as well as injury, were measured. Injury was defined as occurring when a player missed a game or training due to an injury in a rugby game or training and calculated as the injury incidence rate (eg, per 1000 h of game participation).

Results

There were 24 injuries over two seasons. Season one game injury incidence was, for example, 7.5 injuries per 1000 h. No injuries were recorded in the youngest age groups and there was a gradual increase in injury rates with age. In this cohort age and number of players on the field is correlated due to the game structure. Forearm/hand and knee injuries were most common. The tackle and accidental falls were the most common cause of injury. An unusual injury occurred to one player at training – a vertebral artery tear that may have resulted from a fall.

Conclusion

Injuries were typical childhood injuries that occur in sport and recreational activities. Injury rates were much lower than observed in adult rugby (community and professional). Accidental falls appear to be more common in this study than in older age groups. This may be related to gross motor control and developing team and individual rugby skills.
The hamstring syndrome in endurance athletes
Authors: Migliorini S , Merlo M
Published: March 2011

Hamstring syndrome is a gluteal sciatic pain, in which posttraumatic or congenital hard fibrotic bands irritate sciatic nerve at the insertion site of hamstring muscles to ischial tuberosity. Traction, mechanical compression and impingement of the sciatic nerve may occur in certain anatomopathological situations at the origin of the hamstrings on the ischial tuberosity. The symptoms include local pain at the ischial tuberosity irradiating to the posterior thigh which appears with the cyclic stress of running, after physical exercise, and typically during sitting. Hamstring syndrome diagnosis is basically done according to typical symptoms and finding. Differential diagnosis is required from piriformis syndrome, ischiogluteal bursitis, posterior femoral muscle compartment pain, scars in hamstring muscles and back originated symptoms. MRI is the best examination to detect abnormality at the ischial tuberosity area. The majority of the athletes with hamstring syndrome respond positively to conservative therapy but in the refractory cases the hamstring syndrome can be treated surgically by dividing the compressing band and by performing the sciatic neurolysis. This paper describes the results of the surgical treatment during the last 15 years of a personal series of 25 endurance athletes (middle and long distance running, marathon, triathlon, cycling) refractory to non operative treatments for a period of 1 to 6 years. Three bilateral operation have been made in different time; in two cases the operation has been performed after the failed piriformis surgery and in two cases was practised the miotomy of the hypertrofic quadratus femoris. Usually good results are seen in a few months after surgery, and all subjects returned to practice competitive sports except one patient with chronic lumbar back problems. The final healing may take 1/2 years in chronic cases. Hamstring syndrome is still misunderstood and it is often confused with other causes of sciatica despite its frequent occurrence in sports.
Prevention of anterior cruciate ligament injuries in female basketball players in japan: an intervention study over four seasons
Authors: Nagano Y , Miki H , Tsuda K , Shimizu Y , Fukubayashi T
Published: March 2011

Background

Female basketball players are at a higher risk of anterior cruciate ligament (ACL) injury than male players. Therefore, prevention of ACL injury in the former group is essential.

Objective

To assess the effect of an injury prevention training program on the incidence of ACL injuries in female basketball players.

Design

Prospective intervention study.

Setting

Top-level league in Japan.

Participants

Players from 12 top-league teams. The control season (2006–2007) included 158 players; the first intervention season (2007–2008), 168 players; the second intervention season (2008–2009), 174 players; and the third intervention season (2009–2010), 162 players.

Interventions

From the middle of the 2007–2008 season, a 3-step injury prevention program was initiated. The program focused on strength, balance, jump-landing techniques, and basketball skills. Subjects were instructed to perform exercises in a neutral position and to avoid lumbar lordosis, rear axial weight bearing, hip adduction, and knee valgus.

Main outcome measurements

Number and rate of ACL injuries during the four seasons and compliance with the program. Injury incidences were given in terms of per 1000 player-hours (PH).

Results

Seven non-contact ACL injuries were noted during the control season (0.059/1000 PH); 4, during the first intervention season (0.031/1000 PH); 10, during the second intervention season (0.073/1000 PH); and 2, during the third intervention season (0.016/1000 PH). During the second intervention season, the rate of ACL injuries in the teams that complied with the program was 0.053/1000 PH, while the rate in the teams that did not comply was 0.099/1000 PH. During the third intervention season, the rate of ACL injuries in the teams that complied was 0.011/1000 PH, while the rate in the teams that did not comply was 0.032/1000 PH.

Conclusion

The results show that the injury prevention program tended to decrease the frequency of ACL injuries.
Methods for epidemiological study of injury and illness in great britain olympic sport: the injury/illness performance project (IIPP)
Authors: Palmer-Green D , Hunter G , Jaques R , Fuller C , Price C
Published: March 2011

Background

Prevention of injury and illness in elite sport can have not only athlete health benefits but also potential positive performance gains. As the first step towards prevention, valid injury/illness surveillance data is needed.

Objective

Develop and implement a valid and sensitive multisport surveillance model for elite sport in Great Britain, to identify incidence, severity, nature, and risk factors for injury/illness in both individual and team sports.

Design

A longitudinal prospective surveillance study, with definitions for injury/illness, time loss and restriction severity, and implementation practices, was developed by the research group, and methodology framework modified from recent injury surveillance consensus statements to be applicable for individual and team sports.

Setting

National training centres for elite sport in Great Britain, including domestic and international competition venues.

Participants

National team lottery funded athletes from identified sport national governing bodies.

Interventions

Report forms recording all athlete injuries/illnesses causing complete time loss or restricted participation in competition or training are completed by medical support staff, and competition and training exposure by coaching support staff. Data collection commenced pre season 2009/2010 and is ongoing.

Main outcome measure

Sport specific injury incidence and illness prevalence, time loss and restriction severity, and risk factors for the most common and severe injuries/illnesses.

Results

14 Olympic sports are involved in the surveillance study. Sport specific results reports on injury incidence, illness prevalence, and associated risk factors are being produced, with targeted sport specific recommendations for prevention strategies.

Conclusion

The injury/illness performance project provides objective information to medical and coaching support staff, and elite sports are starting to implement prevention interventions for key risk factors. The long term aim is to reduce the number and severity athlete injuries/illnesses, the detrimental effects of time loss and restriction in competition and training, and ultimately through this enhance athlete performance.
Gynecological pre participation examination–a new proposal for female athletes care
Authors: Parmigiano T , Zucchi E , Araujo M , Negra L , Guindalini C , Castro R , Moreno C , Girão M , Cohen M , Sartori M
Published: March 2011

Background

Female athletes are unaware of the influence of sports practice on health and usually do not report sexual or gynecological complaints during a regular Pre Participation Examination (PPE).

Objective

To propose a gynecological PPE for female athletes, assessing questions regarding unsupervised sports practice, sexual transmitted diseases, as well as consciousness of the coaches regarding their gynecological health.

Design

Observational cross-sectional study.

Settings/Patients

A total of 148 athletes participating in regular and competitive sports at the ‘Olympic Center of Training and Research for youth athletes’ in São Paulo – Brazil, during the first semester of 2010. Parents/guardians signed the informed consent form.

Intervention

The athletes participated in an informative lecture about relevant gynecological questions related to their health and sports practice. Subsequently, the subjects responded to a questionnaire evaluating gynecological features, together with the Incontinence Questionnaire-Short Form (ICIQ-SF) and Eating Attitudes Test (EAT-26).

Results

The study assessed 148 athletes, mean age of 15.4 ± 2.0 years, reporting 10.9 ± 4.0 h of practice/week. 50% of the participants described irregular menstrual interval, 23.0% ignored the meaning of sexual transmitted diseases and 72.4% had never been to a gynecological appointment. A total of 23.1% of the athletes complained of urine loss and 14.5% should be evaluated by a nutritionist regarding alimentary disturbance or use of diuretics or laxative for weight loss. Moreover, 89.0% ignored the occurrence of urinary incontinence in athletes and the definition of female athlete triad, and 81.9% affirmed that would not mention these questions to their coaches even if this would improve their health or performance.

Conclusion

The gynecological issues are usually underestimated in the follow up of female athletes. The PPE could be an excellent opportunity to provide a special care to young competitors, improving their knowledge about their body and health and most likely, their goals.
Sports and exercise safety in finland (LiVE): a nationwide implementation case
Authors: Pasanen K , Jussila A-M , Kannus P , Hiilloskorpi H , Parkkari J
Published: March 2011

Background

Sports injuries are the most common injury type in Finland. The Sports and Exercise Safety in Finland (LiVE) program started in 2006, and is financially supported by the Ministry of Education and Culture and the Ministry of Social Affairs and Health.

Objectives

The aim of the program is to increase safety of sports and exercise in a nationwide setting.

Methods

LiVE research projects are carried out in Tampere Research Centre of Sports Medicine. Epidemiology and prevention of sports injuries are in focus on the studies. Results are spread to the field by two campaigns, Healthy Athlete (TU) and Safety in School Sports (TEKO). The target group of the TU is young athletes, their coaches and parents. The target group of the TEKO is secondary school students, their teachers and parents. LiVE program educates annually LiVE-instructors who work in different operational environments. The 1-year education is directed for coaches, physical therapists, PE teachers and PE instructors. Educated LiVE-instructors uses a four-step-approach to prevent injuries: 1) Survey in a target group, 2) Analyses and planning, 3) Implementation, and 4) Evaluation.

Results

Two large randomised controlled trials have been carried through. Also, numerous original studies of sports injury epidemiology have been published. Results have been spread to the field by education and communication. Today, overall 55 LiVE-instructors work in different organisations (eg, sports federations, sports clubs, schools). In addition, the program has appeared annually in about 30 different sports and school events. LiVE website has attracted 4000–6000 visitors and 40,000–60,000 hits per month.

Conclusion

Implementation of preventive strategies against sports injuries will result in a reduction of the number of health problems and work or school absenteeism, as well as a clear decrease in the medical costs. Essential results of the LiVE program will be expressed within five to 10 years.
The polygenic profiles in participants with achilles tendinopathy and controls
Authors: Posthumus M , Saunders C , September A V , Collins M
Published: March 2011

Introduction

Achilles tendinopathy (AT) is a multifactorial condition for which various genetic risk factors have been identified. More specifically, five single nucleotide polymorphisms (SNPs) have been associated with and/or suggested to be implicated in AT. These SNPs are (1) the COL5A1 rs12722, (2) the MMP3 rs679620, (3) the GDF5 rs143383, (4) the IL1B −511, and (5) the IL6 −172 polymorphisms.

Objective

This study determines the validity of a polygenic profile, as proposed by Williams and Folland, as a discriminating ‘tool’ for identifying individuals at risk of developing AT.

Methods

All five polymorphisms was previously genotyped in 69 South African (SA) Caucasian participants with AT and 93 SA Caucasian control participants (CON) with no previous history of AT. Using the model developed by Williams and Folland (Journal of Physiology, 586.1, 113–21:2008), the ‘total genotype score’ (TGS) was calculated from the combination of each of the five SNPs. Individual genotypes were each given a ‘score’ of 2, 1 or 0. The homozygote genotype most closely associated with an increased risk of AT was given the score ‘2’, heterozygote's were scored 1 and the homozygote most closely associated with reduced risk of AT were scored 0. Receiver operating characteristic (ROC) curves were used to evaluate the ability of the TGS to correctly distinguish participants at high and low risk of AT. Significance was accepted when p<0.05.

Results

The TGS of the AT participants (TGS=63.6±15.3) was significantly greater (p<0.001) than the CON participants (TGS=54.3±16.3). ROC analysis showed a significant discriminating accuracy of TGS to identify risk of AT in the SA population (AUC=0.64; 95% CI 0.56 to 0.73; p=0.002).

Conclusion

The method of using TGSs to discriminate between individuals at risk of AT and not, seems valid. This method may be used in future multifactorial models developed to identify ‘at-risk’ individuals.
Functional asymmetry in the lower limb professional soccer players
Authors: Sannicandro I , Piccinno A , Rosa R A , De Pascalis S
Published: March 2011

Background

Soccer, sports asymmetric, requiring different loads to the lower limbs as the player uses separately one leg to kick and the other one to jump and landing; in literature are studies that have described this asymmetry in terms of strength (Samadiet al., 2009; Rahnamaet al., 2005) or ground reaction force in the landing (Sannicandro, 2008).

Objective

Analyzing the relationship between asymmetry of the strength of the lower capacity and ability to manage tasks in one-leg-standing balance in professional players.

Design

Descriptive research (correlation study which investigates the relationship between variables).

Setting

Soccer elite division in the off season.

Participants

29 soccer players (25.3±2.7 year, 180.1±2.6 cm, 78.5±2.2 kg).

Assessment of risk factors

The maximal strength, the explosive strength and the balance test can be considered as indicators for to determine both the functional asymmetry of lower limbs both potential risk factors for soccer player.

Main outcome measurements

For each leg was assessed maximal strength (1RM) using a leg press (Technogym, Italy), explosive strength through hop test, the ability to balance by tilting platform electronics (DEB, Delos Italy). This instrument has provided the percentage of time that the player has complied with the assigned range of motion of ±2°.

Results

The assessment of maximal strength, explosive power and the balance returned respectively asymmetry averaged 9.9±7.2% to 6.6±5.3% and 11.4±3.2%. There was a correlation between 1RM and leg hop test for left and right respectively equal to r=0.55 and r=0.53 (p<0.01), a correlation between test and hop balance equal respectively to r=0.49 and r=0.47 (p<0.01).

Conclusion

The study describes the functional asymmetries of the lower limb in soccer players in relation to 1RM, the explosive strength and balance tasks in one-leg-standing. The correlation between values of explosive strength and balance tasks would suggest a functional relationship between two ability, as already hypothesised in literature (Gstöttneret al., 2009).
Relationship between leg and foot alignment and dynamic knee valgus during single-leg squat, single-leg drop landing and cutting tasks
Authors: Sanomura M , Irie K
Published: March 2011

Background

Biomechanical studies have shown that female athletes have significantly increased dynamic knee valgus during drop landing and cutting tasks. However, the relationship between static leg and foot alignment and dynamic knee valgus is not well understood.

Objective

To determine the relationship between leg and foot alignment and dynamic knee valgus during single-leg squat, single-leg drop landing and cutting tasks.

Design

Controlled study.

Setting

University laboratory.

Participants

50 female collegiate athletes (mean age 20.0 ± 1.3 years; height 159.6 ± 5.8 cm; weight 55.1 ± 6.3 kg).

Interventions

Participants performed single-leg squat, single-leg drop landing and cutting tasks, and kinematic data regarding knee valgus alignment were collected using a high-speed video camera.

Main outcome measurement

Leg and foot alignment including thigh-transmalleolar angle (an indicator of tibial torsion), leg-heel angle and navicular drop test scores were measured, and correlation coefficients between these parameters and knee valgus alignment were analyzed using Spearman's rank correlation and an unpaired t-test.

Results

The thigh-transmalleolar angle was significantly and positively correlated with knee valgus rate in single-leg squat and drop landing tasks (Spearman's rank correlation coefficient=0.360, p=0.012 and 0.414, p=0.004, respectively). The navicular drop test score and leg-heel angle were not significantly correlated with knee valgus rate in each task.

Conclusion

Tibial torsion is related to dynamic knee valgus alignment during squatting and landing tasks and its measurement and evaluation through the thigh-transmalleolar angle might be useful as a pre-participation screening test to prevent injury among female athletes.
The correlation between whole body reaction time and the onset timing of lower extremity muscles during landing
Authors: Sasaki R , Urabe Y , Yamanaka Y , Fujii E , Matsubayashi Y
Published: March 2011

Background

Quickness can be shown as whole body reaction time (WBRT) by measuring how quickly they can react for a stimulus. In addition, it is said that the onset timing of muscles contribute to stabilise joints and to prevent injury during the movement.

Objective

The purpose of this study is to clarify the correlation between WBRT and the onset timing of muscles during landing.

Design

Randomisation study.

Setting

Youth sports.

Participants

15 healthy female college students volunteered in this study.

Intervention

WBRT was defined as the duration from light stimulus to the both feet apart from the floor. The onset timing of muscles were measured by bilateral landing from the 40 cm height box with the electromyography (EMG). EMG data were collected from vastus medialis (VM), vastus lateralis (VL), semimembranosus (SM) and biceps femoris (BF). The onset timing of the muscle was visually identified as the first point, which was the EMG amplitude of 100 ms after the start of landing movement that exceeded the mean baseline activity by three SD. The definition of the baseline was set as the EMG amplitude of the 100 ms after the toe-off from the box.

Main outcome measurements

The hypothesis was that there were the correlation between WBRT and the onset timing of muscles.

Results

The mean±SD of WBRT was 331.8±45.6 ms. VM onset timing during landing was 243.7±78.3 ms, VL was 259.6±75.5 ms, SM was 191.7±86.2 ms, BF was 237.5±73.8 ms. There were correlations between WBRT and SM and BF onset timings (p<0.05).

Conclusion

This study identified the correlation between WBRT and SM and BF onset timing. It might be possible to make SM and BF onset timing occur faster by reacting to certain stimulus faster.
Interrater reliability assessment of a qualitative video analysis protocol to assess injury mechanisms and risks
Authors: Savage T , McIntosh A , Fréchède B
Published: March 2011

Background

Understanding injury aetiology is vital to the development of preventative programs. However, evaluating causation in multifactorial events is difficult. Qualitative analysis may present an effective method to understanding injury situations.

Objective

To develop a reliable qualitative analysis method to assess injury risk, using tackling in rugby union as a target activity.

Design

An analysis protocol was developed following consultation of epidemiological, coaching, and biomechanics literature. An inter-rater reliability (IRR) study was conducted to assess the protocols reliability. The results of the IRR study were reviewed and the results used to inform modifications which were tested in a second IRR study.

Setting

Video analysis of sports skills.

Participants

10 volunteers with a knowledge of the target sport.

Interventions

A standard instruction manual and video clips were provided to each participant. Participants were asked to code all events in the clips and a 5 min passage of play to test the protocol and the event definition used in the study.

Main outcome measurements

IRR was assessed with percent agreement and Kappa.

Results

Good or high agreement (>70%) was obtained in eight fields. Agreement among participants for ‘potential injury events’ was high (91%). Agreement in identifying events according to the definition, and the overall agreement in the selected fields was good (61%). In general, agreement in fields using scientific or rugby specific terms were low. Higher agreement was identified for dichotomous fields. The results of the second IRR study showed that a more specific definition of the point in time during a tackle at which observations were made improved the agreement in some fields.

Conclusion

The results suggest general agreement between raters using the protocol was good, but care needs to be taken in explaining and defining the variables used. Following modifications, the protocol was used in a broader study examining technique and injury risk.
Elevated blood pressure in norwegian elite football players is associated with both increased sympathetic activity and LV mass
Authors: Berge H , Gjerdalen G , Andersen T E , Steine K , Solberg E
Published: March 2011

Background

UEFA requires that all male players of the elite teams undergo cardiovascular screening, which was conducted as a research project in Norway.

Objective

To study the prevalence of elevated blood pressure (BP), and test if there were any relation to consequences of hypertension as increased left ventricle (LV) mass or diastolic dysfunction.

Design

Cross-sectional study.

Setting

Training-camp, La Manga, Spain, 2008.

Participants

All football players in the two elite-divisions in Norway were invited, 28 of 30 teams participated. 594 of 636 players finished the study.

Assessment of risk factors

Standard BP measurements, high BP is defined >=140/90 mm Hg according to ESC standards. Height and weight were self reported, body mass index (BMI), body surface area and pulse pressure (PP) were calculated.

Main outcome measurements

The echocardiographic parameters were indexed LV mass, relative wall thickness (RWT), heart rate (HR), and peak early (E) and late (A) diastolic transmitral velocities. The E/A ratio was calculated as an index for LV diastolic function.

Results

Mean age: 25 years (range 18–38), mean BMI: 23.7 kg/m2 (20–29) and mean BP: 122/69 mm Hg. 38 players (6.4%) had hypertension grade 1, and two had hypertension grade 2. There was a significant linear relationship between mean arterial pressure (MAP) and indexed LV mass, HR and PP with regression coefficient 0.26 (95% CI 0.08 to 0.44), 0.20 (95% CI 0.10 to 0.29), and 0.18 (95% CI 0.07 to 0.29), p<0.01. No such correlation was found between RWT, E/A ratio and MAP.

Conclusion

Elevated BP was associated with increased PP and HR, indicating increased sympathetic activity. Those with elevated BP had significantly increased indexed LV mass, indicating an early start of end organ damage. Considering that detection of elevated BP at one single occasion in young age may predict manifest hypertension later in life, our data support BP screening of athletes.
Functional movement screen: inter-rater and subject reliability
Authors: Shultz R , Mooney K , Anderson S , Marcello B , Garza D , Matheson G O , Besier T
Published: March 2011

Background

A screening test evaluates a functional movement by assessing an athlete's functional limitations, weaknesses, or impairments that may increase the risk of injury for the athlete.

Objective

To assess the inter-rater reliability and subject variability of the Functional Movement Screen (FMS) and to analyze the use of video scoring as opposed to live scoring.

Design

A reliability study. Each athlete was tested and retested, 1 week apart by the same rater, who also scored the athlete's first session from a video recording. These video recordings were then scored by five other raters.

Setting

Human Performance Lab using two standard video cameras (sagittal and frontal views) and SiliconCoach video capture software.

Participants

21 female (19.6±1.5 years, 64.4±5.1 kg, 1.7±0.1 m) and 19 male (19.7± 1.0 years, 80.1 ±9.9 kg, 1.9±0.1 m) Varsity athletes from swimming, soccer, volleyball, cross-country and gymnastics volunteered to participate, along with six raters.

Assessment

The FMS consists of seven tasks that focus on mobility and stability. Each task is rated out of 3, with pain being an automatic zero, for a total score out of 21. Raters (6) looked for malalignment and asymmetry.

Main outcome measurement

The Krippendorff alpha (Kalpha) was used to assess the reliability of each of the three tests: inter-rater, test-retest, live versus video.

Results

The Kalpha for the inter-rater, the test-retest, and the live/video was 0.3806, 0.6161, and 0.9096, respectively.

Conclusion

Inter-rater reliability results show that clinicians should avoid comparison across multiple raters. It is possible that with more training this value may increase. Fortunately, if a single rater is used, clinicians can be confident that a change in the FMS score is due to a change in the athlete as the test-retest produced good reliability. This study also demonstrates that streamlining the FMS process with the use of video capture is appropriate.
Atrial fibrilation in a tetraplegic paralympic athlete
Authors: Silva P , Watt J , Soni B , Hlaing T , Pulya K
Published: March 2011

Background

Individuals with Spinal Cord Injury (SCI) experience various types of cardiovascular dysregulation depending on the level of their cord lesion. The recognition and management of cardiovascular dysfunction following SCI represent challenging clinical issues. Moreover, cardiovascular disorders are among the most common causes of death in individuals with SCI.

Objective

To raise awareness that persons, athletes included, with SCI may develop cardiac arrhytmia without any obvious underlying cause or discernable symptoms.

Design

Case report of atrial fibrilation (AF) in asymptomatic tetraplegic athlete diagnosed on routine pre-op ECG.

Setting

North West Regional Spinal Injuries Centre at Soutport UK and British Wheelchair Athletics Association.

Case report

37 year old, C6 complete (Abbreviated Injury Scale A) traumatic tetraplegic was diagnosed with AF during routine ECG for elective replacement of intrathecal baclofen pump. He is a full time athlete, medallist at Paralympic and World Games and held at one time the world record in his category (F51) in the Discus.

There were no symptoms, no recent history of infection or alcohol excess and no past history suggestive of underlying cardiac pathology, as his previous ECG, echocardiography, thyroid function test and electrolytes were normal. After anticoagulation, cardioversion was successfully carried out after failure of treatment with amiodarone and flecainide for 4 months. Currently, 1 year after initial diagnosis, he is in sinus rhythm, not taking any medication and resumed normal physical activity and competitive sports. In his subjective opinion, he feels he can train harder than before cardioversion.

Conclusion

First, SCI may contribute to increase risk of developing arrhythmia (AF in this case), which will have negative effect on cardiac performance and if left untreated can increase the risk of cerebrovascular events that could further impair the patient's (athlete in this case) functional status and reduce his life expectancy. Second, we feel that more diligent preparticipation athletic screening and diagnosis is recommended in persons with SCI.
Medical facilities and encounters at the 2010 vancouver winter olympic games
Authors: Taunton J , Schamasch P , Wilkinson M , Renstrom P , Engebretsen L , Celebrini R , Stewart R , Sasyniuk T
Published: March 2011

Background

Epidemiological data and logistical details are crucial pieces of information for organisers of medical care at mass sporting events.

Objective

To outline the medical facilities at the 2010 Winter Olympic Games and to report the epidemiology of medical encounters.

Design

Prospective descriptive study.

Setting

Nine competition venues, six non-competition venues and two Polyclinics (Vancouver and Whistler). Medical services were available at all venues. The Polyclinics housed an inter-disciplinary team of health-care professionals. Imaging modalities (including CT and MRI) were on-site at the Polyclinics.

Participants

2567 athletes, 82 National Olympic Committees, an estimated 4000 Officials, 25 000 Workforce/Volunteers, 10 000 Performers and 10 000 Media. Medical Services included 1560 volunteers and 19 full-time staff.

Assessment

Medical encounters were entered into a Medical Encounter Database (ATOS Origin). Games-Time reporting period was February 4th to 28th, inclusive. Computers were located at each Venue.

Main outcome measure

Medical encounters.

Results

There were 9038 medical encounters (8198 accredited; 840 spectator). The busiest venues were the Whistler Polyclinic (n=3124) and Vancouver Polyclinic (n=2930). Of the competition venues, the busiest were Whistler Sliding Centre (bobsleigh/luge/skeleton), Canada Hockey Place and Pacific Coliseum (figure skating and short track speed skating). Venues with the greatest number of spectator medical encounters were Canada Hockey Place (n=186), B.C. Place Stadium (Opening/Closing Ceremonies) (n=128) and UBC Sports Centre (hockey) (n=90). Sports with the highest and lowest athlete medical encounters were Alpine Skiing and Nordic Combined, respectively. The majority of encounters were musculoskeletal (MSK) (n=29%). There were 131 ground ambulance transfers and seven air ambulance extractions/transfers resulting in 14 hospital admissions and 43 outpatient visits.

Conclusion

The majority of medical encounters were seen at the Polyclinics. Although most were MSK, there was a high demand for other disciplines such as Dental and Imaging. Multi-disciplinary Polyclinics equipped with primary and ancillary services are essential at future Games.
What is a sports injury?
Authors: Timpka T , Jacobsson J , Ekberg J , Nordenfeldt L
Published: March 2011

Background

While athletes and coaches, government policy-makers, and sports managers need evidence for decision-making, unambiguous terms and definitions for reporting and analyzing sports injuries across settings are lacking.

Objective

To define unambiguous concepts for reporting sports injuries across settings.

Design

Meta-analysis of sports injury-related concepts followed by development of an integrated conceptual framework and appraisal of current sports injury definition practices.

Setting

Definitions used in the scientific literature on sports injury, injury concepts related to the ICD and ICF, and action-theoretical notions used describe disability.

Main outcome measures

Definition of reportable episodes employed in consensus statements about injury reporting in specific sports and in epidemiological studies of athletics injuries published in PubMed before October 2009.

Results

A three-context framework for cross-referencing of sports injury-related concepts was developed using the WHO notion of impairment as foundation, that is, loss or abnormality of psychological, physiological, or anatomical structure or function. In each context, the concepts are differentiated with regard to the duration of the process leading to the loss or abnormality, reflecting the possibilities for prevention and clinical interventions. This three-context framework covered all definitions of sports injury in the evaluated studies (18/18). In comparison, no single study used a definition of sports injury that covered all contexts included in the three-context framework. The sports institution context (‘time loss from sports’) dominated the definitions of reportable events (13/18 studies). Data from the athlete self-evaluation context was only included in three of the 18 studies. None of the studies used clinical screening as the primary context for defining injury.

Conclusion

Present practices for definition of sports injury have important limitations. A three-context framework representing the major stakeholder perspectives (the athlete, clinical medicine, and sports institutions) have been defined and situated with regard to international definitions of injury, disease, and function.