bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPARISON OF SPORT COMPETITIVE ANXIETY LEVELS OF SAUDI ARABIAN NATIONAL TEAM ATHLETES WITH AND WITHOUT DISABILITIES IN COMPETITIONS
Authors: Halawani H
Published: March 2014

Objective

The purpose of the present study is to compare the individual differences in the levels of somatic anxiety, worry, and concentration disruption of Saudi Arabian national team with and without disabilities in competitions. The purpose of this study was to compare whether significant differences existed in the levels of somatic anxiety, worry, and concentration disruption between individuals of the Saudi Arabian national team with and without disabilities in competitions.

Design

Cross-sectional.

Setting

Survey, where differences in somatic anxiety, worry, and concentration disruption were examined between athletes in an individual or team sport. The Sport Anxiety Sale was employed to measure the subscales.

Participants

Participants were 120 Saudi Arabian national team athletes with and without disabilities who participated in competitions during the 2010 competitive season. Sixty Saudi Arabian national team athletes with disabilities from four different sports (track and field, table tennis, wheelchair basketball and volleyball) were surveyed. Another 60 Saudi Arabian national team athletes without disabilities who competed in the same four sports were also surveyed. Athletes' ages ranged from 18-35 years. Furthermore, athletes varied in their level of competitive experience.

Results

Results of the multivariate analysis indicated that there were no statistically significant differences between athletes with and without disabilities or between individual and team sport participants in their levels of somatic anxiety, worry, and concentration disruption. It was found that Saudi Arabian national team athletes with and without disabilities both have relatively the same levels of somatic anxiety, worry, and concentration disruption.

Conclusion

At this point and especially in Saudi Arabia, individuals with disabilities who participate in sports are considered athletes. They could definitely use their practices and mental skills training to improve performances and promote their enjoyable sporting experience. Therefore, in terms of the anxiety performance relationship, the psychological profile of athletes with and without disabilities seems similar.
SUBSTANTIAL INTER-INDIVIDUAL AND GENDER DIFFERENCES IN JUMP FREQUENCY DURING TRAINING AND MATCHES IN YOUNG ELITE VOLLEYBALL PLAYERS – A RISK FACTOR FOR JUMPER'S KNEE?
Authors: Bahr MA , Bahr R
Published: March 2014

Background

Male gender, training volume (# of hours per week) and match exposure (# of games played per week) have been documented as risk factors for jumper's knee among young elite volleyball players (Visnes & Bahr, 2012). However, it is not known whether jump frequency differs between intra-squad players.

Objective

To examine inter-individual and gender differences in jump frequency during training and matches in young elite volleyball players.

Design

Observational study.

Setting

Norwegian elite volleyball boarding school training program.

Participants

Student-athletes (26 boys and 18 girls, 16–18 yrs).

Main outcome measures

Individual jump counts were recorded based on video recordings obtained from one week of volleyball training (9 training sessions for boys and 10 for girls, 14.1 h and 17.8 h of training, respectively) and 10 matches (5.9 h for boys (16 sets) and 7.7 h for girls (21 sets).

Results

A total of 7805 jumps were recorded during training, 4993 among boys and 2812 among girls. As training attendance and jump frequency varied substantially between players, the total exposure in training ranged from 50 to 666 jumps/week among boys and from 11 to 251 jumps/week among girls. On average, this corresponded to 35.7 jumps/h for boys and 13.7 jumps/h for girls (t-test, P=.002). Total jump exposure ranged between 1 to 339 jumps among boys and between 0 to 379 jumps among girls. Player jump frequency averaged 62.2 jumps/h for boys and 41.9 jumps/h for girls (t-test, P<.039). The inter-individual differences seen in jump frequency were substantially more pronounced than any differences observed between player functions.

Conclusions

Substantial inter-individual and gender differences were observed in jump frequency during training and matches in young elite volleyball players. Thus, jump frequency may represent a more important risk factor for jumper's knee than total training volume and warrants further research attention.
AN EVIDENCE-DRIVEN APPROACH TO SCRUM LAW MODIFICATIONS IN AMATEUR RUGBY PLAYED IN SOUTH AFRICA
Authors: Hendricks S , Micheal L , James B , Clint R , Wayne V
Published: March 2014

Background

In 2012, the South African Rugby Union approved a new set of scrum Laws for amateur rugby, to be implemented at the start of the 2013 rugby season. These Law changes were based on the relatively high proportion of scrum-related catastrophic injury data collected as part of the BokSmart National Rugby Safety Programme over the preceding 4 years.

Objective

Describe the scrum-related catastrophic injury data in South Africa between 2008–2012, and discuss how this evidence justified the change in the Amateur Scrum Laws.

Design

Prospective.

Setting

The South African amateur and professional rugby-playing population.

Participants

Junior and Senior rugby-playing population within South Africa.

Risk factor assessment

Independent variables included playing position, scrum injury mechanism, subjective comments relating to the cause of the injury, possession at the time of the scrum, coaching received on safe scrum techniques, surface footing at the time of the scrum.

Main outcome measurements

Catastrophic head, neck and spinal injuries. These were classified into Acute Spinal Cord Injury (ASCI) or Traumatic Brain Injury (TBI).

Results

The scrum accounted for 33% (n=20 of 60) of all catastrophic injuries between 2008 and 2012. Eighteen of the 20 scrum injuries (90%) were confirmed ASCIs, with 13 of these being permanent injuries. For the scrum injury mechanisms (n=19), ‘impact on the engagement’ was the most frequently reported (n=11 of 19, 58%), followed by “collapsed scrum” (n=7 of 19, 37%) and “popping out” (n=1 of 19, 5%).

Conclusions

Based on these scrum-related catastrophic injury data, a change in the Amateur Scrum Laws of South African Rugby was justified. The purpose of these Scrum Law changes is to reduce the number of scrum-related catastrophic injuries by minimising impact injury and subsequent scrum collapse in amateur rugby in South Africa.
SMALL MULTIFIDUS MUSCLE SIZE PREDICTS FOOTBALL INJURIES
Authors: Hides J , Stanton W , Smith M , Mendis D , Sexton M
Published: March 2014

Background

In Australian Football, hip, groin and thigh (HGT) muscle injuries have had the highest incidence and prevalence. A previous study showed that football players with relatively more severe pre-season ‘HGT’ injuries had a significantly smaller size of the multifidus muscle.

Objective

This study was designed to examine the robustness of multifidus muscle measurements as a predictor of lower limb injuries incurred by Australian Football League players.

Design

This was a prospective quasi-experimental research design. Muscle measurements were conducted at the start of the pre-season to predict pre-season injuries, and at the start of the playing season to predict injuries in the playing season.

Setting

Players from 6 clubs of the Australian National football league were eligible for inclusion (n=275). Players were assessed on club premises.

Participants

Assessments were conducted on 259 elite football players for the pre-season (94.2% of eligible players), and 261 players at the start the playing season (94.9%).

Risk factor assessment

Morphology of the multifidus muscle was assessed using ultrasound imaging. Injury data were obtained from records collected by the AFL club staff during the pre-season and the playing season.

Main outcome measurements

The dependent variable in the binomial logistic regression was occurrence of lower limb injuries in the pre-season and the playing season.

Results

A lower limb injury was incurred by 38.2% of the players in the pre-season and 69.5% of the players in the playing season. A new model using cross-sectional area of the multifidus muscle reliably and consistently predicted lower limb injury in both the pre-season and playing season. In the season, ‘kicking leg’ was related to injury.

Conclusions

The results of this study have established the predictive power of multifidus muscle size to predict injury in elite football players. These results provide a strong direction for clinicians who screen and treat athletes.
RECURRENT MILD TRAUMATIC BRAIN INJURY AMONGST A COHORT OF RUGBY UNION PLAYERS
Authors: Hollis S , Heller G , Stevenson M , Schofield P
Published: March 2014

Background

Community, or non-professional, rugby has a high incidence of mild traumatic brain injury (mTBI). Risk of further mTBI, or long term consequences of repeat mTBI, is an emerging public health issue.

Objective

To identify the time to recurrent mTBI and key predictors for time to recurrent mTBI among community rugby players.

Design

Prospective cohort study.

Setting

Rugby union players from Sydney, Australia playing in grade, suburban and school-level community competitions.

Participants

A cohort of 3 207 male players was recruited pre-season and followed between one and three playing seasons. Demographic information, player characteristics and concussion history was collected. Players sustaining an mTBI were recorded and information pertaining to the injury, recovery and return-to-play was collected over three months.

Risk factor assessment

Loss of consciousness and post-traumatic amnesia.

Main outcome measurements

Time to mTBI, namely, the number of hours of game exposure played up to the time the player sustained a first and repeat mTBI.

Results

Players were more likely to sustain a second mTBI if they experienced loss of consciousness (LOC) or post-traumatic amnesia (PTA) with their first mTBI. Players who experienced LOC with their first mTBI were three times more likely to sustain a second mTBI compared to those who did not experience LOC (P=.037). Players who experienced PTA with their first mTBI were 2.5 times more likely to sustain a second mTBI compared to those who did not experience PTA (P=.059).

Conclusions

Community rugby players are three times more likely to sustain a subsequent mTBI if they experienced a LOC with their first mTBI, and 2.5 times more likely if they experienced PTA. It is recommended that coaches and support staff identify players who experience LOC or PTA with their mTBI in order to prevent or delay subsequent mTBIs from being sustained by the player.
SUBSEQUENT INJURY DURING INJURY RECOVERY IN ELITE ATHLETICS: COHORT STUDY IN SWEDISH MALE AND FEMALE ATHLETES
Authors: Jacobsson J , Timpka T , Kowalski J , Ekberg J , Nilsson S , Dahlström Ö , Renström P
Published: March 2014

Background

In elite athletics, epidemiological studies covering cross-discipline populations of athletes have reported a heavy burden of injuries related to overuse. Many athletes continue to expose themselves to extensive training and competition loads while suffering from partial time loss injuries (forcing them to change their practice schedules).

Objective

To examine risk indicators associated with sustaining a secondary (subsequent) injury while recovering from a primary (index) injury.

Design

Prospective epidemiological study using web-based data collection.

Setting

Swedish elite youth (U17) and adult athletics athletes. Data were collected between March 2009 and March 2010.

Participants

292 youth and adult athletes (91%) responded regularly to web-based questionnaires from an eligible study population of 321 athletes.

Risk factor assessment

Athlete's sex, age, event group and training load.

Main outcome measures

Secondary new injury during recovery from a primary (index) injury.

Results

A total of 122 (42 %) of the athletes reported more than one injury during the study period. Multiple Cox proportional hazards regression analyses revealed risk differences with regard to event group (P=.006) and training load (P=.047) for athletes who sustained a secondary new injury during recovery from a first injury; athletes in the combined events group (hazard ratio (HR) 4.14; 95% CI 1.82–9.40) had almost a fourfold increased risk compared to jumpers and throwers and athletes in the third TLRI quartile (HR=2.02; 95% CI 1.29–3.63) a twofold risk for sustaining a secondary injury compared with their peers.

Conclusions

The risk for sustaining a new secondary injury while recovering from a primary injury is high among athletics athletes. Competing in combined events and a high score in the training load index (combining hours and intensity) are associated with particularly increased risk. Further studies measuring training content during the rehabilitation period and development of protocols for safe return to athletics are warranted.
RISKS OF INTENSE, SPECIALIZED TRAINING AND GROWTH FOR INJURY IN YOUNG ATHLETES: A CLINICAL EVALUATION
Authors: Jayanthi N , Dugas L , Fischer D , Pasulka J , LaBella C
Published: March 2014

Background

There is little data evaluating the risk for serious overuse injury in young athletes focusing on a single-sport or during growth spurts, in a clinical-based population.

Objective

To determine whether sports specialization, weekly training volumes, and growth rates are associated with increased risk for injury and serious overuse injury in young athletes.

Design

Case-control study.

Setting

Injured young athletes ages (7–18yr) were recruited from sports medicine clinics and compared to healthy controls from primary care clinics presenting for sports physicals in 2 medical centers.

Participants

There were 1206 participants (50.7% male) who were evaluated at baseline while longitudinal follow up data collection for up to 3 years is ongoing at time of submission.

Risk factor assessment

Independent variables included hours/week of organized sports, free play, gym, sports specialization, and growth rate.

Main outcome measurements

Dependent variables included total injuries, acute injuries, overuse injuries, and serious overuse injuries.

Results

Injured athletes were older than uninjured athletes (14.1 +/−2.1 vs. 12.9 y/o +/−2.6, P<.001) and reported a higher avg. hrs/wk playing organized sports (11.3+/−6.9 vs. 9.4 +/−8.2 hr, P<.001). Picking a main sport to focus on one sport was an independent risk factor for injury even after adjusting for hrs/week in total sports activity and age (OR 1.48 P<.05). Young athletes participating in more sports hrs/wk than their age (P<.05) and participating in>2 times organized sports:free play were more likely to have a serious overuse injury (P=.001). Annual calculated growth rates did not impact injury status (4.76 vs 4.79 cm/yr,injured vs. uninjured respectively).

Conclusions

Injured young athletes are older, spend more time in organized sports, and specialize. Our data support the need for counseling young specialized athletes as to the risks for overuse injury.
INJURIES CAN BE PREVENTED IN CONTACT FLAG FOOTBALL!
Authors: Kaplan Y , Witvrouw E , Myklebust G , Nyska M , Plamanovich E , Victor J
Published: March 2014

Background

Epidemiological studies in American Flag Football have revealed a high incidence of injuries. No previous study has attempted to prevent injuries.

Objective

To significantly reduce the incidence and the severity of injuries in an intervention cohort as compared to a two-season historical cohort, and to provide recommendations to the International Federation of Football (IFAF) pertaining to prevention measures to make the game safer.

Design

Prospective cohort study.

Setting

Kraft Stadium, Jerusalem, Israel.

Participants

A total of 1 260 amateur male (mean age: 20.4±3.9 yrs) and 244 female (mean age: 18.5±1.7 yrs) players participated in the study.

Interventions

Four prevention measures were implemented: The no-pocket rule, self-fitting mouth guards, ankle braces (for those players with recurrent ankle sprains) and an injury treatment information brochure.

Main outcome measures

All time-loss injuries sustained in game sessions were recorded by the off-the-field medical personnel and followed up by a more detailed phone injury surveillance questionnaire.

Results

There was an 88% reduction in the total number of injuries, and a significant reduction in the incidence rate and incidence proportion between the intervention cohort as compared to the historical cohort (P<.001). There was a trend towards a reduction in the number of injuries in all body parts, reaching statistical significance in hand/wrist injuries related to the use of pockets (P<.001), as well as the severity of mild-moderate injuries (P<.05).

Conclusions

This study provided evidence that hand/wrist injuries can be significantly reduced in flag football. Recommendations to the IFAF include strict enforcement of the no-pocket rule, the use of soft headgear, comfortable-fitting ankle braces and mouth guards and additionally, to change game rules concerning blocking.
IS OVERWEIGHT A RISK FACTOR FOR SPORTS INJURIES IN SPORTS PARTICIPANTS AGED 4–24 YEARS?
Authors: Kemler E
Published: March 2014

Background

Physical activity and sports participation are promoted to counteract the increased prevalence of overweight and obesity in children and young adults. Both high BMI and physical activity level have been associated with an increased risk of sports injuries.

Objective

To determine the relationship between sports injuries and overweight in sports participants (4–24 years), taking physical activity into account.

Design

Data were obtained from the 2006–11 ‘Injuries and Physical Activity in the Netherlands’ (OBiN) retrospective survey.

Setting

OBiN is a continuously executed national survey among Dutch households on accidents, sports injuries and physical activity.

Participants

Analyses were based on a representative sample of 3 846 sports participants.

Risk factor assessment

A sports activity is a physical activity that, according to the respondent, is associated with the term ‘sports’. Respondents who confirmed that they had participated in any kind of sports activity at least once in the previous 12 months were regarded as sports participants. BMI (weight status) was based on self-reported individual weight and height and was calculated as weight (kg)/height (m)2.

Main outcome measurements

Sports injuries, the main outcome measurement, were included if they were in accordance with the following definition: 'Physical damage of a musculoskeletal nature, sustained in the recall period as a result of a sudden event during sports activities or as a result of a gradual process related to sports activities.'.

Results

Of all sports participants, 14.7% were overweight. Compared to normal-weight sports participants, the odds of sustaining a sports injury was 0.73 (CI:0.53–1.00, P=.050) for overweight sports participants; the odds for underweight sports participants was 0.80 (CI:0.56–1.15, P=.226).

Conclusions

There is some evidence that overweight sports participants (4–24 years) do not have an increased injury risk compared to normal-weight sports participants, even when the level of physical activity is accounted for.
KEY ISSUES INFLUENCING THE MANAGEMENT OF RISKS IN THE AUSTRALIAN FITNESS INDUSTRY – COMBINING LEGAL PERSPECTIVES WITH INJURY PREVENTION APPROACHES
Authors: Keyzer P , Finch CF , Norton KI , Dietrich J , Sekendiz B. , Coyle I
Published: March 2014

Background

The Australian Fitness Industry Risk Management Project considers 1) How does Australian regulation currently control risk management in the fitness industry and thereby prevent adverse health outcomes and injury, and the legal liability associated with those risks? 2) What sustainable changes could be made to Australian regulation for more effective risk management in the health and fitness industry in order to prevent the risk of adverse health outcomes and injury, and the legal liability associated with those risks?.

Objective

Develop new best practice benchmarks to improve safety in the fitness industry and reduce the risk of adverse health and injury outcomes.

Setting

Australia-wide fitness facilities.

Participants

1178 respondents from Australian fitness facilities. 62% female. Mean age, 40 years. 46% self-employed or sole traders. 2% were part-time employees of a fitness facility.

Interventions

Observational, ecological study. Based on nominal group technique applied within focus groups in four States of Australia, we developed a national survey that included 45×6-point Likert scale items that were factor analysed. The survey was administered online during May-June 2013 and promoted mainly through social media and direct e-marketing.

Results

Focus group respondents reported (lack of) education and supervision, (poor) technique, (defective) equipment, (unsuitable) environment and overcrowding as principal issues, while also raising issues of scope of practice, defective pre-exercise screening, medical risks associated with de-conditioned clients, inappropriate nutritional advice, inadequacy of qualifications and unrealistic client expectations. The survey designed around these themes identified three key challenges for the fitness industry: management implementation & monitoring of safety policy; client training/education in exercise programmes; and maintenance, design & operation of the facility/equipment.

Conclusion

The key challenges require legal and fitness setting specific solutions to address key risks. Ongoing management within the fitness industry will ensure these are appropriate and can be implemented.
MOTION ANALYSIS OF A SINGLE-LIMB SQUAT WITH ISOKINETIC RESISTANCE
Authors: Kimura Y , Koyanagi M , Koyanagi K , Mukai K , Naruhiko N , Sakai T , Tada S , Satoda Y , Inoue Y , Inoue A
Published: March 2014

Background

Resistive lateral leg reach exercise (RLLR), a single-limb squat with resistance, increases load on the gluteal muscles and is effective for preventing knee valgus moment, a major factor in anterior cruciate ligament (ACL) injury. To enhance the load during RLLR, we devised a novel isokinetic exercise machine.

Objective

To investigate the biomechanical and electromyographic (EMG) characteristics of the support leg during RLLR with isokinetic resistance (RLLR-I).

Design

Quasi-experimental.

Setting

Controlled laboratory setting.

Participants

8 asymptomatic recreational-level female college athletes.

Intervention

Participants performed RLLR-I and lateral leg reach without resistance (LLR). The resistance device was set to 25 cm/s during RLLR-I. A three-dimensional motion capture system and force plate were used for motion analysis. Surface electrodes recorded the EMG at each muscle site: gluteus maximus (GMa), gluteus medius (GMe), rectus femoris, vastus medialis (VM), biceps femoris, adductor longus, soleus, and gastrocnemius.

Main outcome measurements

The external knee valgus/varus moment and the internal joint moment of the support leg were calculated using software. EMG root mean squared amplitude was normalized as a percentage of maximum voluntary contraction (%MVC).

Results

RLLR-I was characterized by a significantly larger internal hip abduction moment (2.2±1.0 Nm/kg) and significantly larger VM (152±54 %MVC), GMa (92±47 %MVC), and GMe (97±33 %MVC) activity compared with LLR (hip abduction moment: 1.5±0.7 Nm/kg; VM: 102±40 %MVC; GMa: 35±25 %MVC; and GMe: 38±13 %MVC). No significant external knee valgus moment occurred during RLLR-I.

Conclusion

RLLR-I serves to increase the load on the VM and gluteal muscles and is effective for preventing external knee valgus moment. These findings suggest that this novel isokinetic exercise will be useful for preventing ACL injury and in rehabilitation after ACL reconstruction.
WHAT IS THE ROLE OF KEY SPORTS SAFETY AGENCIES IN THE DEVELOPMENT AND DISSEMINATION OF SPORT SAFETY POLICIES FOR COMMUNITY SPORT SETTINGS?
Authors: Bekker S , White P , Donaldson A , Cook J , Gabbe B , Lloyd D , Finch CF
Published: March 2014

Background

Although sports clubs have a responsibility to protect their players with a safe training and playing environment, little is known about actual safety policies and procedures adopted by community sports clubs. Currently, there is no definitive macro-level sport safety policy available for clubs to implement in Australia. Community sports clubs use micro-policies around issues deemed relevant to their club, which are sourced from various agencies.

Objective

This presentation will describe the full range of safety resources (policy documents, guidelines, action plans, research papers, fact sheets, posters, and procedures) as developed and disseminated online by key sports safety agencies in Australia. The gaps and duplications in the set of safety resources will also be identified. Finally, a recommendation around the safety needs of community sports clubs with regards to a macro sports safety policy that covers all relevant aspects which can easily be implemented and adopted will be made.

Design

Document analysis as a qualitative research method.

Sources

Online sport safety documents from key sport safety agencies in Australia.

Main outcome measurements

To determine the relevant sport safety resources available online to community sport clubs through key sport safety agencies.

Results

A collated list of recommended sport safety policies and procedures as developed and disseminated online by key sport safety agencies in Australia, for use by community sports clubs. An analysis of the gaps in current sports safety policy is also discussed.

Conclusions

Sport safety policies and procedures are currently provided in the form of micro-polices that cover single issues (SunSmart, blood rule, concussion policy etc). It is recommended that key sport safety agencies collaborate to develop a macro-level policy around sport safety that comprehensively covers the full spectrum of safety under one plan that can be easily accessed, adapted and implemented in a variety of community sports club settings.
TIME LOSS AND INJURY CHANGES WITH MULTIDISCIPLINARY PREVENTIVE APPROACH IN FEMALE VOLLEYBALL PLAYERS
Authors: Mendes de Almeida Gomide Leite M , Bolling C , Reis D , Bittencourt N , Gonçalves G
Published: March 2014

Background

Youth volleyball players have high injury rates in shoulder, knee and ankle. Specific preventive programs could reduce time loss and injury severity reflecting in athlete's performance.

Objective

To describe the difference in time loss and injuries occurrence after a multidisciplinary prevention approach in youth volleyball athletes.

Design

This is longitudinal and prospective study.

Setting

The data colection and interventions were conducted with volleyball players competing in a national level in a Brazilian sports club.

Participants

42 female youth volleyball athletes with a mean age of 13.8 years (±1.4), body mass of 59.2 (±8.6) kg and height of 171.2 (±5.5 cm ).

Intervention

A multidisciplinary preventive approach (MPA) was characterized by CORE, knee and ankle stabilization exercises during warm up. Shoulder rotators, gluteus maximus and hamstrings muscles were trained in strengthening sessions.

Main outcome measurements

The MPA was conducted by team's physiotherapist and coach, performed twice a week, with 20 minutes duration. Injuries and time loss was reported by the team's physiotherapist.

Results

There was a 60% reduction of days out of training and 10% reduction in the number of injuries.

Conclusions

MPA reduces the time loss and injuries occurrence in youth volleyball athletes. It is important to design preventive interventions by the injury profile, focusing in most predisposed injured areas. Time loss and lower injury occurrence reflect in athletes' performance.
APPLICATION OF SURVIVAL MODELS IN SPORTS INJURY PREVENTION RESEARCH: A SYSTEMATIC REVIEW
Authors: Mahmood A , Ullah S , Finch CF
Published: March 2014

Background

Use of survival models for the analysis of sports injury data has grown rapidly potentially enabling better understanding of time to sports injury events. Choosing an appropriate model is a key consideration for survival analysis of sports injuries.

Objective

To identify the application of appropriate survival modelling strategies in sports injury prevention research.

Design

Systematic review.

Setting

Studies were identified by searching six databases and the table of contents of three journals, and evaluated using the PRISMA statement. Reference lists of selected papers were examined to identify additional relevant articles.The search was limited to: original sports injury studies in humans; English-language; published between Jan 1993 and July 2013, inclusive.

Main outcome measurements

Features of survival models, estimators and graphical approaches.

Results

A total of 2147 articles were identified, of which 103 met the inclusion criteria. There has been an increasing trend in use of survival analysis of sports injury data, with 88.0% of the reviewed articles published since 2005. Models identified were: Univariate Cox regression in 62 studies (60.2%); Multivariate Cox regression in 12 studies (11.7%); both univariate and multivariate cox regression in 12 studies (11.7%), frailty model with Univariate Cox regression, Andersen Gill model, WLW-TT model and PWP-GT model in two studies (1.9%); frailty model only in three studies (2.9 %); and Hurdle regression was used in one study (1.0%). Kaplan Meier only was applied in 11 studies (10.7%). Time to first event was considered in 48 studies (46.6%), and recurrent events in 14 studies (13.6%). Five studies used survival models specific for recurrent events.

Conclusions

Use of survival analysis is currently largely limited to modelling of the time to first injury. Even though sports injuries are often recurrent, only in a small number of studies was the correlation structure of recurrent events considered. Future studies should consider recurrent injuries and apply the appropriate survival model.
POST-CONCUSSION STRESS IN ASYMPTOMATIC ATHLETES
Authors: Mainwaring L , Senthinathan A , Hutchison M
Published: March 2014

Background

Post-concussion, the body is “stressed” as it attempts to restore metabolic and psychologic equilibrium. Elevated stress can be evaluated by disrupted cortisol cycling, perturbations in Heart Rate Variability (HRV), and reported mood disturbance and perceived stress. Assessing stress in concussed athletes may be informative for optimal recovery, safe return-to-play (RTP), and subsequent injury prevention.

Objective

To assess the utility of non-invasive stress measures in monitoring concussion recovery.

Design

A prospective matched control group design included collection of salivary cortisol, HRV, and two self-report measures: the Profile of Mood States (POMS), and the Perceived Stress Scale (PSS). All measures were taken at three phases of recovery (1. Symptomatic; 2. Asymptomatic; and 3. One-week following RTP). The same protocol was completed by non-injured athletes.

Setting

Interuniversity sports teams at a single institution.

Participants

11 athletes, across seven sports, diagnosed with concussion and 11 matched-athlete controls volunteered for the study.

Main outcome measurements

Primary outcome measures to test the a-priori hypotheses included: HRV, AM and PM salivary cortisol, Total Mood Disturbance, Depression, Confusion, Fatigue, Vigor, Tension, Anger, and Perceived Stress.

Results

A series of 2 (Group) × 3 (Phase) repeated measures ANOVAs revealed significant interactions for HRV and emotional disturbance. Although no emotional disturbance or perceived stress was reported in the asymptomatic phase, concussed athletes displayed altered HRV [increased Low Frequency norm (P=.041) and decreased High Frequency norm (P=.041)]. In addition, significant differences between groups were found for AM cortisol levels one week after RTP (P=.019).

Conclusions

Concussed athletes displayed perturbations in HRV, indicating neuroautonomic dysfunction, despite resolution of symptom and mood disturbance. In addition, low levels of morning cortisol following RTP may be indicative of a lingering physiological stress response. These non-invasive markers may be clinically useful in post-concussive recovery assessment and prevention of subsequent injury.
EFFECTS OF A PREVENTION PROGRAM FOR HAMSTRING STRAIN INJURY ON OPTIMUM LENGTH OF THE KNEE FLEXORS
Authors: Martínez-Ruiz E , Mendiguchia J , Rubio-Arias JA , Alcaraz PE , Esparza-Ros F
Published: March 2014

Background

The hamstring muscles are especially vulnerable during the late swing phase of sprinting, where the simultaneous actions of hip flexion and knee extension actively stretch the hamstrings to greater lengths.

Objective

To assess whether a functional strengthening program (i.e. eccentric, plyometric and acceleration exercises) increased optimum lengths of the knee flexors in soccer players.

Design

Longitudinal, unblinded randomized controlled study.

Setting

Amateur male soccer players from nine Spanish teams of the same competitive level.

Participants

52 players were assigned to an exercise group (EG) or a control group (CG). Over the study, 8 athletes (6 from CG and 2 from EG) were dropped due to personal reasons, contracting by other clubs or injuries (non-hamstring strain injuries). After these exclusions, 25 players constituted the EG (22.7±4.8 years; 71.2±8.4 kg; 174.5±5.6 cm) and 19 the CG (21.8±2.5 years; 71.1±6.5 kg; 176.8±6.2 cm).

Interventions

Both groups performed their habitual soccer training throughout the study (with a similar physical load profile). Additionally, the EG performed a functional strengthening preventive program twice per week for seven weeks.

Main outcome measurements

The optimum angle of peak torque (and therefore optimum length) was calculated through of a 4th order polynomial curve. Previously, each subject performed 6 maximum concentric repetitions on an isokinetic dynamometer at angular velocity of 60°/s.

Results

After the seven-week period, the optimum length of the EG during knee flexion was significantly greater (i.e. the optimum angle of peak torque was smaller; 39.85±8.42 pre-test vs 35.26±7.50 pos-test). Similarly, the EG (35.26±7.50) showed a significantly great optimum length in the pos-test than the CG (40.89±8.71).

Conclusions

The prevention program proposed increases the optimum length of the knee flexors, promoting the development of strength at longer muscle lengths.
EPIDEMIOLOGIC REVIEW OF COLLEGIATE ACL INJURY RATES ACROSS 14 SPORTS: NATIONAL COLLEGIATE ATHLETIC ASSOCIATION INJURY SURVEILLANCE SYSTEM DATA 2004-05 THROUGH 2011–12
Authors: Agel J , Klossner D
Published: March 2014

Background

Extensive effort has been put into awareness and prevention programs to decrease the overall rate of injury and the difference between sexes.

Objective

The objective of this review is to document the rate of ACL injury in 14 collegiate sports over an eight year period and compare it to an earlier 16 year review.

Design

Descriptive Epidemiology.

Setting

Universities in the U.S.

Participants

NCAA athletes.

Interventions

There was no intervention.

Main outcome measures

The primary outcome chosen apriori is injury.

Results:

The majority of ACL injuries to women occurred by a non-contact mechanism of injury while the majority of ACL injuries to men occurred by a contact mechanism. The highest rates of ACL injury for men were found in American football (0.17 per 1000 A-E and wrestling (0.16 per 1000 A-E). The highest rates of ACL injury for women were found in basketball and lacrosse (0.23 per 1000 A-E). Within the 8 year study period men's and women's ice hockey showed the greatest increase over time with an average annual rate of change of 105% and 136% respectively. Mens' baseball and women's lacrosse showed the greatest decrease in average annual rate of change (16.9% and 17% respectively).When comparing the current 8 years of data to previously reported 16 years of data baseball and women's basketball, showed no change, men's basketball, lacrosse, and wrestling along with field hockey showed an increase and American football, men's and women's ice hockey and soccer, women's lacrosse, softball, and volleyball showed a decrease in overall injury rate.

Conclusions

Despite focused scientific efforts and prevention programs ACL injuries remain a significant injury in collegiate sports. Women continue to sustain ACL injuries at higher rates than men in the comparable sports of soccer, basketball, and lacrosse.
A SYSTEMATIC REVIEW TO INVESTIGATE THE RELIABILITY OF ULTRASOUND IMAGING IN MEASURING TENDON THICKNESS
Authors: Mc Auliffe S , O'Sullivan K , Mc Creesh K
Published: March 2014

Background

Pathological tendons are known to increase their AP diameter. Ultrasound is an important complementary technique to MRI for assessment of musculoskeletal disorders. Although systematic reviews have confirmed its reliability for the measurement of muscle thickness, no such reviews exist to examine the reliability of US measures of tendon dimensions.

Objective

To systematically review the literature on the reliability of Real-time ultrasound to assess tendon dimensions including thickness and cross sectional area in human limbs.

Design

A comprehensive review of electronic databases was performed by two reviewers using agreed range of keywords. Randomised clinical trials which investigated inter or intra rater reliability of real time ultrasound was included in this review. The Quality Appraisal of Reliability Studies (QAREL) checklist was used to assess risk of bias.

Setting

Included studies performed ultrasound analysis in a range of clinical settings.

Participants

698 Symptomatic and asymptomatic participants, mean age range: 17.5–73 years.

Interventions

Tendon thickness of a range of upper and lower limb tendons was assessed using real time ultrasound in both transverse and longitudinal planes by physiotherapists, sonographers and other unspecified investigators.

Main outcome measurements

Inter and Intra rater reliability of tendon thickness measures using estimates of both reliability and precision using intraclass correlation coefficients (ICC's) and coefficients of variation (CVs), coefficient of variation (CV%) limits of agreement (LOA), pearsons correlation coefficient (r2) and 95% confidence intervals (95% CI).

Results

Assessment of the risks of bias indicated 15/16 chosen studies was of high quality. ICC values for inter and intra rater reliability ranged from (0.55–0.99), LOA ranged from (0.35–3.50 mm), r2 ranged from (0.43–0.92), 95% CI ranged from (0.43–0.98), CV% ranged from (0–14.44%).

Conclusion

The use of real time ultrasound method for assessing upper and lower limb tendon thickness has moderate-to-good level reliability. The findings of which may have important implications for management of tendon disorders.
THE USE OF THE ELASTIC COMPRESSION TO DECREASE THE RISK OF INJURY
Authors: Ménétrier A
Published: March 2014

Background

The elastic compression was first used in sports to improve post-exercise recovery and performances. Many anecdotal reports further indicated that the elastic compression could decrease the risk of injury.

Objective

The aim was to determine whether the elastic compression really decreases this risk. We hypothesized that wearing the elastic compression decreases the risk of injury in trail running.

Desgin

Retrospective study.

Setting

Regional sportmen.

Participants

203 runners recruited in regional trail races.

Risk factor assessment

We sent a questionnaire to obtain the age range of the participants and in the past three months: their level of weekly training (hours and sessions), the quantity and type of injuries and whether they used or not the elastic compression. This day, 105 runners wearing the elastic compression (during effort and post-exercise recovery) and 98 non-wearing (control group) answered this questionnaire. We used a multiplier coefficient for reported these two groups to 100.

Main outcome measurements

Number of injuries according to the wearing or not of the elastic compression.

Results

The preliminary results indicate that the control group trained 3.11±0.86 sessions per week (i.e. 4.13±1.32 hours) and the group wearing elastic compression trained 4.00±0.93 sessions per week (i.e. 5.64±1.54 hours). We observed 24.49 injuries (per 100 tendinitis, periostitis, muscular injuries and sprains) in the control group and 18.09 in the group wearing elastic compression (i.e. -26.11%).

Conclusions

The preliminary results seem to indicate that wearing the elastic compression during and after the sports practice decreases the risk of injury of the runners. Further research is required. We are expanding this study to a more consequent population.
EFFECT OF ORAL REHYDRATION SOLUTION ON HYDRATION STATE DURING ‘SUMO’ TRAINING
Authors: Minami K , Ishikawa T , Ishida J , Nakagawa Y
Published: March 2014

Background

Exercise in a hot environment can cause loss of water and electrolytes, which conveys tress on homeostasis.

Objective

To maintain appropriate hydration status in such situation, it expects to be suitable for fluid replacement to drink oral rehydration solutions (ORS) which have higher sodium concentration and higher absorptive of water in the intestine than general purpose sports drinks (SPD).

Design

Randomized crossover study.

Setting

University SUMO League.

Participants

10 members of a university SUMO club voluntarily participated after providing written informed consent.

Interventions

Participants ingested SPD or ORS with an equalized exercise load in a randomized crossover manner at a wet bulb globe temperature of 27–30°C.

Main outcome measurements

Body weight, water distribution with bioelectrical impedance analysis, vital signs, blood analysis and visual analogue scale (VAS) for fatigue and thirst were evaluated between the two drinks. Values are expressed as mean±SD (SPD vs. ORS).

Results

Differences were observed 15 min after training in the changes from the baseline of serum total protein (0.6±0.3 vs. 0.3±0.2 g/dL, P=.02), serum sodium (–1.4±2.1 vs. 0.2±2.0 mEq/L, P<.01), and VAS scores of fatigue (80±13 vs. 64±24, P=.03) and thirst (49±21 vs. 31±15, P=.03). Differences 75 min after training were also observed in the changes of extracellular fluid (0.3±0.2 vs. 0.5±0.2 L, P=.02), serum osmolarity (–2.7±4.0 vs. 0.4±3.5 mOsm, P=.03).

Conclusions

The ORS rather than the SPD were shown to be more suitable to maintain hydration status in a hot environment of SUMO training. The intake of ORS should be considered upon exercise accompanied with marked perspiration.
INJURY PREVENTION PRACTICE IN FEMALE BASKETBALL PLAYERS IN THE JAPANESE TOP LEAGUE: AN INTERVENTIONAL STUDY OVER 7 SEASONS
Authors: Nagano Y , Hori M , Shimizu Y , Takahashi S , Tsuda K , Miki H , Uchiyama E
Published: March 2014

Background

Female basketball players are at a higher risk for injuries such as those of the anterior cruciate ligament (ACL). Therefore, preventing such injuries is essential for their health and the competition.

Objective

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

Design

Prospective intervention study.

Setting

Top-level basketball league in Japan.

Participants

A total of 1127 players from 12 top-league teams during 7 seasons.

Interventions

From the middle of the second (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

All injuries, including ACL injury and ankle sprain, occurring during the 7 seasons that caused a player to miss a current session and/or miss a subsequent session were recorded. Injury incidences were calculated in terms of per 1000 player hours (PH). Compliance with the program was also reported.

Results

During 7 seasons, 8,73,084 PH and 973 injuries were reported. The injury incidence was 1.11/1000 PH, which did not significantly change after the intervention. In each season, ankle or knee injuries were most frequent. 34 non-contact ACL injuries occurred, an incidence of 0.039/1000 PH. During 5 seasons after the intervention, the incidence of non-contact ACL injuries in the team conducting the prevention program was 0.032, while the team without the program had an incidence of 0.046. A total of 235 ankle sprains occurred, an incidence of 0.269/1000 PH. After the intervention, the incidence decreased to 0.19 in the 2011–2012 season.

Conclusions

The results show that the injury prevention program may decrease the frequency of non-contact ACL injuries and ankle sprains.
THE PREVALENCE OF INJURY PREVENTION PROGRAM USE BY HIGH SCHOOL TEAMS
Authors: Norcross M , Johnson S , Hoffman M
Published: March 2014

Background

The use of injury prevention programs (IPPs) during organized warm-up activities is encouraged to reduce lower extremity injury risk. However, the prevalence of structured IPP use by high school teams in Oregon is unknown.

Objective

1) Describe the warm-up practices of Oregon high school teams; and 2) evaluate if these behaviors are influenced by team access to a medical professional (Athletic Trainer-AT) at the school.

Design

Cross-sectional survey.

Setting

High school.

Participants

Athletic directors from all 287 Oregon School Activity Association schools were asked to forward survey invitations to their head girls' and boys' basketball, soccer, and volleyball coaches. Coaches reported information about 276 teams.

Interventions

Independent variable was team access to an AT.

Main outcome measurements

Team use of: 1) any organized warm-up at least three times per week; 2) a scientifically proven IPP; and 3) activities from the five categories common to efficacious IPPs.

Results

Student-athletes on 248/276 (89.9%) teams performed an organized warm-up, but only 27/248 (10.9%) teams used a structured IPP; and just 6/248 (2.4%) used a proven IPP as designed. Teams reported using 3.7±1.2 of the five categories common to IPPs (Flexibility=96%, Balance=48%, Strengthening=79%, Plyometrics=62%, Agility=88%). Access to an AT (AT:129 teams, No AT:147 teams) did not influence organized warm-up use (X2=0.189, P=.664), the types of activities performed (X2=0.014–0.842, P=.359-.907), or the distribution of the total number of IPP categories performed (Mann-WhitneyU=0.354, P=.723).

Conclusions

The use of IPPs in Oregon high schools is extremely rare. However, irrespective of access to an AT, most teams perform an organized warm-up using activities from several categories common to IPPs. Modification of current IPPs and/or the method for IPP delivery to address factors currently limiting program adoption is likely necessary to improve implementation effectiveness.