bluuebunny/crossref_metadata_2025 huggingface dataset:
WHAT PRE-PARTICIPATION HEALTH COMPLAINTS AND ATHLETE CHARACTERISTICS PREDICT INJURY AND ILLNESS AT MAJOR ATHLETICS CHAMPIONSHIPS? COHORT STUDY AT THE BEIJING 2015 IAAF WORLD CHAMPIONSHIPS
Authors: Timpka Toomas , Jacobsson Jenny , Bargoria Victor , Periard Julien , Racinais Sébastien , Ronsen Ola , Halje Karin , Andersson Christer , Dahlström Örjan , Spreco Armin , Edouard Pascal , Alonso Juan Manuel
Published: August 2017

Background

During the month before world championships in individual sports, about one-third of athletes are disturbed by injury complaints. Athletics athletes reporting a pre-championship gradual-onset injury complaint are known to be at increased risk to sustain an injury at the upcoming competitions. Predictors for in-championship illness and the predictive value of anxiety associated with pre-participation injury and illness complaints have not been investigated.

Objective

To determine pre-participation predictors of injury and illness at a major Athletics championship.

Design

Prospective cohort study.

Setting

The 2015 IAAF World Championships in Athletics.

Participants

307 (32.1%) of 957 athletes in 50 national teams that accepted to participate.

Assessment of Risk Factors

Sex, age, home continent, event category and pre-participation health complaints with qualifiers (injury or illness complaint, onset type (injury complaints only), reduction in participation, severity estimated by duration of time loss, associated anxiety, expected performance impact, etc.).

Main Outcome Measurements

In-championship injury and in-championship illness.

Results

116 athletes (38.3%) of the participating athletes reported an injury complaint during the month before the championships, while 40 athletes (13%) reported an illness complaint. Twenty athletes (6.5%) sustained an injury or illness during the championships. Endurance athletes were almost tenfold more likely to sustain an in-championship illness than speed/power athletes (OR, 9.88; 95% CI, 1.20–81.31;P=0.033). Participants reporting a pre-participation gradual-onset injury complaint were three times more likely (OR, 3.09; 95% CI, 1.08–8.79;P=0.035) and those reporting an illness complaint causing anxiety were fivefold more likely (OR, 5.56; 95% CI, 1.34–23.15;P=0.018) to sustain an in-championship injury.

Conclusions

Endurance athletes require particular clinical attention at major Athletics championships. Pre-participation complaints causing anxiety are interesting predictors for in-championship health problems. Diagnostic criteria for different types of exertion-related illness and the clinical and educational services provided to athletes preparing for championships in individual sports warrant further study.
WHAT CHARACTERISES CHAMPION RUNNERS' MANAGEMENT OF INJURY AND ILLNESS? QUALITATIVE STUDY AT IAAF ATHLETICS WORLD CHAMPIONSHIPS
Authors: Timpka Toomas , Bargoria Victor , Halje Karin , Jacobsson Jenny
Published: August 2017

Background

International sports bodies are increasingly on the lookout to balance the excitement of elite sport with the risk that is inevitable. For further understanding of these risks, athletes' reports on how sensations of pain, discomfort, and loss of functioning are interpreted and acted upon are vital.

Objective

To explore what characterizes injury and illness management among champion runners.

Design

Qualitative study using in-depth interviews for data collection.

Setting

Middle- and long-distance runners at IAAF World Athletics Championships.

Participants

12 international runners competing for championships medals.

Assessment of Risk Factors

Thematic analysis to generate understanding reasoning about injury and illness.

Main Outcome Measurements

Qualitative model describing champion runners' injury and illness management over time.

Results

The athletes' behaviours and decisions-making procedures were summarised in the main themes resilience and exigency. Resilience behaviour was constituted of ordinary rather than extraordinary actions and is characterised by a proneness for learning, dynamic adaptations to unforeseen circumstances, and focusing on long-term objectives. The theme prompting and learning describes intense information-seeking performed when experiencing symptoms of injury or illness in order to understand causes and guide responses. This quest for information and knowledge comprised early consultation with clinicians and execution of diagnostic tests, dialogue with coaches, and discussions with peers. The themes effects and consequences describe the short-term outcomes of the athletes' decision-making and their standpoints on how their injury and illness management impacts their overall career, respectively.

Conclusions

A model of injury and illness management among champion runners has been developed. The model offers a positive outlook on progress in sports where overuse injuries are common, and a direction for policies aimed at protection of top-level athletes. Resilience behaviour arises from dynamic adaptations of normal functions, meaning that the greatest threats to health maintenance in this group of athletes are those that compromise such adaptations.
THE EFFECTS OF FATIGUE ON SCAPULA KINEMATICS DURING THROWING IN ELITE TEAM HANDBALL PLAYERS; DOES PAIN INFLUENCE? A PRELIMINARY STUDY
Authors: Torabi Tina Piil , Juul-Kristensen Birgit , Dam Mogens , Andersen Frederik H. , Malchow-Møller Lasse , Zebis Mette K , Møller Merete , Bencke Jesper
Published: August 2017

Background

Non-traumatic shoulder injuries are common in overhead sports, however many athletes still participate in their sport despite pain. Non-optimal scapula kinematics at the instant of maximal humeral external rotation (HumExtRot) is considered a risk factor in overhead throwing sports.

Objective

The aim of the study was to investigate whether a functional fatigue protocol affects scapula kinematics during throwing, and whether this effect is different between players who are pain-free and participating with pain.

Design

A controlled intervention study.

Setting

3D Motion Analysis Laboratory with 8 cameras (Vicon T40, Oxford, UK).

Patients (or Participants)

16 adult, mean age 21,9(2,4) years, elite female team handball players were recruited from top 2 leagues in Denmark. The participants were divided into two groups; 8 subjects playing with pain(P) and 8 subjects playing without pain(NP) served as controls.

Interventions (or Assessment of Risk Factors)

Measurements of scapula and gleno-humeral kinematics were collected during maximal throws before and after a fatiguing protocol, containing 60 alternated submaximal-and maximal throws.

Main Outcome Measurements

Maximal HumExtRot in relation to scapula, scapula posterior tilt (ScapPostTilt), scapula retraction (ScapRetr) and scapula upward rotation (ScapUpRot) at the instant of maximal HumExtRot were selected as outcome parameters. Overall effects for the whole group, between groups and differences in fatigue development between groups were evaluated using 2-way repeated measures ANOVA.

Results

As a result of fatigue, the group (n=16) showed less ScapPostTilt (Mean=5,5°, SD=6,3°, p=0.004), ScapUpRot (Mean=3,7°, SD=4°,p=0,003), and less ScapRetr (Mean=2,7°, SD=4°, p=0,044), and the HumExtRot increased (Mean=3,3°, SD=5,9°, p=0,048). No significant differences between groups were found, however a tendency towards greater HumExtRot was observed (Mean difference=15.2°, SD=16.9°, p=0,089), for players with NP.

Conclusions

The results indicate that fatigue has a detrimental effect on scapula and gleno-humeral kinematics, which may increase the risk of non-traumatic shoulder injuries. However P-players did not respond differently to fatigue-development.
HEAD INJURY EVENTS IN RUGBY UNION: DESCRIPTION OF HIGH RISK TACKLE EVENTS
Authors: Tucker Ross
Published: August 2017

Background

Head injuries are a concern in Rugby Union, accounting for 17% of injuries. Until the risk of specific game events is understood, effective interventions to reduce risk cannot be formulated.

Objective

To describe the relative risk of head injuries in rugby.

Design

Prospective cohort study.

Setting

1,516 Rugby Union matches in six professional tournaments.

Patients (or Participants)

All players in the six professional tournaments were potential cases. Head injury events were identified by trained medical personnel using established Head Injury Assessment protocols.

Assessment of Risk Factors

A professional video analyst evaluated every head injury event, and characterized it according to a pre-determined classification framework of 25 variables.

Main Outcome Measurements

Head Injury Events characterized for relative risk by game event, playing position and match time.

Results

611 Head Injury Events (HIEs) were documented. Tackles had the highest risk of any game event, with a propensity of 1.94 HIEs/1000 events, accounting for 464 (76%) HIEs at a rate of 1 HIE every 3.1 matches. The tackler was 2.6 times more likely to be injured than the ball-carrier. Other high risk events included kick contests (1.57 HIEs/1000 events), mauls (0.7 HIEs/1000 events) and rucks. Rucks accounted for the next highest number of HIEs (73 HIEs at a rate of 1 HIE/20.8 matches. The player most likely to sustain a head injury was the flyhalf (68.9 matches per HIE), with the least likely the wings. Within tackles, backline players have a greater propensity than forwards (220 HIAs, 2.62 HIAs/1000 tackles for backs vs 240 HIAs, 1.54 HIAs/1000 tackles for forwards). HIE risk was unaffected by match-time.

Conclusions

Tackles are the most injurious event, both by propensity and frequency. Tackling accounts for the greatest number of HIEs, and strategies to reduce the risk in tackles, with focus on the tackler, must be sought.
PROXIMAL FIFTH METATARSAL STRESS FRACTURES; SCREENING AND TREATMENT FOR INCOMPLETE FRACTURES
Authors: Ueki Hiroko , Tateishi Tomohiko , AN Saisei , Hatsushika Daisuke , Koga Hideyuki , Ogiuchi Takashi
Published: August 2017

Background

Proximal fifth metatarsal stress fractures (so called Jones fractures) usually occur due to chronic repetitive forces. Soccer players on the status of incomplete fracture don't complain about pain while playing soccer; they can keep playing until progressing to the state of complete fractures. Jones fractures are known for prolonged healing time, high rate of non-union and re-injury. Therefore, it is critical to screen athletes with incomplete fracture.

Objective

To evaluate the effectiveness of "Jones fracture screening" on its prevention for progression from incomplete to complete fracture.

Design

Prospective cohort study.

Setting

Collegiate and high school soccer players.

Patients

Seventy-six players who agreed to participate in the primary screening test.

Interventions

Educational lectures regarding Jones fracture, questionnaires as well as medical checkup including physical examination and ultrasound were conducted in players' school gymnasium as a primary screening. Hump sign, defined as cortex bulging, and increased blood flow around the fracture area in the Doppler ultrasound were defined as positive. Secondary medical examination with X-rays was then conducted for those who were positive for the primary screening. Players with Jones fractures identified by X-rays were then treated conservatively and followed up until radiographic bone union was achieved.

Main Outcome Measurements

Radiographic bone union.

Results

Sixteen players were screened as positive in the primary screening. All positive players received secondary examination, and three players with Jones fracture were identified. Two players had an incomplete fracture and another had an old incomplete fracture. In all players bone union was achieved after conservative treatment without quitting playing soccer.

Conclusions

The use of ultrasonography would be effective to diagnose incomplete Jones fractures. Jones fracture screening can enlighten about the risk of Jones fractures and may prevent soccer players from progressing from incomplete to complete fracture without quitting playing soccer.
FIRST STEPS TOWARDS PREVENTION OF MUSCULOSKELETAL INJURIES IN SPEED SKATING
Authors: de Water Alexander T.M. van , Hendricks Matthias
Published: August 2017

Background

Musculoskeletal injuries are commonly seen by medical staff of speed skating teams, but lack of injury registration underreports the incidence and prevalence of these injuries. Systematic injury prevention research in speed skating has not been undertaken.

Objective

Initiating injury prevention research following the 6-step TRIPP framework.

Design

Qualitative research including literature review and survey amongst medical staff involved with elite level speed skating teams and development of a logbook and risk factor testing battery for musculoskeletal injuries in speed skaters.

Setting

N/A.

Participants

Doctors and specialised physiotherapists in sports medicine involved with elite level speed skaters.

Assessment of risk factors/methods

A qualitative study aimed to initiate the first steps of the TRIPP framework: injury surveillance, aetiology and mechanisms of injury and development of preventative measures. A review for epidemiological studies in speed skaters was conducted. Musculoskeletal injuries and related factors were further explored by interview and expert survey.

Measurements

Literature review for epidemiological studies, interview and survey.

Results

Four epidemiological studies reported on musculoskeletal injury prevalence (one season) between 24 to 60%. The expert survey (n=5, mean experience in sport=10.4 years) identified the lower back (100%), gluteal/pelvic area (80%) and the hip/groin, knee and lower leg (60%) as most commonly injured. The specific speed skating position and technique, kinetic chain instability, reduced joint mobility and falls were identified as risk factors for musculoskeletal injuries. Based on these results, an injury registration system, logbook, physical tests screening battery were created for pilot testing.

Conclusions

This study described the first steps towards injury prevention using the TRIPP framework. Limitations are the small scale study and work at preliminary stages. However, there is underreporting of injuries in speed skaters and potential underestimation of the problem. Future research continues to focus on injury surveillance, aetiology and mechanisms of injury and development of preventative measures.
A STUDY ON MEDICATION USE AND INJURIES IN OVER 1500 NOVICE RUNNERS
Authors: der Worp Henk van , van Middelkoop Marienke , Hartgens Fred , Huisstede Bionka , Wilms Per , Kluitenberg Bas , Verhagen Evert , Rasenberg Nadine , Diercks Ron
Published: August 2017

Background

In sedentary subjects use of medication is expected to be high which may cause problems when taking up exercise as several types of medication have been linked to musculoskeletal disorders.

Objective

To study the relation between medication use and the incidence of running-related injuries in novice runners.

Design

Prospective cohort study with propensity score matching analysis.

Setting

A nationwide start to run program for novice runners (N=7,660).

Patients (or Participants)

Novice runners (N=1,696) aged between 18–65 years taking part in a start to run program.

Interventions (or Assessment of Risk Factors)

Self-reported medication use was assessed with a questionnaire at baseline. Medication was categorized according to (1) condition and (2) chemical properties. Subjects who used medication were matched to controls using propensity score matching.

Main Outcome Measurements

Incidence rate differences were calculated between subjects that used medication and matched controls for each medication category.

Results

Women who took contraceptives had lower incidence densities of running-related injuries compared to matched controls both when medication was categorized according to condition (all contraceptives: incidence rate difference=−21.2 injuries/1000 h, 95% CI −41.9−−0.5) and according to chemical properties (hormonal contraceptives: incidence rate difference=−35.7 injuries/1000 h, 95% CI −61.3−−10.1). For other medication types no relation with injuries was established.

Conclusions

The study gives an overview of the influence of medication use on injuries in novice runners. Only for contraceptive use a relation with injuries was found. The use of contraceptives seems to have a preventive effect on the occurrence of injuries. An explanation for this finding may be the direct hormonal effect of contraceptives, for example on neuromuscular control and joint laxity, or an indirect effect through personal characteristics related to contraceptive use, such as health behaviour or risk-taking behaviour.
DECREASED AVERAGE POWER OF THE HIP EXTERNAL MUSCLES AS A RISK FACTOR FOR THE DEVELOPMENT OF LOWER EXTREMITY INJURY IN WOMEN: A PROSPECTIVE STUDY
Authors: Verrelst Ruth , Tiggelen Damien Van , Ridder Roel De , Witvrouw Erik
Published: August 2017

Background

Attention has turned into the role of proximal risk factors in the development of lower extremity (LE) injury.

Objective

To prospectively identify hip strength associated risk factors contributing to the development of LE injury.

Design

Prospective cohort design.

Setting

Department of Physical Education at the University of Ghent, Belgium.

Participants

Ninety-four healthy, female physical education students aged 19.53±1.07 years were tested.

Assessment of Risk Factors

Testing included isokinetic hip strength measurements of abductors, adductors, internal rotators and external rotators.

Main Outcome Measurements

The LE injury follow-up of the subjects was assessed using a weekly online questionnaire and a three-monthly retrospective control questionnaire. Lower extremity injury was diagnosed by an experienced M.D. (Doctor of Medicine). Cox regression analysis was used to identify the potential risk factors for the development of LE injury.

Results

Thirty-four subjects were diagnosed with LE injury during follow-up. The results of this study identified that decreased average power (AVP) (P=0.031) for concentric external rotation strength was found to be a significant risk factor for LE injury. No other hip strength parameters were found to be significant contributors to the development of LE injury.

Conclusions

Decreased AVP of the hip external muscles was identified as a significant predictor for LE injury in females, whereas no peak torque parameters were found to be of predictive value. A stabilizing muscle group such as the gluteal muscle group might be more challenged in a functional outcome measure then in a peak outcome measure. AVP might be therefore be considered as a more accurate parameter to evaluate strength of stabilizing muscles.
THREE-DIMENSIONAL ANALYSIS OF SCAPULAR KINEMATICS DURING ARM ELEVATION IN BASEBALL PLAYERS WITH SCAPULAR DYSKINESIS: COMPARISON OF DOMINANT AND NON-DOMINANT ARMS
Authors: Yu Ho-Dong , Park Jin-Young
Published: August 2017

Background

The knowledge of 3-dimensional (3D) scapular kinematics is essential for understanding the pathological lesions of shoulder and elbow in throwing athletes. To date, a number of studies about alterations of static scapular position, dynamic scapular motion, or scapular dyskinesis have been conducted, yet none of them have identified consistent pattern of altered scapular kinematics in throwing athletes.

Ojective

To analyze the 3D scapular kinematics of dominant and non-dominant arms in baseball players with a pathological condition of shoulder or elbow.

Design

Cross-Sectional Study.

Setting

Baseball players from middle school to professional players.

Patients (or Participants)

319 baseball players who visited our clinic with the pathological condition of shoulder or elbow from December 2011 to August 2015.

Interventions (or Assessment of Risk Factors)

The CT scan was performed using a 64-channel multidetector CT system in a prone position with the arms at the side of the body and at 150° forward elevation with the palms toward the body.

Main Outcome Measurements

From 3D computed tomography, angular values of the scapula were compared between dominant and non-dominant arms with statistical analysis.

Results

The scapular position of dominant arms showed significantly more AT, less ST at rest and more UR, IR and less ST, PRO, AT at 150° full FE compared to the non-dominant arms. The angular increment of scapular UR, IR, PRO, and AT during arm elevation increased significantly between the paired arms.

Conclusions

When compared to the non-dominant arms, UR, AT and PRO with the arm at 150° FE of dominant symptomatic arms in baseball players tilted towards positive compensation while IR altered towards negative decompensation. In addition, the motion of the scapula increases significantly in dominant symptomatic arms, compared to the non-dominant arms.
NECK FUNCTION IN ELITE MALE RUGBY UNION PLAYERS: RESULTS FROM A PILOT FOR AN INTERVENTION STUDY
Authors: Zietsman Bianca , Holth Espen Aag , McCarthy Peter
Published: August 2017

Background

Elite male rugby union players have a decreased active cervical spine rage of motion (ACROM), the severity correlates to both number of years playing and position (Lark & McCarthy 2007, Scher 1990), but a measurable decrease occurs over a season (Lark & McCarthy 2010).

Objective

The aim was to ascertain whether a neck prehabiliation protocol, using body weighted suspension bands (FKPro),could affect the expected attrition in cervical spine function.

Design

ACROM of all participants was measured with a CROM device (Capuano-Pucciet al1991), using a Latin square randomisation to eliminate order effects. Likert scale questionnaires were also provided to all participants (pain and associated symptomatology).

Setting

A clinical setting within semi professional Welsh Rugby Union Club.

Participants

19 participants were recruited from Beddau RFC first XV. All players were included in the study, unless the player was ruled out from training or playing for clinical reasons. Height 181.5 (±5.9) cm, weight 98.7 (±17.2 kg, age 23.9 (±4.2) yrs.

Interventions (or Assessment of Risk Factors)

Participants underwent a progressive 8 week intervention, using the FKPRO with neck harness. Postural and isometric holds were performed of 30 seconds duration in four directions under clinical supervision twice weekly (training days).

Main Outcome Measurements

Change in ACROM.

Results

Table 1

Total flexion/ extensionTotal rotationTotal lateral flexionPRE intervention122.8 (±14.2)123.0 (±19.5)89.3 (±14.3)POST intervention126.4 (±16.7)128.6 (±15.4)87.1 (±13.8)

Conclusions

The apparent lack of decrease in ACROM (i.e. no statistical difference) could indicate that the prehabilitation protocol helps compensate for the effects of participation in the contact sport on the cervical spine of athletes. A full study (duration of the playing season) is currently underway.
THE EFFECT OF PREVENTIVE PROGRAM IN DECREASING INJURY INCIDENCE IN GYMNASTIC ATHLETES
Authors: Bittencourt Natalia , Weschenfelder Mariana , Leite Marcela , Gonçalves Gabriela , Freire Rafael , Mendonça Luciana
Published: August 2017

Background

Youth gymnastic athletes have high risk for knee, ankle, spine and shoulder injury. Specific preventive programs could reduce injury incidence and sports time loss, which may reflect positively in an athlete's performance.

Objective

Compare injury incidence rate before and after the implementation of a tailored preventive intervention in youth gymnastic athletes.

Design

Prospective study.

Setting

All athletes were followed-up over a three-year period at Minas Tenis Clube. The tailored preventive intervention was implemented only in the third year.

Patients (or Participants)

82 female and male gymnastic athletes participated in this study; the mean for age was 10.59±2.69 years; body mass, 33.36 ±12.86 kg; and height 136.99±15.98 cm.

Interventions (or Assessment of Risk Factors)

After a preseason assessment a tailored preventive intervention was developed, including: 1) thoracic spine, shoulder, hip and ankle mobility; 2) core and scapular stabilization; 3) hip external rotation, eccentric lower limb and intrinsic foot muscle strengthening; 4) breathing exercises associated with core muscles. This preventive program was applied four times a week for 20 min supervised by the coaches and two times a week was executed by the sports physiotherapist.

Main Outcome Measurements

Injury incidence rate by 1000 hours of exposure and days of time loss were calculated each year.

Results

during the first two years without preventive intervention the injury incidence was 8.8 and 8 injuries/1000 h, respectively. The third year with preventive intervention had an incidence rate of 3.8 injury/1000 h. The average time loss of the two years was 902 days and in the third year was 345 days. T-test revealed statistical difference pre and post intervention (p<0,02).

Conclusions

This study has shown that a tailored preventive intervention was effective to reduce the injury incidence rate in youth gymnastic athletes.
DYNAMIC TAPING AND HIGH FRONTAL PLANE KNEE PROJECTION ANGLE IN FEMALE VOLLEYBALL ATHLETES
Authors: Bittencourt Natalia , Leite Marcela , Zuin Alysson , Pereira Marina , Gonçalves Gabriela , Signoretti Silvanio
Published: August 2017

Background

Two-dimensional frontal plane knee projection angle (FPKPA) has been used to assess dynamic knee alignment during single leg squat in athletes with patellofemoral pain and to screen athletes who are at risk for anterior cruciate ligament (ACL) injury. The Dynamic Taping (DT) could be used in motor control training to decrease load of lower limbs muscles and improve movement pattern.

Objective

Compare FPKPA before and after the application of dynamic taping in female volleyball athletes.

Design

Cross-sectional study.

Setting

The FPKPA was used to measure knee medial motion. The ICC was 0.90 and the standard error of measurement (SEM) was 1.65°. All these measurements were performed at Minas Tenis Clube.

Patients (or Participants)

18 female volleyball players participated in this study; the mean for age was 19.44±4.48 years; body mass, 72.28±8.20 kg; and height 182.67±7.63 cm.

Interventions (or Assessment of Risk Factors)

A spiral DT(double-layer /Powerband) technique was placed with the hip in 40° abduction, 20° extension and full available external rotation, aiming to resist hip adduction, flexion and internal rotation. The tape was applied by the same professional stretching until resistance begins such that increasing resistance would be created with any movement towards adduction, internal rotation and flexion thereby creating a deceleration force.

Main Outcome Measurements

The FPKPA was recorded during single leg squat until 80° knee flexion before and after the Dynamic Taping(R)application.

Results

10 of 18 athletes had high FPKPA (>8o) and the T-test revealed statistical difference pre and post DT (p<0,0001). Pre DT Mean of FPKPA was 10.5oand Post DT mean was 5.4o.

Conclusions

This study has shown the DT application decreased FPKPA during single leg squat in female volleyball athletes. This approach could be an important tool to enhance movement quality and prevent knee injuries.
THE EFFECTIVENESS OF A NATIONAL BODY CHECKING POLICY CHANGE ON REDUCING INJURY RISK IN YOUTH ICE HOCKEY
Authors: Black Amanda M. , Hagel Brent E. , Palacios-Derflingher Luz , Schneider Kathryn J. , Emery Carolyn A.
Published: August 2017

Background

In 2013, Hockey Canada introduced an evidence-informed policy change delaying the earliest age of introduction to body checking in hockey until Bantam (ages 13–14) nationwide.

Objective

To determine if the risk of injury, including concussions, differs for Pee Wee (11–12 years) ice hockey players in the hockey season following a national policy change disallowing body checking (2013–2014) compared with a season (2011–2012) when body checking was allowed.

Design

Historical cohort study.

Setting

Ice hockey rinks (Alberta, Canada).

Participants

Pee Wee players (all divisions of play) in 2011/12 Alberta prior to the rule change (59 teams, n=883) and 2013/14 following the rule change (73 teams, n=617).

Assessment of Risk Factors

Exposure to a Pee Wee league where policy change disallowed body checking.

Main Outcome Measurements

Injuries were identified by a safety designate or team therapist if players: 1) required medical attention, 2) were unable to complete the session and/or 3) were unable to participate in sporting activity for one day. Any player with a suspected concussion was referred to a study sport medicine physician.

Results

There were 163 game-related injuries [incidence rate (IR)=4.37/1000 game-hours], and 104 concussions (IR=2.79/1000 game-hours) prior to the rule change and 48 injuries (IR=2.16/1000 game-hours) and 24 concussions (IR=1.08/1000 game-hours) after the rule change. Based on a multivariable Poisson regression model adjusting for player size, age, body checking attitudes, previous injury, level of play, and position, accounting for clustering by team, the rate of injury and concussions significantly declined following policy change [IRR=0.50 (95% CI; 0.33 to 0.75)] and [IRR=0.34 (95% CI; 0.21 to 0.56), respectively].

Conclusions

Introduction of the 2013 national body checking policy change disallowing body checking in Pee Wee had a significant public health impact resulting in a 50% reduction in injury risk and a 66% reduction in concussion risk in Alberta, Canada.
PREVENTING CONCUSSIONS IN YOUTH ICE HOCKEY: THE EFFECT OF LOCAL BODY CHECKING POLICY CHANGE
Authors: Black Amanda M. , Hagel Brent E. , Schneider Kathryn J. , Meeuwisse Willem H. , Palacios-Derflingher Luz , Babul Shelina , Mrazik Martin , Emery Carolyn A.
Published: August 2017

Background

In 2013, Hockey Canada announced a national policy change delaying the introduction of body checking in ice hockey until Bantam (ages 13–14). Following this change, several local organizations in Canada changed policy to also disallow body checking in Bantam non-elite levels (lower 60–70% by division of play).

Objective

To determine if the risk of concussion and severe concussion differs for non-elite Bantam ice hockey players in leagues where body checking is permitted compared with leagues where local policy change removed body checking.

Design

Cohort study.

Setting

Ice hockey rinks (2014/15, 2015/16 seasons).

Participants

Youth ice hockey players in non-elite Bantam body checking leagues (52 teams, 653 players) in Calgary and Edmonton (2014/15) and non-body checking leagues (33 teams, 396 players) in Kelowna and Vancouver (2014/15) and Calgary (2015/16), Canada.

Assessment of Risk Factors

Exposure to a Bantam league where body checking was not allowed.

Main Outcome Measurements

Suspected concussions were identified by a team designate and referred to a sport medicine physician. Severe concussions were defined by greater than 10 days of time-loss from ice hockey.

Results

There were 47 game-related concussions (Incidence Proportion per 100 players [IP] =7.2; 95% CI; 5.33-9.46) and 27 severe concussions (IP=4.1; 95% CI; 2.74-5.96) in body checking leagues. In non-body checking leagues there were 12 concussions (IP=3.03; 95% CI; 1.58-5.23) and 8 severe concussions (IP=2.02; 95% CI; 0.87-3.94). There was no evidence of a difference between the non-body checking leagues in Kelowna and Vancouver (2014/15) and Calgary (2015/16). Preliminary univariate analysis indicates a protective effect of policy disallowing body checking [risk ratio (RR)=0.42 (95% CI; 0.2-0.88) for concussion and RR=0.49 (95% CI; 0.23-1.04) for severe concussion.

Conclusions

This preliminary analysis suggests a 58% lower risk of game-related concussion in non-elite Bantam leagues where local policy disallows body checking.
USING MOBILE DEVICES TO MONITOR HEALTH AND WELLBEING, IN AND OUT OF COMPETITION, IN ELITE INTERNATIONAL WOMENS SOCCER
Authors: Boyce Stephen , White Andrew , McKenna Michael , Dixon Mark , Davies Oliver , Elliott Niall
Published: August 2017

Background

In recent years mobile devices (smartphones) have been used to gather subjective and objective international athlete health and wellbeing data via athlete self-report measures (ASRM).

Objective

To implement a system of ASRM in elite women's international soccer players.

Design

Prospective observational study.

Setting

Scotland women's soccer national squad.

Participants

Elite women international soccer players.

Interventions

Players were asked to provide data on a daily basis via a hand held mobile device both during periods of international duty and when with their domestic clubs.

Main Outcome Measurements

ASRM require players to rate their perceived level of fatigue, motivation, stress, sleep quality on a 10 point scale and objective data such as sleep hours, illness/injury and menstrual cycle.

Results

26 international soccer players compiled this data over a period of six months. The adherence rate overall was 48% (home based players 64%, exiles 38%). Strengths of this process include decreased administration time for support staff, quantification of athlete wellbeing providing the ability to analyse this longitudinally and decrease both observer and peer bias. Weaknesses of this form of data collection include poor compliance, unstandardised timing of completion and decreased face-to-face conversations leading to a reduction in the identification of changes to body language.

Conclusions

ASRM have proved an invaluable tool for the quantification of health and wellbeing within the Scottish women's national soccer team. They have provided important initial ‘red flags’ for many illness and injury situations during international and club duty. However, they cannot remove face-to-face wellbeing conversations completely and require practitioners to communicate the results obtained from ASRM for continued athlete buy-in.
SPORT SPECIFIC PREVALENCE OF CHONDRAL INJURIES IN THE HIP
Authors: Briggs Karen , Philippon Marc , Trinidade Christiano , Daniela Maglione
Published: August 2017

Background

Cartilage defect in the hip can progress to osteoarthritis. It is unclear if certain sports put an individual at increased risk of cartilage injury.

Objective

The purpose of this study was to determine the prevalence of chondral defects in the an active population of recreational and elite athletes that underwent hip arthroscopy for femoroacetabular impingment (FAI).

Design

Comparative cohort.

Setting

Clinical recreational to elite athletes.

Patients (or Participants)

1037 (769 recreational/amateur and 268 professional athletes)patients between 18 to 50 years old. The exclusion criteria included joint space of 2 mm or less, patients over the age of 50 and nonactive individuals.

Interventions (or Assessment of Risk Factors)

Independent variable was presence of cartilage damage in the hip.

Main Outcome Measurements

Type of Sports: Rotational sports; Repetitive non weightbearing; Running sports; Snow sports; Soccer; Football; Hockey; Dance.

Results

Chondral defects were seen in 822 of 1037 hips. In professional athletes, 86% had a chondral defect and in recreational 77% had a chondral defect (p=0.002). Grade III/IV defects were seen in 476 of 1037 hips. In professional athletes, 50% had grade III/IV defects and 45% in recreational athletes (p=0.155).The prevalence of chondral defects was different by sport for both amateur (p=<0.001) and professional athletes (p=0.001). Grade 3 or 4 defects in professionals were most commonly see in soccer, football and hockey. Grade 3 or 4 defects in recreational/amateur athletes were most commonly seen in football, hockey and skiing. Significant differences between pro and recreational athletes was seen in hockey, rotational sports and running.

Conclusions

Prevalence was different between sports and level of athletes. Sports involving contact, such as football, soccer, hockey, had higher risk of more severe defects (grade III / IV), as was snow sports with falls at high speed and sports involving repetitive rotation movements leading to high forces crossing the joint.
A COMPARISON OF THE ISOMETRIC FORCE FATIGUE-RECOVERY PROFILE IN TWO POSTERIOR CHAIN LOWER LIMB TESTS FOLLOWING SIMULATED FOOTBALL
Authors: Alcaraz Pedro E. , Matinlauri Anton , Abedin-Maghanagi Afy , Freitas Tomas T. , Martínez-Ruiz Enrique , Castillo Alberto , Mendiguchia Jurdan , Cohen Daniel D.
Published: August 2017

Background

Lower limb posterior chain isometric peak force (IPF) measured in the supine position was found to be sensitive to match induced fatigue in footballers (McCallet al. 2015). However, hamstrings fatigue following simulated football may be greatest close to full knee extension (Cohenet al. 2014), and the majority of hamstring strains occur in an extended position (Mendiguchiaet al. 2012).

Objective

To evaluate the effects of a simulated match on IPF in a novel test and a supine position test immediately post, and at +48 h, and +72 h post-match.

Design

A within-subject, repeated-measures design was used to investigate the short-term effects of fatigue following a simulated football match-protocol –the BEASTmod904(Akubatet al. 2014).

Participants

17 semi-professional players (age 21.2±2.4 yrs, body mass 73.8±8.9 kg) competing in a Spanish Third-Division team volunteered to participate in the study, which was implemented after the end of their competitive season.

Interventions

IPF was measured using a portable force platform immediately before (PRE) and after (POST) the BEASTmod90protocol, and at +48 h and +72 h post match. Two tests were used: (i) Standing with tested leg at 90° hip and 20° knee flexion (90:20); (ii) Supine with tested leg at 90° knee and hip flexion (S90).

Main Outcome Measurements

Fatigue after a simulated football match-protocol. We hypothesized that the 90:20 would show greater levels of fatigue than the S90.

Results

IPF significantly declined PRE versus POST match in the 90:20 in both legs (p<0.001), and in the S90 in the non-dominant (p<0.001) and dominant leg (p<0.01). IPF was significantly lower at +48 h compared to PRE in the 90:20 in both legs (p<0.01, p≤0.05), but not in the S90. At +72 h, IPF was not significantly different from PRE in either test.

Conclusions

These findings suggest potential angle-specific differences in posterior chain fatigue following a simulated match, and that the 90:20 may be more sensitive to post competition residual posterior chain fatigue.
THE IMPACT OF HEAVY MENSTRUAL BLEEDING (MENORRHAGIA) AND IRON STATUS IN EXERCISING FEMALES
Authors: Bruinvels Georgie , Burden Richard J , Cushway Timothy , Brown Nicola , Pedlar Charles , Richards Toby
Published: August 2017

Background

The effects of the menstrual cycle on exercise participation and performance are poorly researched. Menstrual blood loss is a leading cause of iron deficiency (ID) and ultimately iron deficiency anaemia (IDA). Furthermore, iron losses are increased in those who exercise. The menstrual cycle, ID and IDA may affect the ability to exercise, mood state, productivity and quality of life while also increasing fatigue and anxiety.

Objective

To determine the impact of heavy menstrual bleeding (HMB) on iron status; to identify the association between HMB, ID and IDA with self-reported exercise training and performance.

Design

A cross-sectional study design was used.

Setting

Routine healthcare assessments in Singapore.

Participants

Healthy females (n=271; mean age 36.3±9.6 years, body mass 58.3±12.5 kg, height 1.59±0.12 m). Inclusion criteria: regularly menstruating and reporting >60 minutes exercise participation per week or ‘taking part in races, in a relatively non-competitive manner’.

Interventions

No interventions were applied.

Main Outcome Measurements

Participants completed a ‘Female Health Questionnaire’ capturing: a 4-part diagnostic criteria for HMB; aspects of exercise training habits and performance; exercise volume; and competition level. Haemoglobin concentration ([Hb]) and serum ferritin were measured in all participants.

Results

22.4% reported HMB, 18.8% had IDA ([Hb]<12 g/dL), 30.0% severe ID (ferritin<16 ug/L), and 48.0% had moderate ID (ferritin <30 ug/L). Those with HMB were twice as likely to suffer IDA or have moderate ID, while they were nearly three times as likely to have severe ID (p<0.05). When controlling for IDA those with HMB were 3.9 times more likely to cite negative impacts on training and performance as a result of the menstrual cycle (p<0.05).

Conclusions

Heavy menstrual bleeding is common in exercising women. Regular screening should be encouraged to check iron status as this has potential to cause IDA in addition to compromising exercise training behaviours and performance.
MOUTHGUARD USE IN YOUTH ICE HOCKEY AND THE RISK OF CONCUSSION AND DENTAL INJURIES
Authors: Chisholm Dirk , Atkins Christine , Palacios-Derflingher Luz , Schneider Kathryn , Emery Carolyn , Hagel Brent
Published: August 2017

Background

Concussion is the most common injury in youth ice hockey. Mouthguards can play a role in reducing the risk dental injuries; however there is limited evidence evaluating their association with concussion in youth ice hockey.

Objective

To assess the association between mouthguard use and risk of concussion and dental trauma in youth ice hockey.

Design

Nested case-control.

Setting

Youth ice hockey leagues (elite and non-elite) in Calgary, Canada, where mouthguard use is not mandatory.

Participants

Baseline and injury data were collected for 11–17 year old players from 2013–2016.

Assessment of Risk Factors

Mouthguard use at time of injury as reported on Injury Report Forms.

Main Outcome Measurements

Case groups were defined as concussed players (therapist suspected or study physician diagnosed) and those with dental injuries; controls were players who sustained a non-concussion/non-dental injury during a game or practice. Only the first injury sustained within or between seasons was included. Frequency of mouthguard usage between cases and controls was compared. Information on baseline self-reported mouthguard use and type was also collected.

Results

At baseline, the majority of players self reported always wearing a mouthguard during games 2,156/2,606 (82.7%) and practices 1,853/2,539 (73.0%). No dental injuries were reported during the study period. Amongst concussion cases 147/185 players (79.5%) reported mouthguard use at time of injury, compared with 134/147 controls (91.2%) (unadjusted OR=0.38 95% CI 0.18–0.76). Future analyses will include multivariable logistic regression adjusting for relevant covariates and considering effect modification. The effect of mouthguard type at time of injury, and concordance between mouthguard use at baseline and time of injury will also be examined.

Conclusions

The majority of players self reported always wearing a mouthguard at baseline when there was not mandatory enforcement. Based on preliminary univariate analyses, mouthguard use was associated with reduced odds of concussion.
KNEE VALGUS ANGLE AND LOADING ACROSS COMMON ATHLETIC TASKS; REFERENCE VALUES AND GENDER DIFFERENCES IN A HEALTHY POPULATION
Authors: Alenezi Faisal , Herrington Lee , Jones Paul , Jones Richard
Published: August 2017

Background

Abnormal lower-limb mechanics during functional activities have been reported as being associated with several knee injuries. Hence it is important to develop screening tests to identify healthy individuals who may be susceptible to knee injury and then to design individual intervention programs.

Objective

To established reference values for knee valgus angle and moment during single leg squat (SLS), single leg landing (SLL), running (RUN), and cutting (CUT) tasks. Moreover, assessing gender differences in knee biomechanics during these tasks.

Design

An observational study.

Setting

Undertaken in the human performance laboratory at the University of Salford.

Participants

90 healthy individuals, 55 males and 35 females, (age 25.2±5.1 years; height 1.6±7.38 m; and mass 67.6 ±10.93 kg) were recruited.

Assessment of Risk Factors

Qualisys motion analysis system (10 Cameras) connected to an AMTI force platform were used to collect knee biomechanical variables. Then, Visual 3D software (C-Motion, USA) was used to process all data.

Main Outcome Measurements

Knee valgus angles and moments during SLS, SLL, RUN and CUT tasks.

Results

Knee valgus angle values were: SLS (−1.5°±4.1), SLL (−4.2°±4.9), RUN (−5.2°±4.3), and CUT (−8.3°±6.1). Knee valgus moment values for SLS, SLL, RUN and CUT were (0.01±0.1; 0.49±0.3; 0.31±0.1; 1.2±0.6, Nm/kg), respectively. Females demonstrated significantly higher knee valgus angles across all tasks. Knee-valgus moments were significantly different between the genders during RUN and CUT tasks (p=0.007 and 0.001, respectively).

Discussion

Finding reference values for knee valgus angles and loading during commonly assessed screening tasks in non-injured individuals may help to find ways of identifying at-risk individuals for non-contact knee injuries associated with misalignment, such ACL and PFPS. However, more research is required to discover the underlying causes of poor mechanics when performing these tasks, this would help in devising more efficient injury-prevention protocols.
ONE-YEAR FOLLOW-UP PROSPECTIVE EPIDEMIOLOGICAL STUDY OF INJURY TYPES IN THE KOREA LADIES PROFESSIONAL GOLFERS, 2015 SEASON
Authors: Cho Young Jae , Na Young Moo , Jung Hee Seong , Lee Sae Yong
Published: August 2017

Background

There are limited numbers of prospective epidemiological study regarding injuries of women professional golfers in Korea.

Objective

To analyse types of injury of women golf player in different tour levels (ie, Division I, II and III tour).

Design

Prospective epidemiological study.

Setting

The Yonsei Institute of Sports Science and Exercise Medicine Injury Surveillance System (YISSEM ISS) questionnaire survey was used to collect epidemiological data of Korean Women professional golfer. Division I, II and III tour golfers were participated in this study.

Patients (or Participants)

A total of 388 professional golfers who participated in the 2015 KLPGA tour.

Interventions (or Assessment of Risk Factors)

Injuries sustained as a professional golfer.

Main Outcome Measurements

Main outcomes related golf injuries were golfers' injury rate sustained during the year, time of injury, body part injured, type of injury. Frequency and Chi-square analysis was used to evaluate rate of golf-related injury.

Results

The injury rate was greater in division I tour (79.4%) than II (68.1%) and III (72.1%) tour. The golfer were most likely to injured both in-season and preseason (51.4%) followed by solely in-season (44%), and solely preseason (4.6%). The most common injured body part was the wrist/forearm/elbow (I:23%, II:26%, III:27%), closely followed by the low back (I:22%, II:23%, III:23%), and shoulder/upper arm (I:21%, II:19%, III:21%). The type of the most common injury was the tendinitis or inflammation (I:35%, II:37%, III:37%), followed by the ligament sprain (I:22%, II:21%, III:23%), and muscle-tendon strain (I:19%, II:19%, III:14%).

Conclusions

The injuries in golf are most likely sustained in the wrist/forearm/elbow and low back region during swing. Injury types of KLPGA golfer were not significantly associated with tour levels. Analysis of golf injury during multiple years may provide better information to prevent injury.