bluuebunny/crossref_metadata_2025_split huggingface dataset:
A COMPARISON OF CALCANEAL BONE DENSITY IN COLLEGIATE ATHLETES AND NON-ATHLETES
Authors: Bennett Jason 
Published: August 2017

BackgroundLimited evidence exists regarding calcaneal bone mineral density (cBMD) and lower extremity overuse bone injury (LEOBI).ObjectiveDetermine if there is an association between LEOBI (stress fractures and MTSS) and cBMD.DesignProspective cohort design.SettingNCAA Division I University.Patients (or Participants)84 (64 females, 20 males) intercollegiate athletes and 103 (82 females, 21 males) non-athlete college students. Inclusion criteria: ≥18 years of age and no current lower extremity injury.Interventions (or Assessment of Risk Factors)In Phase I, athlete surveys regarding injury history and for females, menstrual history, and height and weight were measured. Athletes were followed for 9–10 months to identify the occurrence of LEOBI. In Phase II, non-athlete college students completed injury history, physical activity, and, for females, menstrual history surveys, and height and weight were measured.Main Outcome MeasurementscBMD was assessed using ultrasound densitometry. At the end of the study, athletes received a second cBMD measurement.ResultsIn Phase I, there was no difference in initial cBMD (p>0.05) between athletes with and without LEOBI, but there was a trend towards decreased cBMD in athletes with LEOBI. At the end of the study, right cBMD (p=0.05) and left cBMD (p=0.07) were lower in athletes with LEOBI. In Phase II, non-athletes had significantly lower bilateral cBMD (p=.000) and speed of sound (SOS) (p=0.000) than athletes. Sub-analysis revealed highly significant differences in SOS (p=0.000) and cBMD (p=0.000) for females (non-athletes vs. athletes). Being a female non-athlete was a significant risk factor for a negative cBMD T-score for both the right (RR=2.2, 95% CI=1.4–3.3) and left (RR=1.7, 95% CI=1.1–2.6).ConclusionsAthletes who did not experience LEOBI had significantly higher cBMD than non-athletes and athletes experiencing LEOBI. Future research should include larger sample sizes and adolescent subjects to identify influences on bone response to loading over time.
SHOULDER INJURIES IN TALENTED, COMPETITIVE SWIMMERS
Authors: van Dorssen Elsbeth , Stubbe Janine 
Published: August 2017

BackgroundShoulder injuries are common in swimmers. However, prevalence and risk factors for shoulder injuries in talented, competitive swimmers are unknown.ObjectiveTo gain insight in the prevalence and risk factors for shoulder injuries in talented swimmers.DesignA prospective cohort study was conducted.SettingTalented, Dutch swimmers, competing at National or International level, swimming at talent or training Centres of the Royal Dutch Swimming Federation.Patients (or Participants)128 swimmers were included at the start of the study. Five swimmers were excluded due to missing technique data, five swimmers quit their swimming career during the follow-up for different reasons than shoulder injuries. Data of the remaining 118 swimmers were included into the analyses.Interventions (or Assessment of Risk Factors)At baseline the following swimming technique was recorded during a 200 m race: 1. Maximal forward flexion in the shoulder joint during glide phase; 2. Crossing the vertical midline axis of the swimmers body with the hand during thrust-phase; 3. Dropped elbow (elbow at a lower level than line shoulder-wrist), at hand entry or early pull-through. Furthermore, online questionnaires were send to the participants on a two-weekly basis to record the time-loss shoulder injuries.Main Outcome MeasurementsA time-loss shoulder injury was defined as: ‘a shoulder complaint occurred as a result of participation in swimming practice or competition, resulted in the restriction of swimmers participation of at least 1 day’. Prevalence and incidence rates were calculated.ResultsIn total, 28,8% of the swimmers sustained a shoulder injury during 1 year. Chi-squared tests showed an association between crossing the midline during thrust-phase and shoulder injuries (p-value=0.03). No significant association was found between the two other swimming techniques and shoulder injuries.ConclusionsThe prevalence of shoulder injuries is high in talented, competitive swimmers. Crossing the midline during thrust-phase may be a risk factor in developing shoulder pain.
RISK FACTORS FOR INJURIES IN ELITE YOUTH TENNIS PLAYERS
Authors: van Mechelen Joost , Nauta Joske , Pluim Babette , Verhagen Evert 
Published: August 2017

BackgroundThe number of elite junior tennis players is growing. However, very little is known about the risk factors for injuries in this specific population.ObjectiveTo identify risk factors for musculoskeletal injuries in elite youth tennis players.DesignA prospective cohort study during the 2012–2013 Dutch tennis season.SettingElite youth players.ParticipantsPlayers were recruited from the Dutch national high-performance program during the pre-season intake. Seventy-three players agreed to participate (age range 11–14 years, 29 girls and 44 boys). All 73 players completed the entire follow-up period.Assessment of Risk FactorsAt baseline all players underwent a basic screening. Potential risk factors recorded included: (1) anthropometric data, (2) joint range of motion(ankle, hip, and shoulder), (3) pubertal stage, (4) current physical complaints.Main Outcome MeasurementsDuring the season, players reported physical complains on a weekly basis through the OSTRC injury questionnaire. The outcome of interest were the musculoskeletal injuries, subdivided into acute and overuse injuries.ResultsDuring the season, 113 musculoskeletal injuries were reported (78% overuse injuries). For acute injuries, no significant risk factors could be identified. Only pre-season complaints showed a borderline association with all acute injuries (HR 0.36 [95% CI 0.12–1.06], yes=1). When only considering lower extremities, a significant association between preseason complaints and injury at the lower extremity could be reported (HR 0.29 [95% CI 0.10–0.88], yes=1). Overuse injuries were significantly associated with total hours of sports participation (OR 7.15 [95% CI 1.32–38.98]) and wearing supportive insoles (OR 0.13 [95% CI 0.02–0.79], yes=1).ConclusionsPreseason complaints, total hours of sports participation and the use of supportive soles were the factors associated of injuries in elite youth tennis players. Gender, pubertal stage and range of motion were not found to be risk factors for tennis injuries.
REPRODUCIBILITY OF THE DRGONIOMETER APP IN NORDIC HAMSTRING TEST ASSESSMENT
Authors: Vercelli Stefano , Baldaccini Alex , Sartorio Francesco , Bravini Elisabetta , Ferriero Giorgio 
Published: August 2017

BackgroundThe break-point angle (BPA) obtained during the Nordic Hamstring Test (NHT) can be used for preventive purposes to identify individuals with low eccentric hamstring strength. Video analysis is the preferred standard method, but there lacks an easily accessible and highly reproducible method for field use.ObjectiveTo establish the reproducibility (reliability and agreement) of the smartphone application ‘DrGoniometer’ (DrG) for measuring BPA in healthy adults.DesignDiagnostic study.SettingClinical setting.Patients (or Participants)Five volunteers and four raters (two physiotherapists and two physiotherapy students).Interventions (or Assessment of Risk Factors)Ten NHT videos per subject were obtained by smartphone camera (total=50 videos). Raters independently measured the BPA, first using DrG app set in blind modality on two separate occasions (one week apart), then by standardized video analysis software on a PC.Main Outcome MeasurementsIntra- and inter-rater reliability of DrG was calculated with ICC(2,1)(95% IC). Longitudinal standard error of measurement (SEM) and inter-rater agreement within 5° and 10° were also calculated. The agreement of DrG with video analysis was expressed as 95% limits of agreement (LoA) with the Bland-Altman method.ResultsIntra- and inter-rater reliability of the DrG were excellent, with ICC=0.885 (95% IC=0.836–0.918) and .821 (95%IC=0.738–0.885), respectively. The SEM was 2°. All four raters had substantial inter-rater agreement within the limits of 5° (68% and 78%) and 10° (94% and 100%) for the DrG and video analysis methods, respectively. The agreement between the two methods was good, with 95% LoA equal to 13.4° (mean difference=1.0±6.7°).ConclusionsDrG proved to be a highly reproducible method for measuring the BPA in the NHT in healthy subjects. Given its wide availability, low cost, and ease of use, the DrG app can be considered a good resource for field-based BPA measurement.
EFFECTIVELY TRAINING PHYSICAL EDUCATION TEACHERS TO IMPLEMENT INJURY PREVENTIVE STRATEGIES INTO THEIR PE LESSONS
Authors: Vercruysse Sien 
Published: August 2017

BackgroundPhysical education teachers (PETs) can be effectively trained to implement injury preventive strategies into their own lives.1 However, to decrease negative effects of sports injuries in adolescents, injury prevention within this population is needed as well. Therefore, the current study trains PETs to implement injury preventive strategies both in their own lives and in their PE lessons.ObjectiveAim 1 was investigating whether an intervention can effectively improve PETs' injury preventive knowledge. Aim 2 was investigating whether the intervention led to more injury preventive implementation in PETs own extracurricular sporting activities. Aim 3 was investigating whether the intervention enhanced PET injury preventive implementation in their PE lessons.DesignAn RCT was conducted.SettingSecondary school PETs, active in second grade (14–16 years), were recruited.ParticipantsFourteen PETs were randomly assigned to either intervention (Mage 41.43±10.21) or control group (Mage 38.86±8.32). Per PET one of their classes of pupils from second grade was questioned (n=271).InterventionsAn effective injury prevention intervention1 was provided with adaptations for a more easily implementation in PE lessons.Main Outcome MeasurementsPET injury preventive knowledge, preventive behaviour in extracurricular sporting activities and during PE lessons were assessed at three different time points; before the intervention (pre), 4 (post) and 7 weeks (follow-up) after receiving the intervention. Pupils filled out a questionnaire on their PET injury preventive teaching behaviour (pre-post-follow-up).ResultsThe injury prevention intervention resulted in an improvement of PET injury preventive knowledge (F(10,2)=7.718, p=0.005), PET preventive behaviour in own extracurricular sporting activities (F(14,2)=4.105; p=0.047) and in their teaching behaviour towards the pupils in PE lessons (F(14,2)=3.147; p=0.061). Reports of pupils pointed in the same direction as the reports of PETs.ConclusionsThe intervention improved PET injury preventive knowledge and behaviour, both in their own lives as in their PE lessons.
THE FEASIBILITY OF A SPORTS PHYSICAL THERAPIST LED IMPLEMENTATION OF A PREVENTIVE TRAINING PROGRAM IN A DUTCH AMATEUR FOOTBALL CLUB
Authors: Verheul Maartje , Barendrecht Maarten 
Published: August 2017

BackgroundPreventive training programs are effective in reducing injury risk but the implementation of these programs on club level remains a challenge. The sports physical therapist (SPT) could play an important role in this process. The feasibility of a SPT led implementation process has not yet been investigated.ObjectiveTo investigate the feasibility of a SPT led implementation of a preventive warm-up program in a Dutch amateur football club.DesignImplementation study.SettingA Dutch amateur football club.Patients (or Participants)Club officials, trainers, coaches and athletes.Interventions (or Assessment of Risk Factors)SPT led implementation of the FIFA11+ warm-up program on all club levels in a Dutch amateur football club.Main Outcome MeasurementsTasks and time-management of the SPT. Effectiveness of different aspects of the implementation process using the RE-AIM framework.ResultsImportant tasks on sports medical subjects were the development of a training program adjusted to the context and the adopters, and yearly coach education (workshops and manuals). Management tasks consisted of the composition of an implementation team and plan, and the support of this team during the implementation process. Overall during the first season it took the SPT 50 hours to complete these tasks. After one season adoption (88.4%) and implementation (88.9%) on trainer level as well as maintenance on club level (>92%) were high.ConclusionsA SPT led implementation process of an injury prevention program in an amateur football club seems a feasible option to change club level policy and behaviour on injury prevention, in addition to implementation strategies on national level and in coach education. Prospective randomized trials are needed to investigate the additional effectiveness of such club level implementation.
KINETIC CHAIN RELATED RISK FACTORS FOR THE DEVELOPMENT OF LOWER EXTREMITY INJURIES IN WOMEN: A PROSPECTIVE STUDY
Authors: Verrelst Ruth , Tiggelen Damien Van , Ridder Roel De , Witvrouw Erik 
Published: August 2017

BackgroundAttention has turned to the role of the overall kinetic chain function within the development of lower extremity (LE) injury, however few longitudinal studies have been conducted so far.ObjectiveTo prospectively determine kinetic chain related risk factors for the development of lower extremity (LE) injury in women.DesignProspective cohort design.SettingDepartment of Physical Education at the University of Ghent, Belgium.ParticipantsNinety healthy, female physical education students aged 19.33±0.87 years were tested.Assessment of Risk FactorsKinematic and VGRF parameters were measured during a triple hop jump (THJ). Cox regression analysis was used to identify the kinetic chain related risk factors for the development of LE injury.Main Outcome MeasurementsThe LE injury follow-up was assessed using a weekly online questionnaire and a three-monthly retrospective control questionnaire. LE injury was diagnosed by an experienced medical doctor.ResultsThirty-five participants were diagnosed with a LE injury. The results of this study identified that in the sagittal plane, decreased dynamic range of motion (ROM) of the pelvis segment (P=0.043) and increased dynamic ROM of the knee and ankle joint (P=0.041 andP=0.028 respectively) during landing phase are predictive parameters for the development of LE injury in females. No VGRF parameters were found to be of predictive value.ConclusionsThe pattern of decreased ROM of the pelvis segment in the sagittal plane combined with increased ROM of knee and ankle joint in the sagittal plane during landing phase, can be seen as decreased ability of equally absorbing forces throughout the kinetic chain during the landing phase of the THJ, which might lead to LE injury.
AN ASSESSMENT OF CLINICAL JOINT AND LIMB MEASURES IN PROFESSIONAL FEMALE SOCCER PLAYERS: SCREENING TOOLS FOR INJURY PREVENTION?
Authors: Weaver Kristian , Relph Nicola 
Published: August 2017

BackgroundFemale soccer has only recently become a professional sport within the UK. The need for accurate and reliable screening and profiling of professional female soccer players could assist in the design of injury prevention programmes.ObjectiveTo evaluate the clinical joint and limb measures during a preseason screening process in professional female soccer players.DesignCross-sectional, descriptive study.SettingSports Therapy clinic.Participants32 professional UK-based female soccer players (aged 23±3.60, mass 62.41±6.37 kg, height 167±6.65 cm) participated in the study.Assessment of Risk FactorsRisk factors were assessed during the English Women's Super League preseason, January 2016. The independent variable was leg dominance.Main Outcome MeasurementsThe outcome measures were leg length, knee to wall distance, knee flexion and extension, hip flexion and extension, hip internal and external rotation ranges of motion (ROM), straight leg raise hip flexion angle from both dominant and non-dominant legs. A qualified and experienced Sports Therapist subjectively assessed and recorded joint ligament laxity at the knee and ankle.ResultsPaired T-Tests revealed significantly reduced ROM in the dominant side compared to the non-dominant side for both hip flexion (p=0.005) and hip internal rotation (p=0.021). However, all other ROM measurements demonstrated limb symmetry. The most notable findings from the subjective laxity measures was that 35.9% of players had ankle talar inversion laxity.ConclusionsReduced hip ROM in the dominant side of players may increase the risk of lower limb injury. It may be important to include hip flexibility training into pre-season injury prevention programmes for female soccer players to ensure lower limb symmetry. Furthermore, ankle strengthening, proprioception and single leg change of direction exercises may be included in training programmes due to the high prevalence of ankle laxity in this sample. Future studies should monitor these measurements across a season and correlate them with injury incidence.
UNDERSTANDING HOW CLINICIANS AND ATHLETES MAKE RETURN TO PLAY DECISIONS – TOWARDS PREVENTING RE INJURIES
Authors: Weir Adam , Wangensteen Arnlaug , Serner Andreas , Steele Russel J. , Shrier Ian 
Published: August 2017

BackgroundClinicians and athletes do not always agree when return to play (RTP) is advisable. A better understanding of how RTP decisions are made could help prevent re injury.ObjectiveTo describe and compare risk assessments from sport medicine physicians, physiotherapists and athletes during routine care of injured athletes, and to elicit if there were factors that influenced their risk tolerance.DesignFeasibility study to establish this method of examining the way athletes and clinicians make RTP decisions.SettingSpecialized orthopedic and sports medicine hospital in Doha, Qatar.PatientsWe recruited the physician, the physiotherapist, and the athlete they were caring for (“triplet”) to participate. Triplets were recruited from an acute groin injury study and an acute hamstring injury study. Of the 15 athletes approached, 5 were excluded because we obtained risk estimates from only 1 stakeholder. Of the remaining 10 cases, we obtained risk estimates from 7 triplets and 3 doublets.Outcome measuresParticipants provided their own estimated probability distribution for risk of re-injury within the subsequent 2 months after RTP, based on the available knowledge. In addition, we asked participants about factors that influenced their risk tolerance for the particular case.ResultsThe figure shows the risk estimations in 2 of the 10 cases, illustrating that there were clear and considerable differences in risk estimates.Figure 1Factors that modified risk tolerance in at least three participants were “timing and season”, “pressure from athlete” and “external pressure”. Overall, risk modifiers influenced the decision in 13 of 27 possible cases.ConclusionClinicians and athletes with access to the same information can have considerably different estimates for the risk of reinjury. Risk tolerance in the real world is sometimes modified by external factors.
WORKLOAD SPIKES COMBINED WITH HIGH CUMULATIVE LOAD IS ASSOCIATED WITH INCREASED INJURY RISK IN ELITE RUGBY SEVENS PLAYERS
Authors: West Stephen , Williams Sean , Cross Matthew , Howells Dan , Mobed Remi , Kemp Simon , Stokes Keith 
Published: August 2017

BackgroundMatch and training demands differ between seven and fifteen-a-side rugby. The association between training load and injury risk has not been examined in elite Rugby Sevens.ObjectiveTo explore the association between training load measures and injury risk in elite Rugby Sevens players.DesignTwo-season (2014/15 and 2015/16) prospective cohort study.SettingThe England men's Rugby Sevens squad.Participants42 players (31 players followed over one-season, 11 players over two-seasons).Assessment of Risk FactorsTraining loads were recorded for all sessions using the session-Rating of Perceived Exertion method. A generalised linear mixed effects model examined the association between training load measures and injury risk in the subsequent week. The acute:chronic workload variable (one-week load divided by four-week average load) was parsed into tertiles: low=<1.15; medium=1.15–1.45; high=>1.45.Main Outcome MeasurementsInjury and the relative risk (RR) associated with increases in training load measures.Results152 training and 30 match injuries were recorded. The incidence rate was 91/1000 player-match-hours (90% CI: 68–123) and 14/1000 player-training-hours (90% CI: 12–16). Mean severity (day's absence) of injuries was 31 days during matches and 21 days during training. There was a substantial interaction between four-week cumulative load and acute:chronic workloads, such that typically high versus typically low four-week cumulative loads (i.e., a 7140 AU difference) coupled with high acute:chronic workloads were clearly associated with injury risk (RR: 2.08, 90% CI 1.17–3.68). This effect was unclear in the low (RR: 1.02, 90% CI: 0.62–1.68) and medium (RR: 1.44, 90% CI: 0.81–2.55) acute:chronic workload ranges.ConclusionsThe injury incidence rate in elite Rugby Sevens training is substantially higher than in the 15-a-side game. The coupling of high cumulative loads with high acute:chronic workloads was associated with an increased injury risk, therefore practitioners should avoid high acute:chronic workloads during periods of high cumulative load.
THE USE OF NON-STEROIDAL ANTI-INFLAMMATORIES (NSAIDS) AT THE 2016 LONDON MARATHON
Authors: Whatmough Steven , Mears Stephen , Kipps Courtney 
Published: August 2017

BackgroundNon-steroidal Anti-Inflammatories (NSAID) used during exercise are associated with medical risks. Such risks include gastric side effects and renal side effects (Kusteret al, 2013). More specifically NSAIDs are implicated in the development of exercise-associated hyponatremia (Hew-Butleret al, 2015)).ObjectiveTo identify the incidence of NSAID use in runners at the 2016 London Marathon.DesignThis study will take the form of a prospective observational study.SettingThe 2016 London Marathon.ParticipantsParticipants were recruited during the marathon registration. 109 runners completed the questionnaire. In addition, a subset of 41 runners completed an immediate pre-race questionnaire on the morning of the race, of which 28 were followed up after crossing the finish line.Independent VariablesOnline and printed medical advice was available to all race participants. This included advice to refrain from using NSAIDs before and during the race was provided.Main Outcome MeasuresPlanned NSAID use, actual NSAID use and awareness of safe doses and NSAID risks.Results50 (45.9%) of the registration cohort planned to take an NSAID during the marathon. Of the athletes returning for data collection at the start line, 14 (34.1%) had already consumed an NSAID on the morning of the marathon. At the finish line, 16 of the 28 (57.1%) of athletes completing the study had consumed an NSAID. Seven runners had taken over the recommended dose of NSAID during the marathon. 13 (46%) correctly stated the risks of taking an NSAIDs, whilst only 10 (35%) were aware of the correct safe dose.ConclusionsNSAID use by runners during the marathon remains high despite published medical guidance advising against its use. Overdose of NSAIDs is a concern as it carries increased risks. A lack of awareness of the risks of taking NSAIDs may contribute towards these findings.