bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial risk factors preceding overuse injury in floor-ball
Authors: Tranaeus U , Johnson U
Published: March 2011

Background

Previous research demonstrates an injury risk of traumatic and overuse injuries in floor-ball which is one of the major sports in Sweden with 1 24 000 licensed players. One important step to prevent overuse injuries to occur is to understand its psychosocial nature.

Objective

The aim of this study is to describe and structure athletes' experience of psychosocial risk factors preceding overuse injury.

Design

Elite floor-ball players were interviewed by the first author and based on a semi-structured interview guide. To uncover the underlying meaning in the transcribed interviews, a thematic content analysis was used.

Setting

Team doctors and physiotherapists in the highest floor-ball leagues (women and men), were contacted and asked to make contact with overuse injured players for interviews regarding their injury. Interviews were recorded at the interviewer's office or the floor-ball arena. The interviews were transcribed verbatim. Participants were informed about the purpose and the method of the study. That participation was voluntary, that their responses would be treated confidentially and that their identities would not be revealed in the reporting of the findings.

Participants

Nine male and one female elite floor-ball players diagnosed with a present overuse injury were recruited for voluntary participation.

Main outcome measurements

Psychosocial factors experienced by elite floor-ball players preceding overuse injuries.

Assessment of risk factors

Assessment is conducted through qualitative analysis.

Results

Three main themes evolved in the analysis; a) several players experienced pain while competing. However, it is difficult to separate normal/daily pain to warnings signals of an injury, b) many players experienced a culture in the team including not talking about their first symptoms, and, c) time for mental and physical recovery was not given during the season.

Conclusion

Players experienced a culture where it is not acceptable to talk about non traumatic pain. Periods of rest were limited leading to a need for mental recovery.
Relationship between core strength and balance ability in high school female handball and basketball players
Authors: Tsukagoshi T , Shima Y , Nakase J , Goshima K , Takahashi R , Aiba T , Yoneda Y , Moriyama S , Kitaoka K
Published: March 2011

Background

Although a lot of reports have suggested that the core strength has an important role for the prevention of sports injuries, the relationship between core strength and balance ability is poorly documented.

Objective

The purpose of this study is to examine the relationship between core strength and balance ability.

Participants

119 healthy high school female players (age: 15–16 years, handball: 49 players, basketball: 70 players) were participated in this study.

Main outcome measurements

We measured endurance time of right side-bridge, left side-bridge and frontal-bridge as the core strength test (CST). To assess static balance, we used stabilometer and recorded the circumference area of the single leg standing position of 30 s. For the assessment of dynamic balance, we used star excursion balance test (SEBT). SEBT reach distances and limb lengths were examined, then the distance scores (cm) for each direction of the SEBT grid were averaged over the three trials and normalised to leg length (reach distance/leg length x 100=percentage of leg length). The normalised distances in each direction were then summed for both leg. We divided the players into three groups according to their CST score and compared them with the results of static balance and dynamic balance.

Results

No significant differences were found in body size among the three groups (p<0.05). The significant difference was not found with the static balance among the CST (p<0.05). In the dynamic balance, the players with good result of CST score had significantly better results of the SEBT in frontal-bridge and left side-bridge (p<0.05). There was no significant difference in right side-bridge.

Conclusion

This study showed that the core strength had certain relationship to the dynamic balance and may contribute to the prevention of sports injuries.
A two-dimensional video analysis of shoulder injuries in rugby tackles
Authors: Usman J , McIntosh A S
Published: March 2011

Background

Studies indicate that the risk of shoulder injury in rugby union football is high and that the tackle is a leading cause of shoulder injury. Qualitative video analysis of the game events in rugby, such as the tackle, can provide important insights into the causes of injury and injury prevention.

Objective

To describe shoulder injury mechanisms in rugby union football using a qualitative video analysis protocol.

Design

A case control study design was applied using shoulder injury and other/no-injury cases collected prospectively from Super 14 matches between 2006 and 2008. A qualitative video analysis method was applied to code skill performance and injury risk factors.

Setting

Professional provincial rugby competition (Super 14 competition) between 2006 and 2008.

Participants

Professional Australian male rugby players.

Assessment of risk factors

The analysis focused on the identification of shoulder loading patterns, either direct or indirect (eg, loading of the hand or arm). The characteristics were compared to an existing dataset in a case-control framework.

Main outcome measurements

OR for skill and specific injury risk factors were calculated.

Results

Two main shoulder injury mechanisms were (1) falling on an outstretched hand during a tackle and (2) direct impact to the tip of the shoulder during a tackle causing injuries to the glenohumeral joint and the acromioclavicular joint.

Conclusion

The results provided valuable information in understanding the mechanism of shoulder injuries in rugby union football. Improvements in shoulder padding and tackle skills, for both the ball carrier and tackler, are required to reduce the incidence of shoulder injury.
Injuries of the upper body extremities in recreational climbers: incidence and risk factors
Authors: van Middelkoop M , Rakhshandehroo S , Bruens M L , Koes B W , Bierma-Zeinstra S M A
Published: March 2011

Background

In recent years sport climbing is increasing in popularity, due to the improvements of climbing facilities. This sport has a spectrum of associated injuries which involve most frequently overuse injuries of the hand and the finger.

Objective

To determine the incidence of climbing related injuries in Dutch recreational climbers and to identify possible risk factors that are associated with these injuries.

Design

A prospective cohort study.

Setting

Indoor climbing halls.

Participants

426 recreational climbers in four different climbing halls were recruited.

Assessment of risk factors

All climbers filled in a baseline questionnaire including potential risk factors such as age, gender, body mass index, education level, finger strength, climbing level/experience/time, main climbing activity, earlier injury, training with campus board, performing warming-up/cooling down and other sport activities. Finger strength was measured with the DIGITSgrip. A physical examination was performed to examine the shoulders, elbow, wrist, hand and fingers.

Main outcome measurements

Follow-up questionnaires were sent to all climbers at 3, 6, 9 and 12 months follow-up and reported on new injuries occurred due to climbing.

Results

A total of 178 (41.8%) climbers reported a new injury during the 1-year follow-up period. Fingers were the most reported injuries, followed by the elbow and shoulder. A climbing level >6a, climbing more than 40 h per 3 months, bouldering and those who train with a campus board and perform warming-up and cooling-down exercises are univariately associated with a higher injury risk. Only a climbing level >6a (OR 2.00, 95%CI 1.25 to 3.19) remained in the multivariate regression model as being associated with climbing injuries.

Conclusion

Climbing injuries of the upper body extremities in Dutch recreational climbers are very frequent. The most common site of an injury is the finger. A climbing level >6a is a risk factor for climbing injuries in this recreational climbing population.
Neuromuscular activity and force production during slide-based and stationary ergometer rowing
Authors: Vinther A , Alkjaer T , Kanstrup I-L , Zerahn B , Ekdahl C , Jensen K , Holsgaard-Larsen A , Aagaard P
Published: March 2011

Background

The type of rowing ergometer may influence the injury risk in rowers. Overuse rowing injuries (ie, rib stress fractures and low back pain) may be related to the timing and magnitude of neuromuscular activity and handle force production, respectively.

Objective

To investigate neuromuscular activity and force production profile during slide-based and stationary ergometer rowing.

Design

Biomechanical cross-over study.

Setting

Danish National Rowing Team.

Participants

14 male (M) and eight female (F) rowers.

Intervention

Ergometer rowing with and without slides in a randomised order at matched exercise intensity.

Main outcome measurements

Timing and magnitude of: (1) Normalised Electromyography (EMG) from selected thoracic and leg muscles. (2) Peak handle force (PF) including rate of force development (RFD).

Results

Slide-based ergometer rowing decreased the magnitude of neuromuscular activity in m. vastus lateralis from 59/57% (M/F) to 51/52% EMGmax in the initial drive phase (p<0.01/0.05) and from 20/17% to 7/7% EMGmax in the late recovery phase (p<0.01) while Ankle dorsiflexors (M, F) and m. serratus anterior (M) showed increased neuromuscular activity (p<0.05) during the late recovery phase. EMG timing remained unchanged and no changes in magnitude were observed in other thoracic muscles. RFD (at 50–70% of PF) decreased (21%) in M (p<0.05) while PF decreased 8.4/3.1% (M/F) (p<0.001/0.05). PF and maximal shoulder retractor neuromuscular activity always occurred in the second quartile of the drive phase supporting previously suggested rib stress fracture injury mechanisms.

Conclusion

Slide-based ergometer rowing affected neuromuscular activity in the leg muscles more than thoracic muscle activity. The reduced knee extensor neuromuscular activity in the catch phase may partly explain the observed reduction in peak force, which in addition to the decreased RFD (M), is likely to result in reduced loading of the ribs and spine. Prospective studies are needed to elucidate if long-term slide-based ergometer rowing leads to reduced injury incidence.
TRiathlon injury review
Authors: Vleck V , Alves F Bessone
Published: March 2011

Background

Triathlons increasing popularity has not been matched by an increase in the quantity and quality of triathlon injury research.

Objective

To summarise current knowledge of the distribution and determinants of injury, and the efficacy of preventive measures implemented by the International Triathlon Union (ITU), in the sport.

Design

English language computer search of the ‘Medline’, ‘PubMed’, and ‘PsychLit’ databases, from 1986 to 2009, using the headings: ‘triathlon’, ‘triathlete’, ‘swimming’, ‘cycling’, ‘running’, ‘runner’, ‘injury’/’injuries’, and ‘epidemiology’. Articles currently in press and unpublished, postgraduate theses were also used.

Setting

Novice, competitive/age-group to National Squad level athletes over the sprint to Ironman distances.

Participants

Less than 50, mostly retrospective, peer reviewed publications were obtained. No data were available for youth or junior athletes, different senior age-groups, or athletes with a disability.

Assessment of risk factors

Only risk factor data that had been tested for correlation or predictive value were included.

Main outcome measurements

Injury type, time loss, clinical outcome and economic cost.

Results

Although the long term implications for pulmonary, musculoskeletal or cardiac health are unknown, triathlon ‘appears to be relatively safe for persons of all ages assuming that high risk individuals undertake health screening’. Most injuries appear to be gradual onset or overuse, training related, lower limb injuries, occurring during running. Catastrophic injuries occur, usually ‘as a result of failure to adjust pace within safe limits for specific environmental conditions’ or inadequate implementation of safety guidelines, but are largely unreported. Triathlon cross-training may engender an increase in injury risk over that faced in swimming, cycling and running in isolation. Injury recurrence is significant.

Conclusion

It is recommended that a longitudinal prospective survey of injury in ITU events be carried out, after a consensus statement on definition and recording of triathlon injuries has been developed.
A prospective study of injuries in ncaa intercollegiate ice-hockey goaltenders
Authors: Wijdicks C , Spiridonov S , LaPrade R
Published: March 2011

Background

While relatively well protected and padded, ice-hockey goaltenders are at risk for impact injuries.

Objective

To study incidence and mechanism of intercollegiate ice-hockey goaltender injuries.

Design

Analyzed seasons prospectively starting in 2000–01 through 2006–07.

Setting

All National Collegiate Athletic Association (NCAA) ice-hockey goaltender injuries through the Injury Surveillance System.

Participants

NCAA ice-hockey goaltenders.

Assessment of risk factors

Injury rates were calculated per 1000 player games.

Main outcome measurements

Injury rates.

Results

The overall rate of NCAA men's ice-hockey goaltender injuries was 0.5/1000 player games. 56 men's ice-hockey goaltender injuries resulted in further time loss from practices or games. 13 injuries resulted in time loss of 1–2 days, 18 resulted in time loss of 3–5 days, 10 injuries resulted in time loss of 6–9 days, and 10 injuries resulted in 10 or more days of time loss from competition. The overall rate of NCAA women's ice-hockey goaltender injuries was 0.72/1000 player games. Overall, women sustained 23 time-loss game injuries. Five of these resulted in further loss of on-ice practice/game times of 1 day, eight resulted in 3–5 days of time loss, two resulted in 6–9 days of time loss, and seven injuries resulted in 10 or more days of time loss.

Conclusions

Further understanding of the aetiology of these on-ice goaltender-player contact injuries could assist in the development of possible interventions to reduce the incidence of NCAA ice-hockey goaltender injuries. The current Injury Surveillance System has shortcomings and does not provide us with enough information to evaluate the effectiveness of goalie equipment and the impact that possible rule changes would have on the game. This study is the first step in analyzing all participants in hockey with anticipation for future rule and equipment optimisation and subsequent injury reduction.
Prevalence of haemoglobinopathy in sportsmen in qatar
Authors: Tremblay C , Hamilton B , Sala M , Paoloni J , Chalabi H
Published: March 2011

Background

Haemoglobinopathy are the most common genetically inherited disease in many parts of the world. Both health and athletic performance may be affected in athletes training at high intensity and in extreme conditions.

Objective

This retrospective study evaluates the prevalence of haemoglobinopathy in sportmen of Qatar.

Design and setting

712 male athletes (age 14–36 years) of all levels were medically screened in our sports hospital during the period of January 2008 to April 2009. Athletes with a low Mean Cell Volume (Value) and low Mean Cell Haemoglobin (Hb value) were investigated for haemoglobinopathy with an electrophoresis screen and DNA analysis in the event of a normal electrophoresis, and unexplained low MCV/MCH.

Intervention

112 athletes (15.7%) met the criteria for investigation. 93 (83.04%) of these underwent electrophoresis and 76 (81.7%) had a normal result.

Results

Abnormal results included nine â-thalassemia minor, four sickle cell trait, one Hb D Los Angeles and three subtypes of HbX. 49 (64.7%) of the 76 normal Hb electrophoresis were further tested with DNA analysis. 45 DNA results were subsequently abnormal for three subforms of alpha thalassemia minor.

Main outcome measurements

Overall, no athletes were found to have thalassaemia major but 8.85% of total number of athletes in this cohort were positive for thalassaemia minor. Nearly 2/3 of the positive results were in Qatari athletes, with the remainder being from other Gulf, Asian and African countries.

Conclusion

Thus we conclude that there is a high prevalence of haemoglobinopathies in Qatar sportsmen. The use of electrophoresis as a screening tool is challenged by the high rate of false negative observed in this study. Screening, education and counselling is needed to prevent possible health hazards and to optimise performance in this group of athletes often performing in extreme environmental conditions.
The incidence and risk factors for pre-race respiratory tract symptoms in ironman triathletes
Authors: Schwellnus M , Lichaba M , Collins M
Published: March 2011

Background

Pre-race respiratory tract symptoms (RTS) in Ironman triathletes appear to be common but the incidence and risk factors for pre-race RTS have not been well studied.

Objective

The objectives of this study were to determine the incidence of RTS in triathletes preparing for an Ironman Triathlon and to establish the risk factors associated with pre-race RTS.

Setting

International Ironman Triathlon competition.

Participants

304 triathletes entering the Ironman triathlon were recruited.

Assessments

All the subjects completed a validated questionnaire in the 1–3 days before the race that contained sections on demographics, training and previous competitions, and a detailed section pertaining to RTS and allergies. Data on race performance were collected after the race. Subjects were divided into the following groups, based on their self-reported history of RTS in the 6 week and 1 week period prior to the race: no RTS, all RTS, only upper respiratory tract symptoms (URTS), lower respiratory tract and/or systemic symptoms (LRT+SS).

Measures of outcome

Incidence (%) of triathletes with RTS in the 6 weeks and 1 week before the race and factors associated with pre-race RTS.

Results

The main findings in this study were that 49% of the Ironman triathletes reported RTS in the 6-week period before competition. There was a strong association between self reported RTS in Ironman triathletes and a history of self reported allergies rather than training volume (in the 15 weeks before the race). Self-reported LRT+SS but not URTS in triathletes were associated with decreased training in the 6 weeks before the race.

Conclusion

Triathletes, in preparation for a race, report a high incidence of RTS, which appear to be related to allergies rather than other factors including training volume or the calibre of the athlete.
Development of a high performance jockey helmet
Authors: Patton D , McIntosh A , Thai K
Published: March 2011

Background

A high performance European equestrian helmet standard (EN 14572) was created to promote a higher level of protection for jockeys than existing equestrian helmet standards. Currently no equestrian helmet has been manufactured that meets this standard with the main challenge being the requirement to meet high and low impact energy attenuation criteria while passing tests against hazard and hemispherical anvils.

Objective

To develop and assess helmet prototypes to meet the energy attenuation requirements of EN 14572.

Design

Materials and helmet prototypes were assessed using impact tests. Polymer honeycomb and foams of selected densities and thicknesses (expanded polystyrene, expanded polypropylene, and polyurethane) were sourced as possible energy attenuating liner materials. These materials were impact tested both as single material samples and combination samples consisting of relative high and low density materials. Impact tests were performed using a rigid headform with test heights ranging from 1.2 m to 2.5 m. A series of prototype helmets were constructed with a high performing material combination as the energy attenuating liner in a typical thermoplastic shell. The prototypes were impact tested and compared to existing models.

Setting

Jockeys and equestrian sportspeople.

Intervention

Helmet design.

Main outcome measurements

Linear headform acceleration measured during impact tests.

Results

Increasing the liner thickness increased the energy attenuation performance of all materials and allowed lower density materials to perform better during higher velocity impacts. Combination samples of polymer honeycomb and low density foam performed better than single material samples over the range of impact velocities. The prototype helmets had higher energy attenuation performance when compared to unmodified helmets with the same shell, especially for lower severity impacts, but were larger and heavier.

Conclusion

There is potential to increase the energy attenuation capabilities of current equestrian helmets through utilisation of novel materials and dimensional changes. The impact of these changes on helmet ergonomics needs consideration.
Effect of stabilisation training on trunk muscle size, motor control, low back pain and player availability among elite australian rules football players
Authors: Hides J , Stanton W , Mendis M D , Gildea J
Published: March 2011

Background

Among the injuries in Australian Rules Football League (AFL), hip, thigh and groin muscle injuries are highly prevalent. The prevalence rates of injuries classified as ‘trunk/back’ in the AFL injury report have not decreased over the past 16 years. In addition, low back pain (LBP) is common among AFL players. Deficits within the lumbo-pelvic region such as impaired motor control, is thought to contribute to injuries.

Objective

To investigate the effect of a staged stabilisation training program on trunk muscle size and motor control.

Design

Randomised control trial.

Setting

MRI examinations were carried out in a hospital setting, and the stabilisation training was conducted at the AFL club premises.

Participants

42 male elite players representing the training squad of an AFL club, participated in the study.

Interventions

The stabilisation program involved voluntary contraction of the multifidus, transversus abdominis, and pelvic floor muscles, with real-time feedback from rehabilitative ultrasound imaging, progressed from non-weight-bearing to weight-bearing positions. Training sessions were 30 min in duration, and were conducted twice per week for 7–15 weeks.

Main outcome measurements

The dependent variables were the cross-sectional areas (CSA) of the multifidus muscles, the ability to draw in the abdominal wall (CSA of the trunk, relaxed versus contracted), pain (Visual analogue scale) and player availability for competition games.

Results

In the control group, multifidus muscle CSA decreased. Stabilisation training was associated with an increase in multifidus muscle CSA and an increased amount of abdominal wall draw-in. This was concomitant with a decrease in LBP and an increase in player availability.

Conclusion

Alterations in muscle size and motor control can exist in highly active, elite athletes. Specific retraining during the season was effective in terms of increasing availability of players and decreasing LBP.
The relationship between ACL injuries and physical fitness in junior austrian alpine ski racers – a 10 year longitudinal study
Authors: Raschner C , Platzer H P , Patterson C , Werner I , Hildebrandt C
Published: March 2011

Background

Epidemiological studies have shown a high incidence of anterior cruciate ligament (ACL) injuries among competitive alpine skiers. Little is known about modifiable risk factors and there is still equivocal discussion about the gender-related risk factors.

Objective

To determine the relationship between ACL injuries and internal risk factors among competitive junior alpine skiers.

Design

Retrospective data analyses of a cohort.

Participants

175 female and 195 male competitive alpine ski racers between the ages of 14 and 19.

Assessment of risk factors

Athletes of the Skigymnasium Stams underwent a test battery three times annually from 1996 to 2006. Norm profiles were established and Z score transformations normalised the different age groups. In the case of an ACL injury the last test result before the injury was compared with the norm values.

Main outcome measurements

Physical parameters between injured and non-injured athletes.

Results

Between 1996 and 2006, 57 ACL injuries occurred. The injury rate in females was 2.1 times greater than in males. The binary logistic regression revealed Nagelkerkes R2of 0.368 and 0.236 for men and women, respectively. Z scores for relative leg force, ratio of absolute flexion/extension force, relative core strength and reactive strength index were predictive variables for men. Z scores of all these predictive variables except relative leg force were higher (p<0.05) in the non-injured group than in the injured group. Ratio of absolute flexion/extension force and absolute core strength were predictive covariates for women. Z scores for absolute core strength were higher in the non-injured group (p<0.01).

Conclusion

The risk of injury was higher in females compared with males. Findings suggest that core and leg strength are critical factors for ACL injuries in young ski racers. Targeted evidence-based preventative training programs must include these aspects.
The effect of fatigue on frontal plane angular changes in the lumbar spine of elite rowers
Authors: Wilson F , Simms C , Gormley G , Gissane C
Published: March 2011

Background

The incidence of lumbar spine injury is high in rowers. Spinal kinematics and fatigue may influence onset of this injury.

Objective

To quantify lumbar spine motion in the frontal plane (at L3) and examine the effects of fatigue (measured by changes in blood lactate accumulation) on changes in angular displacement of the lumbar spine during ergometer rowing.

Design

The lumbar spine kinematics of the study cohort were measured using a Spectrotilt Inclinometer connected to a Biometrics DataLog system.

Setting

A laboratory based study of elite level rowing.

Participants

12 elite rowers, all male, mean age 23.2 (5.2) years, mean weight 79.1 (5) Kg.

Assessment of risk factors

Lumbar spine angular kinematics were measured in the frontal plane at L3 during an ergometer rowing trial. The trial was an incremental ‘step test’ on a Concept 2 ergometer. Blood lactate was sampled at 3 min intervals throughout the test using a portable lactate analyser.

Main outcome measurements

Changes in spinal angular displacement between the first and last stage of the test. Fatigue was indicated by accumulation of blood lactate.

Results

Mean angular displacement was 4.6° (1.4) at the first stage of the test, increasing to 8.7° (2.1) for the last stage. A significant increase in frontal plane angular displacement between the first and last stage of the test was observed (mean increase=4.1° (1.94), 95% CI 2.9 to 5.3°, t=7.36, p=0.000014). Incremental rise in angular displacement was associated with an incremental rise in blood lactate.

Conclusion

The high values of angular displacement reached by the participants in this study confirm that there is considerable frontal plane motion during rowing and this increases with fatigue and should be considered as a factor for injury.
Sequence variants within the 3′-UTR of the col5a1 gene alters mrna stability: implications for musculoskeletal soft tissue injuries
Authors: Laguette M-J , Prince S , Collins M
Published: March 2011

Background

COL5A1 encodes the à1 chain of type V collagen, a minor fibrillar collagen that regulates fibrillogenesis within non-cartilaginous connective tissues. A variant within the COL5A1 3'-untranslated region (UTR) is associated with Achilles tendinopathy (AT), Anterior cruciate ligament ruptures in females, flexibility and endurance running performance.

Objective

To provide functional evidence for these genetic associations, the aim of this study was to identify common variants of the COL5A1 3′-UTR from patients with chronic AT and asymptomatic controls. Functional differences between the different variants were tested using reporter gene constructs.

Methods

The entire COL5A1 3′-UTR from four AT patients and three controls were cloned, from genomic DNA using nested PCR, within the pGL3-Promoter vector, substituting the poly (A) signal of the firefly-luciferase reporter gene. The constructs were transiently co-transfected with an internal control HT1080 cells. The normalised results were expressed as relative luciferase activity.

Results

Inter-individual variation was demonstrated with a 2.6-fold difference (p<0.001) in the highest activity for an AT patient (110.5±11.6%) and the lowest activity for an asymptomatic subject (42.8±8.6%). In addition, an overall significantly higher activity (87.5±14.3% vs 67.6±20.0%, p<0.001) was observed for the clones from the AT patients. Two major forms of the COL5A1 3′-UTR were identified when all the cloned 3′-UTRs were sequenced. One form (WT-allele) was predominantly identified in the controls, while the second form (TEN-allele) was predominately identified in AT subjects. The luciferase activity of the WT-allele was also significantly lower than the TEN-allele (68.3±24.9% vs 86.0±18.5%, p=0.007).

Conclusion

Two major COL5A1 3′-UTR alleles were identified; one from the AT patients and the other from the asymptomatic controls. There was an overall increase in mRNA stability for the TEN-allele. These results demonstrate that the COL5A1 3′-UTR may play an important regulatory role which could results is susceptibility to musculoskeletal soft tissue injures and other phenotypes.
Consciousness survey of junior-high school handball instructors regarding anterior cruciate ligament injuries in japan
Authors: Nakase J , Kitaoka K , Goshima K , Takahashi R , Tsuchiya H
Published: March 2011

Background

Recently, prevention of anterior cruciate ligament (ACL) injuries has gained attention. However, there has not been any report on a consciousness survey of sports instructors regarding ACL injuries in Japan.

Objective

The purpose of the present study was to conduct a consciousness survey regarding ACL injuries of instructors who coached junior-high school handball team and to ascertain their current knowledge or awareness.

Participants

The subjects of the survey were instructors who coached teams that participated in the national junior-high school handball championships in Japan (the subjects were 102 coaches (69 males and 33 females) from 70 teams).

Methods

The questions were the following: (1) Do you know what an ACL injury is? (2) Have you had players with ACL injuries? (3) Do you know the mechanisms of ACL injury? (4) Do you know about the training programs for ACL injury prevention? In addition, the instructors coaching experience in handball was surveyed.

Results

The instructors had a mean of approximately 10 years of coaching experience, and 89.2% of the instructors knew about ACL injuries, 49% knew the mechanisms of ACL injury, and 13.7% knew about training programs for ACL injury prevention. The percentage of instructors who had players with ACL injuries was 27.5%.

Conclusion

Puberty has been reported to be a suitable time to introduce programs for ACL injury prevention. Although most handball instructors who coached in the Japanese national championships knew what an ACL injury is, only 14% knew about training programs for ACL injury prevention. As sports medicine physicians, we can help reduce the incidence of ACL injuries through lectures to educate instructors about the mechanisms of ACL injury and training methods for ACL injury prevention.
Online tailored intervention, http://www.voorkomblessures.nl, effective on injury preventive behaviour of dutch runners
Authors: Kloet S , Adriaensens L , Harting L , Fabrie M , van Huik B , Kraaij S
Published: March 2011

Background

On a population of 10 million sportsmen in the Netherlands, 3.6 million sports injuries are sustained each year. Behaviour is essential in preventing those injuries. An online tailored intervention,http://www.voorkomblessures.nl, provides Dutch amateur athletes with sport-specific and personalised (tailored) advice.

Objective

To test the effectiveness of the online intervention on (determinants of) behaviour to prevent sports injuries among amateur runners between 18 and 35 years old.

Design

In a prospective randomised controlled trial participants were randomly assigned to: experimental group 1 (with baseline), experimental group 2 (without baseline) or control-group. Baseline, 30 min follow up and 3 month follow up data were obtained through online questionnaires between September 2009 and February 2010.

Setting

Real life setting.

Participants

After selection on age (18–35), skill level (amateur) and familiarity with the intervention (none) 318 of 352 recruited runners were included in the study and participated at baseline and 30 min follow up measurement. 199 runners participated at 3 month follow up.

Intervention

Participants in both experimental groups had to view the online intervention for 30 min. Respondents in the control group had to read non running related magazines for 30 min.

Main outcome measurements

The intervention aims to influence taking four preventive behaviours and/or change their determinants.

Results

At 30 min follow up significant effects of the intervention are found on various determinants: attitude, risk perception, knowledge and intention. At 3 month follow up significant effects are found on the determinants knowledge and risk perception. More importantly significant effects are shown on two injury preventive behaviours.

Conclusions

This study shows the online interventionhttp://www.voorkomblessures.nlsucceeds in positively influencing the (determinants of) injury preventive behaviours. More research is needed on long term effects and effects on other types of sport.
The use of biomarkers to assess the response of cartilage to exercise
Authors: Savage T , Niehoff A , Brüggemann L , Müller M , Zaucke F , Eckstein F , Müller-Lung U , Brüggemann G-P
Published: March 2011

Background

Osteoarthritis (OA) is a progressive degenerative disease of all joint structures, affecting over 50% of the population over the age of 65 in the US. Joint injury, a common outcome of sport participation, and high impact loading, such as that experienced in landing and running, are associated with an increased risk of cartilage degeneration and OA development. However, joint loading is also important to cartilage matrix health. The relationship between mechanical loading and joint degeneration is not clear.

Objective

To investigate the response of biological markers of cartilage metabolism to moderate cyclical and high impact loading activities.

Design

Comparative cohort study.

Setting

High level athletes.

Participants

10 impact athletes (five women and five men) and 14 adult non-athletic controls (seven women and seven men).

Interventions

Data were collected and compared between three experimental conditions: complete rest; moderate cyclical loading (slow jog); and high impact loading (landing). The duration of intervention was 30 min and subjects were supervised throughout the intervention.

Main outcome measurements

Blood samples were collected from each subject at baseline and 30, 60, 120 and 240 min after three interventions. Blood samples were allowed to clot, centrifuged to separate the serum and aliquots were stored at −80° until testing. Serum concentrations of glucosaminoglycans, C-propeptide of collagen II (CP2), cleavage of collagen II (C2C) and cartilage oligomeric matrix protein (COMP) were evaluated using commercially available Enzyme Linked Immunosorbent Assay kits.

Results

A significant change in serum biomarker concentration in response to the loading intervention was observed for COMP.

Conclusion

The results of this study suggest that serum CP2 and C2C concentrations were not influenced by the loading interventions at the analysed time points. However, COMP increased immediately after the loading interventions. Future studies should investigate the role of biomarkers as a diagnostic tool for evidence based workload assessment.
Mechanisms of anterior cruciate ligament injury in world cup alpine skiing: a systematic video analysis of 20 cases
Authors: Bere T , Flørenes T W , Krosshaug T , Koga H , Nordsletten L , Irving C , Muller E , Reid R C , Senner V , Bahr R
Published: March 2011

Background

We have limited insight into the mechanisms of anterior cruciate ligament (ACL) injuries in alpine skiing, particularly among professional ski racers.

Objective

To describe the mechanisms of ACL injury in World Cup alpine skiing.

Design

Descriptive video analysis.

Setting

World Cup alpine skiing.

Methods

20 cases of ACL injuries reported through the International Ski Federation Injury Surveillance System for three consecutive World Cup seasons (2006–2009) were obtained on video. Seven international experts performed visual analyses of each case to describe the injury mechanisms in detail (skiing situation, skier behaviour, biomechanical characteristics).

Results

Three main categories of injury mechanisms were identified: the slip-catch, landing back-weighted and the dynamic snowplow. The slip-catch mechanism accounted for half of the cases (n=10), and all these injuries occurred during turning, without or before falling. The skier lost pressure on the outer ski, and while extending the outer knee to regain grip, the inside edge of the outer ski abruptly caught in the snow, forcing the knee into internal rotation and valgus. The same loading pattern was observed for the dynamic snowplow (n=3). The landing back-weighted category included cases (n=4) where the skier was out of balance backwards in-flight after a jump and landed on the ski tails with nearly extended knees. The suggested loading mechanism was a combination of tibiofemoral compression, boot induced anterior drawer and quadriceps anterior drawer.

Conclusion

A consistent pattern was observed where the main mechanism of ACL injury in World Cup alpine skiing appeared to be a slip-catch situation where the outer ski suddenly catches the inside edge, abruptly forcing the outer knee into internal rotation and valgus. A similar loading pattern was observed for the dynamic snowplow. Injury prevention efforts should focus on the slip-catch mechanism and the dynamic snowplow.
Kinematics of a slip-catch mechanism for anterior cruciate ligament injury in world cup alpine skiing
Authors: Koga H , Bere T , Bahr R , Krosshaug T
Published: March 2011

Background

We have identified that a slip-catch situation is the main mechanism for anterior cruciate ligament (ACL) injuries in World Cup alpine skiing by simple visual inspection of injury videos. This occurs when the skier loses pressure on the outer ski during turning, and while extending the outer knee to regain grip, the inside edge of the outer ski catches abruptly, forcing the knee into valgus and internal rotation. To develop injury prevention methods based on this mechanism, a more precise description is needed.

Objective

To describe the detailed joint kinematics in a slip-catch situation using a model-based image-matching (MBIM) technique.

Design

Case study.

Setting

Men's World Cup alpine skiing.

Methods

Video of a slip-catch injury situation in slalom captured with two nearly perpendicular camera views was analyzed using the MBIM method to obtain the time course of knee and hip joint kinematics.

Results

Knee valgus and internal rotation angle increased by 13° and 13°, respectively, in the last 60 ms before the time of ACL rupture, which was estimated to occur 100 ms after the catching the edge. Knee flexion angle increased by 32° in the last 20 ms from 22° at snow contact to a final position. Hip flexion and adduction angle increased by 18° and 13°, respectively, in the last 20 ms and the hip stayed at approximately 30° of internal rotation in the last 60 ms.

Conclusion

Abrupt compression, valgus and internal rotation loading seems to be the main mechanism of slip-catch injury situations in ACL injuries in World Cup alpine skiing. The knee loading pattern described from the previous simple visual inspection study matched well with the more detailed analysis using the MBIM technique. Prevention efforts should focus on avoiding valgus and internal rotation loading on the knee.
The vancouver 2010 paralympic winter games medical care programme: facts, figures and recommendations
Authors: Van de Vliet P , Willick S , Ferrer O Martinez , Wilkinson M , Stewart R , Sasyniuk T M , Celebrini R , Pit-Grosheide P , Taunton J
Published: March 2011

Background

The medical care programme during Paralympic Winter Games should reflect the particular needs and necessities of Paralympic athletes and their support staff.

Objective

To characterise in detail the medical encounters at the 2010 Vancouver Paralympic Winter Games in order to improve knowledge or injury and illness patterns for medical providers at future adaptive sports events.

Design

Prospective (sports) injury epidemiological study.

Setting

The data collection took place during the Vancouver 2010 Paralympic Winter Games.

Participants

Data are reported on all persons involved in the Vancouver 2010 Paralympic Winter Games that consulted VANOC Medical Services, with particular emphasis on athlete records (n=502 participating athletes).

Interventions

Systematic records were held on all medical and physical therapy consultations throughout the duration of the Games.

Main outcome measurements

Number of patients treated during the 2010 Vancouver Paralympic Winter Games, stratified by accreditation status, injury or illness type and services consulted.

Results

At the Vancouver 2010 Paralympic Winter Games, more than 2717 medical interventions occurred for injury or illness, of whom 25% were athlete encounters (n=657). Consultations were mainly for minor injury/illness, majority of musculoskeletal nature; with only seven hospitalisations (five athletes) for a total of 24 inpatient days stay (16 days for athletes). 977 pharmacy prescriptions were issued, which in seven cases were followed up with a Therapeutic Use Exemption application. Alpine Ski was responsible for over 50% of the athlete imaging visits and approximately 20% of total imaging visits (n=332). Physical therapy interventions (n=897) primarily addressed back and shoulder structures.

Conclusion

A critical analysis of the actual findings and an efficient transfer of knowledge indicate the need for a multidisciplinary approach with other functional areas related to the organisation of Paralympic (Winter) Games, as well as for the initiating of longitudinal study to gain further and in-depth knowledge on sport injuries and exercise-induced physiological reactions in Paralympic Athletes.
A comparison of muscular activation patterns during running and landing
Authors: Savage T , Fantini C , Brüggemann G-P
Published: March 2011

Background

Coactivation of the hamstrings and quadriceps has been identified as the most effective stabilising pattern of the knee. The risk of knee injury is increased in landing compared to running and may be associated with a different muscular response to the loading pattern.

Objective

The aim of this study was to compare coactivation patterns of the knee flexors and extensors during two common athletic activities.

Design

Kinetic and EMG analysis.

Setting

Competitive athletes.

Participants

Eight young adult athletes (5 male/3 female).

Interventions

Data were collected from two running interventions (2.5 and 3.0 m/s) and expected landings from a height of 73 cm.

Main outcome measurements

Muscular activation of selected quadriceps and hamstrings muscles was determined using normalised RMS of surface EMG. The relative amount of knee flexor and extensor activity was determined using a coactivation ratio (CCR, Sum RMS Hams/Sum RMS Quads). For the running trials, the stance phase was normalised and mean muscle activity calculated during three intervals: weight acceptance (WA); middle stance (MS); and late stance (LS). Landing trials were divided into two phases: initial contact (IC, the first 100 ms after touchdown) and eccentric (EC, from 100 ms until maximal knee flexion).

Results

The CCR was significantly greater (p<0.001) during running (WA=0.56, MS=0.49) than landing (IC=0.20, EC=0.32). Muscular activity observed during landing greatly favoured the quadriceps while hamstring activity was highest during LS in running. There was a trend for an increase in CCR with running velocity, however only during LS was CCR significantly higher (p<0.05) (2.5 m/s=1.67, 3 m/s=2.14).

Conclusion

Quadriceps activity was observed to be much higher than the hamstrings in landing than running and this has been hypothesised as a mechanism of anterior cruciate ligament injury. The Quadriceps contract eccentrically to control landing and a low hamstring contribution may affect joint stability and loading patterns.
Exploring dynamic stability in a group of intercollegiate athletes
Authors: Liu K , Gustavsen G , Kaminski T W
Published: March 2011

Background

Deficits in postural stability have been linked to an increased risk of ankle sprain. Repeated ankle sprains can lead to ankle instability. Time to stabilisation (TTS) has been used to measure dynamic stability.

Objective

To determine if differences exist in TTS between stable and unstable ankles.

Design

Controlled, cross-sectional.

Setting

Biomechanics Laboratory.

Participants

64 Division I collegiate athletes (25 females and 39 males, age=18±0.9, height=180.5±10.3 cm, mass=82.5±18.9 kg).

Interventions

Group status (stable vs unstable) was determined by the Cumberland Ankle Instability Tool (CAIT). Each participant completed hops onto a force plate from four different directions (forward, backward, medial, lateral) and were instructed to land in the middle of the force plate on a single leg, stabilise as quickly as possible, and remain motionless for 5 sec. Three trials were collected for each of the four directions. TTS was quantified as the time it takes the vertical component of the ground reaction force to reach and stay within ±5% of the participant's body mass after landing.

Main outcome measurements

TTS (sec) data were analyzed using an independent t-test (p≤0.05) comparing the stable and unstable groups for each of the jump directions.

Results

There were no significant differences in TTS (sec) between stable and unstable ankles.

Jump Directionmean±SD, stablemean±SD, unstablep-valuetBackward1.04±0.551.22±0.510.152−1.442Forward1.17±0.511.20±0.620.792−0.265Lateral1.15±0.561.09±0.500.6260.488Medial1.12±0.501.14±0.640.884−0.146

Conclusion

Contrast to other reports, our results indicate no difference in TTS between subjects that are classified as functionally stable and unstable. The CAIT determines functional instability without consideration for mechanical instability. Although not significant, it appears that the backward direction created the greatest discrepancy in TTS between the groups. We question the sensitivity of our TTS calculations as others have reported different techniques. Additional research is needed employing these refined methods.