bluuebunny/crossref_metadata_2025 huggingface dataset:
THE EFFECTS OF FUNCTIONAL GARMENT ON THE JUMP LANDING TASK
Authors: Mukai K , Koyanagi M , Kimura Y , Nakae N , Ogawa T , Yokotani Y , Shioki T , Notani M , Hirama T
Published: March 2014

Background

The effectiveness of wearing a brace to prevent sports injuries of the knee remains controversial. We examined the impact of functional newly developed garments.

Objective

To investigate the biomechanics of the knee joint when wearing the functional garment with lines in the fabric of different elasticities.

Design

Quasi-experimental.

Setting

Controlled laboratory setting.

Participants

22 healthy male and female college students who participated in recreational sports.

Interventions

A single-leg drop jump onto the force plate was performed from a height of 30 cm. Infrared-reflective markers were attached to a total of 39 points for each subject. Body movements were tracked using a high-speed (200 Hz) three-dimensional motion analyzer and a force plate (ground reaction force of 1000 Hz). Long garments were used: two types of garments with fabric lines of hard and soft elasticity and the same garment with no processing (NT) as a control.

Main outcome measurements

External knee and knee valgus-varus moments as well as joint angle of the support leg were calculated using computer software.

Results

At 40 ms after ground contact, a significant decrease in the knee valgus angle was observed when wearing the Hard garment (5.33±3.32°) compared to the NT garment (1.33±4.91°; P<.05). A significantly low knee valgus-varus moment was observed when wearing the Hard garment (–6.08±7.07 Nm/kg) compared with the NT garment (0.93±8.60 Nm/kg) (P<.05).

Conclusion

The developed functional garment is considered to have reduced the knee abduction moment by controlling the knee valgus moment in a single-leg drop jump.The garment has the potential to avoid malalignment of the lower extremity and prevent sports injury of the knee joint.
MEASUREMENT METHOD IS IMPORTANT FOR INTERPRETATION OF ATHLETES' ECG
Authors: Berge HM , Steine K , Andersen TE , Solberg EE , Gjesdal K
Published: March 2014

Background

Electrocardiography (ECG) is recommended as part of IOC's preparticipation health examination in athletes. The new Seattle criteria for interpreting ECG in athletes are developed with reference values for abnormality, but yet, no guidelines exist on how to perform the measurements.

Objective

To test the correlations between visual and computer-based measurements, and examine how method choice influences prevalence of abnormal ECG findings.

Design

Cross-sectional study on the Seattle criteria comparing visual and computer-based reading of ECGs.

Setting

Preparticipation cardiac screening examination of male professional football players in Norway during a preseason training camp in 2008.

Participants

Athletes aged 18–38 years.

Assessment of risk factors

All ECG findings suggestive of cardiomyopathy or primary electrical disease were categorized according to the Seattle criteria. Visually, the measurements were conducted with calipers on-screen on the average PQRST complex in each lead, calculated by the trimmed mean. Computer-based measurements were derived from the medium beat. For both, heart rhythm and conduction were scored visually by cardiologist.

Main outcome measurements

Prevalence of abnormal ECG findings, and differences between visual and computer-based measurements. Categorical variables were compared by kappa statistics (K).

Results

ECG of good quality were available from 579 (97%) of 595 players. The ECG was categorized as abnormal in 64 (11%) players after visual assessment, versus in 122 (21%) after computer-based measurements, mainly due to more abnormal Q wave durations (35), T wave inversions (24) and ST depressions (12) detected by the computer. Abnormal ECG findings suggestive of; cardiomyopathy were present in 62 versus 122 players (Κ=0.544), and primary electrical disease in 8 versus 6 players (Κ=0.855).

Conclusions

The correlations between visual and computer-based measurements are moderate. Clinically, this difference will influence the prevalence of abnormal ECG findings in athletes. Thus, method choice should always be reported in preparticipation health examination studies. Reference values may need adjustments dependent on measurement methods.
SHOULDER PAIN PROBLEMS IN YOUTH HANDBALL
Authors: Møller M , Myklebust G , Attermann J , Wedderkopp N , Sørensen H , Lind M
Published: March 2014

Background

Assessment of prevalence and consequences of shoulder pain problems in youth handball is an integral first step towards injury prevention, but the literature is scarce.

Objective

To evaluate prevalence and impact of shoulder pain problems among youth handball players.

Design

Pilot cohort study with 3 months of weekly SMS-based injury registrations based on the OSTRC Overuse Injury Questionnaire.

Setting

Danish youth handball.

Participants

Danish 109 male and 90 female aged 14–16 years (age group U16) and 16–18 years (age group U18) players recruited as a convenient sample from 5 handball schools in Denmark.

Risk factor assessment

Gender and age group differences in shoulder pain prevalence were assessed.

Main outcome measurements

Current and previous shoulder pain registered at baseline via the Fahlstrøm questionnaire. A weekly average severity score (0–100) for the 3-month period was calculated for those with current shoulder pain.

Results

At baseline, 14% and 33% players reported current and previous shoulder pain, respectively. Of all reported shoulder pain, 56% had gradual onset. There were no significant differences between gender (P=.783) and age groups (P=.187). For players with current or previous pain, 70% had changed their training habits and 30% had missed games. Seventy-eight percent suffered from shoulder pain in their throwing (dominant) arm. Of the players reporting present pain, 41%, 15%, 11%, and 15% had pain durations of >0–4, >4–12, >12–26 and >26–52 weeks, respectively, while 19% had pain duration of more than one year. Thirty percent of these players reported problems more than 8 weeks in the registration period with a median severity score of 48, which is defined as substantial problems.

Conclusions

Shoulder pain problems poses a significant burden to Danish youth handball players, with a negative impact on both training and game participation. Further studies to identify risk factors in this population are needed to develop injury prevention strategies.
EPIDEMIOLOGY OF LOWER LIMB INJURY IN GAELIC FOOTBALL AND HURLING
Authors: O'Malley E , Murphy J , Gissane C , Blake C
Published: March 2014

Background

Gaelic football (GF) and hurling (H) are multi-directional, high velocity, contact sports. Elevated physical demands are thought to cause an increased rate of injury in the lower limb.

Objective

To examine the incidence and describe lower limb injury in both Gaelic Football and hurling (2008–2011).

Design

Four-year prospective epidemiological study.

Setting

25 Gaelic football teams and 21 hurling teams who compete at inter-county level participated. All data were anonymous. Ethical approval was received by the University College Dublin Human Research Ethics Committee.

Participants

Adult male Gaelic football (n=841) and hurling (n=696) players were included.

Interventions

Injury definitions comply with international best practice guidelines and consensus statements.

Main outcome measurements

Lower Limb injury (LLI) characteristics, exposure information and player demographics were collected via an online platform. Injury rates are expressed as number of injuries per 1000 hours. Severity is expressed as days lost from sport. Percentages were calculated from available totals.

Results

There were a total of 654 football and 560 hurling LLIs recorded. Match-play LLIs had a higher incidence in both codes (GF:29.8/1000 hrs, H:37.6/1000 hrs) than training LLIs (GF:2.4/1000 hrs, H:2.1/1000 hrs). LLIs caused a median of 16 days timeloss from Gaelic football and 14 days timeloss from hurling. When broken down by body-region, the thigh was the most commonly injured area (GF:42.0%, H:32.1%) followed by knee (GF:16.1%, H:19.3%). Hamstring injury was most prevalent (GF:29.1%; H:23.6%). Hamstring injuries caused a median of 20 days timeloss from football, 21 days lost in hurling. Muscle was the most commonly injured tissue (GF:51.2%, H:46.4%). The most common mechanism of LLI was sprinting (GF:32.1%, H:34.1%).

Conclusions

This study provides new specific lower limb injury epidemiological information and is the first step towards injury prevention in two sports native to Ireland.
EPIDEMIOLOGICAL STUDY OF INJURY IN BRITISH CYCLING: 2011–2013
Authors: Palmer-Green D , Burt P , Jaques R , Hunter G
Published: March 2014

Background

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

Objective

Provide injury epidemiology information on the British Cycling squad (road/track endurance; track sprint; MTB; BMX).

Design

Longitudinal prospective surveillance study, recording injury data. Definitions for injury, time-loss and performance-restriction were used to identify the rate and severity of athlete injuries.

Setting

British Cycling National training centre, including domestic and international training/competition venues during the 2011/12–2012/13 seasons.

Participants

61 (16 female; 45 male) National team athletes.

Interventions

Standardised report forms for injuries completed by medical staff.

Main outcome measure

Injury rate, severity and causes.

Results

There were 95 injuries each lasting 16 days, equating 35% of the squad sustaining at least one injury per season. Training injuries were more prevalent (n=77; 30%vs.n=18; 11%), but competition injuries more severe (27dvs. 14d). The majority of competition injuries (83%) resulted in time-loss and training injuries (75%) in performance-restriction. Injury prevalence and severity was highest for the BMX squad and lowest for the endurance squad. Injuries to the lumbar spine (29%), knee (18%) and shoulder/clavicle (14%) were most common, with 17, 9, and 23 days lost per injury, respectively. Overuse (gradual/sudden onset: 58%) and recurrent (35%) were the most common causes of injury, with contact – static object (32d) most severe. Weight training related lumbar spine injuries in the sprint squad and road cycling related shoulder/clavicle and knee injuries in the endurance squad caused the greatest burden in terms of total days lost.

Conclusions

Prevention initiatives targeting common and severe injuries may be beneficial in reducing the number of athlete days lost to training/competition.
RISK FACTORS FOR BODY REGION SPECIFIC INJURIES IN SKIERS AND SNOWBOARDERS
Authors: Romanow NTR , Pfister K , Rowe BH , Emery CA , Meeuwisse WH , Nettel-Aguirre A , Goulet C , Russell K , McRae A , Lang E , Hagel BE
Published: March 2014

Background

Little is known about risk factors (e.g., wrist guards, binding adjustment, equipment ownership) for body region specific skiing/snowboarding injuries.

Objective

Identify risk factors for body region specific injuries and severe injuries in skiers/snowboarders.

Design

Case-control study using emergency department (ED) interviews, ski patrol Accident Report Forms (ARF), and ski area interviews. Severe injury cases presented to the ED. Non-severe injury cases presented to the ski patrol. Controls were uninjured skiers/snowboarders.

Setting

An urban ski area and 2 EDs in Alberta, Canada.

Participants

Injured skiers/snowboarders who saw the ski patrol (n=552) or went to one of the study EDs (n=192). Controls were interviewed at the ski area (n=914).

Risk factor assessment

Risk factor data were collected by interview and from ARFs. Injury outcomes were determined from the ED chart or ARF.

Main outcome measurements

Body region categories were: lower extremities, upper extremities, trunk, and head/neck. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for each body region by case group. Intrinsic risk factors (age, sex, activity, ability) will be included in the models.

Results

Preliminary results for non-severe cases indicate that the odds of injury for all body regions were lower for those 12+ years old compared with younger participants (OR range 0.07; 95% CI 0.04–0.11 to 0.42; 95% CI 0.24–0.73) and higher for beginners (OR range 1.79; 95% CI 1.01–3.15 to 4.97; 95% CI 2.97–8.32). Overcast weather reduced the odds of any injury (OR range 0.06; 95% CI 0.02–0.18 to 0.44; 95% CI 0.2–0.98), as did increased run difficulty (OR range 0.06; 95% CI 0.02–0.17 to 0.19; 95% CI 0.0–0.54). Skiers had lower odds of upper body injury (ARF OR 0.27; 95% CI 0.2–0.38 & ED OR 0.33; 95% CI 0.21–0.51) compared with snowboarders.

Conclusions

These results will inform the development of an injury prevention program for skiers/snowboarders targeting modifiable risk factors.
AMENORRHEA IN ELITE ATHLETICS ATHLETES: PREVALENCE AND ASSOCIATIONS TO ATHLETICS INJURY
Authors: Rost M , Jacobsson J , Dahlström Ö , Hammar M , Timpka T
Published: March 2014

Background

Knowledge is lacking about the associations between sport injuries and components of the female athlete triad.

Objective

To assess the prevalence of amenorrhea in elite female athletics athletes and if athletes with history of amenorrhea are at higher injury risk than athletes with regular menstrual cycles or on combined oral contraceptives.

Design

Cohort study during a period of 52 weeks.

Setting

Swedish female youth and adult elite athletics athletes.

Participants

Athletes ranked in the national top-10 in each event were invited to take part in a 52-week surveillance study. Among the female athletes that consented to participate (n=161), 149 (92%) completed a baseline gynecological survey.

Risk factor assessment

Amenorrhea, event group, previous injury, training volume and intensity (measured by the TLRI), and interactions with age.

Main outcome measurements

Time to first injury causing full or partial time loss from athletics.

Results

37 (25%) athletes reported having history of amenorrhea. More runners reported amenorrhea (P=.017; Cramer's V=0.19) than athletes in the throwing and jumping event groups; this difference in amenorrhea prevalence was distributed to adult runners only (P=.016; Cramer's V=0.26). Additionally, there was a tendency for that runners with a lower BMI had a prevalence of amenorrhea (P=.062). Sixty-six percent of the athletes sustained an injury during the study period. Cox proportional hazards regression analyses did not show statistical associations between amenorrhea and athletics injury.

Conclusions

Swedish female athletics athletes reported a high prevalence of amenorrhea compared to the normal population. Athletes with extended exposure to participation in running events with high demands on aerobic performance sufferred more extensively from amenorrhea. No associations with injury incidence could be established, but this finding needs to be confirmed in studies with larger sample size. Further studies of amenorrhea and its health implications among female athletes are warranted.
EXPLOSIVE STRENGTH CAPACITY IN THE LOWER LIMBS AND SPEED PERFORMANCE IN YOUNG SOCCER PLAYERS
Authors: Sannicandro I , Piccinno A , Cofano G , Lupelli N , Rosa RA
Published: March 2014

Background

The explosive strength capacity of each limb influences acceleration capacity in soccer players.

Objective

To investigate whether a relationship exists between the individual strength capacities of the lower limbs and performances in sprinting in a straight line and with a change of direction(CoD) in young soccer players.

Design

Correlational research.

Setting

Youth sport.

Participants

205 young soccer players (11.3±0.2 yrs, 180.1±2.6 cm, 78.5±2.2 kg).

Interventions

All subjects performed the Hop test (HT), the Triple hop test (THT) and the Side hop test (SHT) (testing strength capacity); the 5m and 10m sprint test, the Foran test, and the 10×5m shuttle sprint test (tests to assess sprinting capacity in a straight line and with CoD) were executed using a photocell.

Main outcome measurements

The correlation between the results of the three strength tests and sprinting performance was assessed.

Results

The results are summarised in tables 1–2.

Table 1.

Correlation coefficients between performances in tests of lower limb strength using the HT/THT and performances in sprinting in a straight line (#P<.0005).

5 m10 mHTRight−0.35#−0.31#HTLeft−0.36#−0.34#THTRight−0.37#−0.33#THTLeft−0.44#−0.40#Table 2.

Correlation coefficients between performances in tests of lower limb strength using the SHT and sprinting performance with a CoD.

Foran10x5SHTright−0.26#−0.21**SHTLeft−0.15*−0.12

*P<.05,**P<.01#P<.0005.

Conclusions

The results show that the athletes with high values of lower limb strength as assessed using the HT obtain significantly better performances in a straight line sprinting. However, the correlation coefficients indicate that the strength of the relationship is only moderate: 0.35 to 0.44 for performances in the HTvssprinting in a straight line; and 0.12 to 0.26 for performances in the SHTvssprinting with a CoD.
THE IMPACT OF CONCUSSION ON CARDIAC AUTONOMIC FUNCTION: A SYSTEMATIC REVIEW OF EVIDENCE FOR RECOVERY AND PREVENTION
Authors: Blake T , McKay C , Meeuwisse WH , Emery C
Published: March 2014

Background

Concussions can negatively impact cognitive, behavioural, and physiological function. The current standard of care does not account for the physiological impact of concussion. Cardiac autonomic function (CAF) is responsive to changes in physical and cognitive exertion in healthy populations. The influence of concussion on CAF is not well understood.

Objective

To evaluate the evidence regarding the effect of concussion on cardiac autonomic function.

Design

Systematic Review.

Setting

Databases [Medline, SportDiscus, HealthSTAR, PsycINFO, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PubMed and ProQuest, Web of Science and Google Scholar] were systematically searched using keywords and MeSH terms.

Sample

Inclusion criteria: original research, available in English, included participants with concussion or mild traumatic brain injury (mTBI) and had a comparison group. Studies of humans (greater than 6 years old) and animals were included. Ten articles were identified for critical appraisal (six cohort studies, four cross-sectional).

Independent variable

Diagnosis of a concussion or mTBI.

Main outcome measurements

Heart rate (HR) and/or heart rate variability (HRV). Critical appraisal was conducted using the Downs and Black criteria.

Results

There is conflicting evidence regarding CAF at rest following concussion/mTBI. There is evidence of elevated HR and reduced HRV with low intensity, steady-state exercise up to 10 days following concussion. No significant difference in HRV was found during isometric handgrip testing following concussion. The validity of current literature is limited by small sample sizes, lack of female or pediatric participants, varying methodologies and lack of follow-up. No studies evaluating CAF during cognitive exertion following concussion were found.

Conclusions

There is evidence to suggest that CAF is altered during physical activity following concussion. The limitations in available literature highlight the need further research. Understanding the effect of concussion on CAF will contribute to the development of more comprehensive concussion management and prevention strategies.
DIFFERENCES IN THE MUSCLE ONSET TIMING BETWEEN LANDING POSTURES DECIDED BEFORE AND DURING JUMP-LANDING
Authors: Sasaki R , Yukio U , Eri F
Published: March 2014

Backgraound

Jump-landing is a well-studied movement that causes sports injuries.

Objective

The purpose of this study was to clarify the differences in the onset timing of the muscles during jump-landing among landing postures decided before and during landing.

Design

Experimental study.

Setting

Youth sports.

Participants

8 healthy female college students volunteered.

Interventions

Jump-landing was performed from a 40 cm height box with both legs or a single leg. The landing posture was decided before or during landing. The onset timing of the vastus medialis (VM), vastus lateralis (VL), semmembranosus (SM) and biceps femoris (BF) was determined using the electromyography (EMG). The onset timing of muscle was identified as the first point that exceeded the mean baseline +3SD of the EMG amplitude. The baseline was set as the EMG amplitude at 100 ms after toe-off from the box. The landing duration was normalized in 100%.

Main outcome measurements

A deley of the onset timing of muscles may be risk factor of injury during jump-landing when the landing posture is decided late.

Results

The onset timing for both legs where the posture was decided before landing was 83.8±15.5%, 82.2±13.4%, 76.8±10.1%, 77.6±6.6% for the VM, VL, SM, BF, respectively; no significant defferences were noted among the muscles. During single-leg landing, values were 74.3±19.1%, 73.4±15.6%, 71.2±11.9%, 72.4±6.9%, respectively; the values significantly deffered for the VM and VL between movements with both legs and single leg (P<.05). No significant differences between cases where the landing posture was decided before and during landing.

Conclusions

The onset timing of muscles did not significantly differ according to the time at which the landing posture was decided. However, muscle activities were only assessed during successful trials, and a significant difference may be noted if failed trials are included.
VALIDATING THE 3-STEP RETURN TO PLAY DECISION MAKING MODEL
Authors: Shrier I , Matheson G , Boudier-Reveret M , Steele R
Published: March 2014

Background

A recent return to play decision-making (RTP-DM) model for sport medicine has organized the underlying concepts into 3 steps but has not yet been validated.

Objective

To examine the validity of the 3-step RTP-DM model recently proposed.

Design

Repeated measures cross-over survey design.

Setting

World-wide.

Participants

American College of Sports Medicine clinicians involved in RTP-DM.

Risk factor assessment

We provided clinical vignettes of injuries and illnesses in athletes to participants through an online survey. Each vignette included examples of 3 factor types: increasing injury severity, changing risk associated with sport (e.g. different positions), and changing non-injury risk factors (e.g. financial considerations).

Main Outcome Measurements

For each vignette, participants indicated the level of activity restriction they would recommend (6 options from No Restrictions to No Activity) in accordance with the risk they placed on continued participation. We analyzed the data using multiple regression, adjusting for the correlated participant outcomes, to measure how changes in factors affected individual participants.

Results

The estimated participation rate for those involved in RTP decisions was 24.7%. As expected, we found that clinicians increase restrictions as injury severity increases. We also found that changing factors related to sport risk, and changing factors that are unrelated to sport risk will affect RTP decisions, although the effect is context-dependent and does not occur equally across all injury severities and clinical cases. The effect was also observed in each subgroup examined that included sex, age, specialty, region of training, academic status, and years of experience making RTP decisions.

Conclusions

Our findings that clinicians from a wide variety of backgrounds will change RTP recommendations based on clinical vignettes with changing injury severity, sport risk modifiers and decision modifiers provides evidentiary support for the 3-step model for RTP decision making recently proposed.
NEUROCOGNITIVE PERFORMANCE AT RETURN TO PLAY IN ELITE YOUTH HOCKEY PLAYERS WITH SPORT-RELATED CONCUSSION
Authors: Taylor K , Brooks BL , Schneider KJ , Blake TA , McKay CD , Meeuwisse WH , Barlow KM , Kang J , Emery CA
Published: March 2014

Background

Neurocognitive recovery following sport-related concussion is important for re-injury risk reduction. In elite youth hockey, it is unknown if neurocognitive function returns to baseline values at the time of medical clearance to return to play (RTP).

Objective

To determine if ImPACT composite scores have returned to baseline values at the time of medical clearance to RTP.

Design

Prospective case series.

Setting

Sport Medicine Clinics (Alberta, Canada).

Participants

Concussed elite male and female youth (13–17 years) ice hockey players (n=68) and healthy controls (n=22) completed ImPACT and SCAT2 testing at baseline and RTP following concussion.

Main outcome measurements

Team therapists/trainers referred concussed players to the study sport medicine physician. The physician determined RTP via symptom resolution and SCAT2 score normalization. Physicians were blinded to ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) composite scores (verbal memory, visual memory, reaction time and visual motor), which were used to evaluate neurocognitive performance.

Results

Comparisons between baseline and RTP ImPACT scores were based on reliable change (RC) scores derived from a sample of healthy players tested twice at baseline within 2 weeks (RC scores with 90% CI: verbal memory +/−14; visual memory, +/−15; reaction time, +/−0.1; and visual motor, +/−8). All four ImPACT composite scores were normalized at RTP in 73.5% (95C% CI: 61.5–82.8) of concussed participants and all but one [95.5%; 95% CI:70.39–99.46) controls. In the concussed players, 25.0% (95% CI: 16.0–36.9) had 1 composite score not return to baseline at RTP. One player had three composite scores not return to baseline at RTP.

Conclusions

Elite hockey players are often cleared for RTP without the benefit of knowing neurocognitive performance on ImPACT. In this cohort, 25% of concussed players who were cleared to return to hockey had 1 composite score that had not yet returned to baseline. These results may have implications for tertiary prevention.
DOES RUNNING SHOE MIDSOLE HARDNESS INFLUENCE RUNNING-RELATED INJURIES? RESULTS FROM A DOUBLE BLIND RANDOMIZED CONTROLLED TRIAL
Authors: Theisen D , Malisoux L , Delattre N , Seil R , Urhausen A
Published: March 2014

Background

The shock absorption qualities of running shoes are thought to have an important influence on running-related injuries (RRIs). However, scientific evidence of this relationship is still lacking.

Objective

To test if midsole hardness of standard running shoes was related to RRIs.

Design

Double-blind randomized controlled trial.

Setting

Free-roaming leisure-time distance runners.

Participants

Study participants were recruited through newspaper advertisements, posts on specialized internet sites and via mouth-to-ear. They were required to report any running activity, sport practice and injury using a dedicated internet platform. Recorded information was systematically verified, if necessary through direct contacts with the participants.

Risk factor assessment

Leisure-time runners were provided with identical running shoes, except for their midsole hardness which was either hard (H; n=113) or soft (S; n=134). They were followed prospectively for 5 months.

Main outcome measurements

The primary outcome measure was exposure volume (hours) to running practice until first-time RRI (Cox proportional hazards regression analyses).

Results

Overall, 12.1 RRIs were recorded per 1000 hours of running. There was a 15% difference between the shoe types regarding midsole stiffness. The type of shoe used for running was not related to RRI (hazard ratio (HR)=0.92; 95% confidence interval (CI)=0.57–1.48). Furthermore, no difference was detected regarding RRI patterns (location, severity, etc.). Significant risk factors for RRIs were body mass index (HR=1.13; 95% CI 1.03–1.23), injury in the 12 months preceding the study (HR=1.74; 95% CI 1.04–2.90) and average session intensity (HR=1.40; 95% CI 1.04–1.87). Previous regular running practice (HR=0.42; 95% CI 0.23–0.78) and volume of other sport activities (HR=0.70; 95% CI 0.56–0.88) were significant protective factors.

Conclusions

RRI risk was not associated with running shoe midsole hardness in this study.
PSYCHOLOGICAL RISK FACTORS FOR OVERUSE INJURIES IN ELITE ATHLETICS: A COHORT STUDY IN SWEDISH YOUTH AND ADULT ATHLETES
Authors: Timpka T , Jacobsson J , Dahlström Ö , Kowalski J , Bargoria V , Ekberg J , Nilsson S , Renström P
Published: March 2014

Background

There is growing evidence that athletes' psychological characteristics are of importance for understanding overuse injuries in sports.

Objective

To examine the importance of psychological factors as risk indicators for sustaining athletics injuries.

Design

Cohort study with 52 weeks duration.

Setting

Swedish male and female youth and adult elite athletics athletes.

Participants

Athletes ranked in the national top 10 in each event were invited to a one-year surveillance study. Among those consenting to participate (n=292), 73% (n=212) completed a psychological survey at baseline.

Risk factor assessment

Event group, previous injury, training volume and intensity (measured by the TLRI), perceived motivational climate (PMCSQ), coping behaviors (Brief Cope), body consciousness and hyperactivity (BCS-ADHD), commitment to exercise (CES), and interactions with gender and age.

Main outcome measurements

Time to first injury causing full or partial time loss from athletics.

Results

199 (68%) athletes reported an injury during the study period. Ninety-six percent of reported injuries were classified as associated with overuse. Cox proportional hazards regression analyses showed that maladaptive coping through self-blame (P=.001; HR 1.37 (95% CI 1.14–1.67)) and hyperactivity (P=.025; HR=1.01 (95% 1.00–1.02)) were associated with increased injury risk. Additionally, male adult athletes with a previous serious injury had an increased risk of injury (P=.043; HR=2.05 (95% CI 1.02–4.07)), while the injury risk was decreased for male(P=.032; HR=0.47 (95% CI 0.23–0.94)) and female (P=.025; HR=0.49 (95% CI 0.26–0.91)) adult athletes without previous injury.

Conclusions

The psychological factors self-blame and hyperactivity earlier linked to non-suicidal self-injury in general populations were together with causal interactions combining previous injury, age and gender found to be related with overuse injury in athletics athletes. Further studies on associations between injury and indicators of depression and stress in elite athletics athletes are warranted.
LIFETIME SEXUAL AND PHYSICAL ABUSE AMONG ELITE ATHLETIC ATHLETES: A CROSS-SECTIONAL STUDY OF PREVALENCE AND CORRELATES WITH ATHLETICS INJURY
Authors: Timpka T , Janson S , Jacobsson J , Kowalski J , Ekberg J , Mountjoy M , Svedin CG
Published: March 2014

Background

Sexual and physical abuse have been reported from all levels of sports. Associations between abuse victimization and sports injury have not been fully investigated.

Objective

To examine the lifetime prevalence of sexual and physical abuse in elite athletics athletes and explore associations with prevalence of athletics injuries.

Design

Cross-sectional study using e-epidemiological survey methods.

Setting

Swedish male and female youth and adult elite athletics athletes.

Participants

Athletes ranked in the national top-15 with recorded email addresses (n=507) were invited. 198 (39%) athletes returned complete data.

Risk factor assessment

Gender, age, sexual orientation, event group, lifetime physical abuse, lifetime sexual abuse (noncontact sexual abuse (indecent exposure), contact sexual abuse without penetration, penetrating sexual abuse) within and outside sports.

Main outcome measurements

One-year prevalence of injury causing at least three consecutive weeks of full or partial time loss from athletics.

Results

27 (14%) athletes reported lifetime exposure to sexual abuse and 36 (18%) athletes to physical abuse. More women than men (P=.005; Cramer's V=0.21) reported lifetime sexual abuse. Non-heterosexual athletes tended to more often be lifetime physical abuse victims than their heterosexual peers (P=.058). 6 (3%) athletes reported having been sexually abused in the athletics setting. The perpetrators of sexual abuse in athletics were both men and women extending from coaches to peers in mid-adolescence; two athletes reported suicidal ideation as a consequence of the abuse. The one-year prevalence of 3-week athletics injuries was higher for physical abuse victims among women (P=.021; Cramer's V=0.23), but not for male victims (P=.90). Sexual abuse was not found to be statistically associated with athletics injury.

Conclusions

Physical abuse victimization was associated with higher injury prevalence among female athletics athletes. Sexual and physical abuse victims are common in elite athletics and further studies of abuse, abuse victims, and abuse prevention are needed.
NEITHER GOOD KNEE STABILITY NOR RECOVERED MUSCULAR STRENGTH GUARANTEE SAFE RETURN TO SPORTS AFTER ANATOMICAL SINGLE- AND DOUBLE-BUNDLE ACL RECONSTRUCTION
Authors: Tsuda E , Hiraga Y , Yamamoto Y , Maeda S , Ishibashi Y
Published: March 2014

Background

Recent innovation in ACL reconstruction has provided improved knee stability and function, however, the effect to decrease the incidence of the second ACL injury has not been established.

Objective

To determine the incidence of the second ACL injury after anatomical ACL reconstruction and the associated factors.

Design

Retrospective study.

Setting

Patients who underwent primary ACL reconstruction from 2003 to 2010 in our institute.

Patients

177 patients received single-bundle reconstruction with a bone-patellar tendon-bone graft and 257 patients received double-bundle reconstruction with hamstring tendon grafts.

Risk factor assessment

The patients who suffered the second ACL injury were searched by reviewing medical records.

Main outcome measurement

Gender, age at the primary ACL surgery, graft type, traumatic event which caused second ACL injury, the period from the primary ACL surgery to the second ACL injury, and the stability of ACL-reconstructed knee and muscular recovery rate of quadriceps and hamstrings immediate before the second ACL injury were investigated in the patients with the second ACL injury.

Results

34 patients (7.8%) had reconstructed ACL tear and 32 patients (7.4%) had contralateral ACL tear. The second ACL injury frequently occurred in lower age patients, while was not associated with gender, graft type. All patients except one had the second ACL injury after return to sports. Before the second ACL injury, 92.4% ACL-reconstructed knees showed 1 mm or less of side-to-side difference in KT-1000 measurements, and 89.4% knees were negative in pivot-shift test. Good muscular recovery with more than 80% of healthy side achieved in 89.4% before the second ACL injury.

Conclusions

The good results in either knee stability or muscular recovery after anatomically ACL-reconstructed knee does not guarantee safe return to sports or decreased risk of the second ACL injury.
THE CONTRIBUTION OF A FATIGUE PROTOCOL TO A DYNAMIC STABILITY SCREENING TEST FOR EXERTIONAL MEDIAL TIBIAL PAIN
Authors: Verrelst R
Published: March 2014

Background

The development of accurate measurement techniques to detect risk factors for common injuries should be of concern to health care professionals.

Objective

To determine the contribution of a fatigue protocol to a risk factor screening test for the development of exertional medial tibial pain(EMTP).

Design

3D kinematic parameters were prospectively evaluated during a single leg drop jump (SLDJ) in both non-fatigued and fatigued state.

Setting:

Female students in physical education were tested at the beginning of their first academic year and followed throughout 1–2 years.

Participants

69 healthy female students were included in the study.

Risk factor assessment

Cox regression analysis was used to identify the potential risk of dynamic joint instability in the development of EMTP.

Main outcome measurements

It was hypothesized that dynamic joint instability in frontal and transverse plane might play a role in the development of EMTP.

Results

21 subjects were diagnosed with EMTP. The results identified that for the leg at risk in non-fatigued state, only increased range of motion in the transverse plane (ROMT) of the hip during landing (P=.002) could be identified. In the fatigued state, increased ROMT of hip (P=.038) and pelvis (P=.040) during landing and increased ROMT of thorax (P=0036) during push-off could be determined. For the leg not at risk for EMTP, increased ROMT for the knee (P=.023) during landing and decreased ROMT for the pelvis (P=.034) during push-off were determined. These significant parameters could no longer be determined in the fatigued state.

Conclusions

It can be concluded that adding a fatigue protocol to the SLDJ enhances the possibility to identify the leg at risk in a predisposed female athlete and determine the proximal risk factors for that leg at risk more thoroughly.
CASUALTY INCIDENCE AT THE WORLD TRIATHLON CHAMPIONSHIPS: ARE AGE, GENDER AND EVENT TYPE ASSOCIATED WITH INCREASED RISK?
Authors: Walker M , Vleck V , Ussher M , Sanjay S
Published: March 2014

Background

Despite the growing popularity of triathlon, very few studies have assessed the casualty incidence and profile during races. The World Triathlon Championships in London offered the opportunity to observe this at the largest triathlon ever held.

Objective

This study describes the profile of casualties sustained across a five day triathlon event. It is hypothesised that an association exists between casualty risk and the variables of age, gender, event standard and distance.

Design

Observational data was collected on all participants who were entered to compete in the event, and whom sought medical aid either during the event or after the finish of the event. Casualty nature was categorised into topical, musculoskeletal and constitutional.

Setting

The World Triathlon Championship Grand Final was held in Hyde Park, London over five consecutive days in September 2013, comprising both elite and non-elite fields.

Participants

A total of 6 103 inidviduals participated from 84 countries. Age ranged from 16 to 80 years.

Risk factor assessment

Independent variabales included: age; gender; event standard, event distance and event type.

Main outcome measurements

1) Total casualty incidence for age, gender and standard. 2) Casualty incidence difference by gender for each event type 3) Nature of casualty incidence for age, gender and event type.

Results

Females had a higher casualty rate than males, across majority of event types. Elite athletes had a higher casualty rate. Topical casualties were highest in 40–49 age group, and for sprint distances, musculoskeletal casualties were highest in 50–59 age group. For the Olympic distance, constitutional casualties were highest for females, the oldest and the youngest.

Conclusions

In a large world triathlon championship event, the incidence and nature of participant casualties is associated with age, gender, event distance and standard. These findings could support organisers seeking to plan effective medical resourcing and injury prevention strategies for such future events, and help inform triathletes of their risk of injury during races.
THE EFFECTS OF FATIGUE ON PEAK TORQUE, MUSCLE STIFFNESS, AND MUSCULOARTICULAR STIFFNESS OF THE KNEE JOINT IN YOUNG MALE ATHLETES
Authors: Wang D , De Vito G , Ditroilo M , Fong D , Delahunt E
Published: March 2014

Background

Appropriate levels of muscle strength, muscle stiffness (MS) and musculoarticular stiffness (MAS) are important factors linked to athletic performance. Alterations in knee joint mechanical behavior induced by neuromuscular fatigue may have implications for injury susceptibility.

Objective

To investigate the acute effects of fatigue on peak torque of the knee joint extensor musculature, MS of the vastus lateralis and MAS of the knee joint in young male athletes.

Design

Experimental study.

Setting

University biomechanics laboratory.

Participants

27 male recreational athletes.

Interventions

A 15-minute cycle ergometer fatiguing protocol.

Main outcome measurements

Peak torque of the knee joint extensor musculature was assessed on a leg-extension dynamometer, whilst MS of the vastus lateralis was measured using a myometer (Müomeetria AS, Tallinn, Estonia) in both relaxed and contracted conditions. MAS was evaluated by the free oscillation technique on a leg-extension dynamometer. These measures were performed before and after the fatiguing intervention.

Results

A significant decrease in peak torque was observed from pre-fatigue (208.2±47.1 Nm) to post-fatigue (189.3±52.5 Nm) (P<.01). Absolute MS was significantly increased from pre-fatigue (362.7±49.4 Nm−1–relaxed; 493.6±71.2 Nm−1–contracted) to post-fatigue (454.3±82.8 Nm−1–relaxed; 551.3±89.7 Nm−1–contracted) (P<.01). Normalized MS (MS/load supported) was significantly increased from pre-fatigue (26.4±6.9 Nm−1·kg−1) to post-fatigue (230.8±6.5 Nm−1·kg−1) (P<.01). MAS was decreased significantly from pre-fatigue (1518.8±502.6 Nm−1) to post-fatigue (1421.6±445.7 Nm−1) (P<.05). However, for normalized MAS (MAS/load supported) no significant difference was observed (P=.06).

Conclusions

It is hypothesized that the observed increase in MS may be a compensatory mechanism to offset the fatigue induced decrease in peak torque and MAS, with the aim of preserving knee joint stability.
A DESCRIPTIVE STUDY ON INJURY RELATED PHYSICAL DISABILITY IN URBAN SRI LANKA
Authors: Weerasinghe I , Pushpa F , Samath D , Sumedha J
Published: March 2014

Background

Injuries remain the leading cause of death and disability among all age groups except 60 years of age or older. Road traffic accidents, occupations, sports, violence and humanitarian crisis significantly contribute to injuries. In Sri Lanka non-accident, traumatic injury, such as stepping on pressure mines, grenade and mortar blasts and trap gun accidents are common. Sri Lankans also suffer from a high rate of train mishaps. However, the magnitude of the contribution of various types of injuries to disability is still not well documented in Sri Lanka.

Objective

This study assessed prevalence of physical disability due to injuries among adults in Kandy Municipal Council area (KMC) in Central Sri Lanka.

Design

A community-based descriptive cross sectional study.

Setting

KMC area in Kandy, Sri Lanka.

Participants

2 460 adults aged 18 to 59 years selected using cluster sampling.

Main outcome measurements

Physical disability was measured using a physical examination and World Health Organization Disability Assessment Schedule-Version II. An interviewer-administered questionnaire was used to reveal injury related data. Prevalence of physical disability due to injury and types of injuries were the main outcome measures.

Results

Prevalence of physical disability due to injuries was 0.6% (95% CI: 0.3–0.9). 13.6% (n=14) of physical disabilities were caused by injuries. Injuries reported included road traffic accidents (42.8%, n=6), falls (42.8%, n=6), war injuries (7.2%, n=1) and sports injuries (7.2%, n=1). Majority who underwent injuries were females (57.1%, n=8). There was no significant difference between males and females according to injury occurrence (P<.05).

Conclusion

A significant proportion of physical disabilities were due to injuries. A majority of injuries occurred due to road traffic accidents while sports injuries contributed least for physical disability in the community in Sri Lanka.
THE PREVALENCE OF PATELLAR TENDINOPATHY IN ELITE ACADEMY RUGBY; A CLINICAL AND IMAGING STUDY WITH 12 MONTH FOLLOW UP
Authors: Wilson F , Durcan L , McCarthy E , O'Shea B , Coole A , Webb M , Johnston C , Gissane C
Published: March 2014

Background

Patellar tendinopathy (PT) is a challenging condition with variable outcomes. Injuries that are traditionally associated with training volume such as tendinopathies are less frequently reported in rugby but are likely to increase as a result of more intensive training regimens.

Objective

To evaluate the prevalence of PT in elite academy rugby.

Design

Cross sectional, observational study with 12 month follow-up.

Setting

Elite/international division rugby.

Participants

All members of the academies of the rugby provinces (Munster, Leinster, Ulster and Connacht) of the Irish Rugby Football Union (IRFU) were invited (N=87) and 83 players participated in the study. Mean age was 20.4 years (1.48), with a mean of 11.9 years (2.8) experience.

Risk factor assessment

Anthropometrics, body mass, and fat % were measured by bio-impedance. Clinical examination investigated symptoms. Ultrasound examination established tendon thickness, echogenicity and homogeneity including focal areas of tendinopathy in both transverse and longitudinal planes. Statistical analysis was performed using PASW 18 and CIA software.

Main outcome measurements

The Cincinnati Sports Activity Scale, established activity levels. The VISA-P scale evaluated symptoms. Ultrasounds were reviewed and graded by two musculoskeletal radiologists.

Results

30 participants (36.1%) had US abnormalities with 38 abnormal tendons. The abnormalities were microcalculi (44.7%) (N=17), thickened tendons +/- large areas of cystic degenerative change (26.3%) and macrocalculi or large hypoechoic areas (28.9%) (N=11). Eleven participants (13.3%) fulfilled the clinical diagnosis of PT based on clinical examination. Combining both US and clinical exam, the prevalence of PT was 9.6% (N=8). There was a statistically significant difference between the prevalence of patellar tendinopathy based upon US findings (P=.027) and the combination of both clinical examination and US (P=.044) in different training academies. Twelve-month follow up data will be reported.

Conclusions

PT is a relatively common injury in elite academy rugby players and training practices may contribute to its development.
HIGH PREVALENCE OF OSTEOCHONDRAL AND SOFT-TISSUE DAMAGE IN THE ANKLES OF ASYMPTOMATIC PROFESSIONAL SNOWBOARDERS: A PROSPECTIVE EVALUATION WITH 3T MRI
Authors: Briggs K , Ho C , Ryan W , Bower G , Hackett T , Clanton T
Published: March 2014

Background

Professional snowboarders are exposed to repetitive high-impact loading on a daily basis throughout their competitive and training careers.

Objective

The purpose of this study was to determine the prevalence of ankle derangements on magnetic resonance imaging (MRI) in asymptomatic professional snowboarding athletes. We hypothesized that elite snowboarders with asymptomatic ankles would exhibit osteochondral and soft-tissue changes on 3T MRI.

Design

Between February and March 2013, professional snowboarders specializing in various disciplines were recruited to participate in the study. 3T MRIs of each ankle were obtained prospectively.

Setting

World Cup snowboarding competition.

Participants

Each participant underwent a physical examination of each ankle and completed a short survey including demographic, pain, and functional questions prior to MRI evaluation to ensure that each of the included ankles were truly asymptomatic. Sixteen professional snowboarders (29 asymptomatic ankles) were included in the study.

Risk factor assessment

A 3T MRI scan of each asymptomatic ankle was performed.

Main outcome measurements

The MRI findings were recorded by an experienced musuloskeletal radiologist.

Results

There were 9 males (16 ankles) and 7 females (13 ankles) with a mean age of 23.4 years (range, 18–31 years) who had been professional snowboarders for a median of 6.5 years (range, 2–15 years). It was found that all 29 ankles (100%) had notable derangements on 3T MRI scans including various ligamentous pathologies, tendinous pathologies, syndesmosis injuries, effusions, osteochondral injuries and bony edema. Increasing age and years of competitive snowboarding were significantly associated with chondral damage of the ankle (P=.017 and P=.026, respectively).

Conclusion

All 29 asymptomatic ankles in this study had notable derangements on MRI scans, signifying a potentially high prevalence of asymptomatic ankle pathology in elite snowboarding athletes. Recognition of these injuries is important to create future strategies for the prevention of long-term sequelae in this high-risk group.