bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEUROMUSCULAR CONTROL ADAPTATIONS TO BALANCE TRAINING: A SYSTEMATIC REVIEW
Authors: Sato Sheila Miho 
Published: August 2017

BackgroundBalance training (BT) programs seem to be appropriate for non-athletes and athletes, but the use of multi-intervention BT protocols make difficult to observe how balance exercises improve neuromuscular control.ObjectiveThe purpose of this study is to evaluate the current knowledge regarding the neuromuscular control adaptations in healthy participants following a BT protocol with exclusively balance exercises.DesignSystematic review.SettingRandomised controlled trials and controlled clinical trials.Patients (or Participants)Healthy and physically active participants.Interventions (or Assessment of Risk Factors)The methodological quality and risk of bias were assessed using a modified Downs and Black checklist.Main Outcome MeasurementsThe primary outcome is the measurements of electromyography (EMG) activity, like the rate of muscle activation, H-reflex, and M-wave.ResultsThere were inconsistent findings regarding neuromuscular control outcomes. In relation to muscular activity observed by EMG signs, there was no change in the majority of the studies. However, one study reported a decrease in EMG activity for plantar flexors, and two studies observed an increase in muscular activity for soleus, gastrocnemius medialis, and quadriceps muscles after BT. Concerning H-reflex/M-wave ratio of the soleus muscle, two studies observed no change, while three studies reported significant reduction. Also, the reduction observed in the H-reflex/M-wave ratio was associated with a decrease of the maximal H-reflex and no change of the maximal W-wave. Following BT, the rate of force development normalized by maximum voluntary contraction (MVC) had a transient increase for plantar flexors and leg extensors. Although some authors reported a slight enhancement or no improvement on isometric MVC for plantar flexors, leg extensors, quadriceps, and hamstrings muscles.ConclusionsDespite the moderate level of proof for neuromuscular control enhancement following BT, adaptations in neuromuscular control remain a significant factor to determine an appropriate exercise that would improve specific athletic performance.
PROXIMAL NEUROMUSCULAR CONTROL PROTECTS AGAINST HAMSTRING INJURY IN MALE FOOTBALL PLAYERS: A PROSPECTIVE STUDY WITH EMG TIME-SERIES ANALYSIS DURING MAXIMAL SPRINTING
Authors: Schuermans Joke , Danneels Lieven , Tiggelen Damien Van , Palmans Tanneke , Witvrouw Erik 
Published: August 2017

BackgroundHamstring injuries remain a substantial problem in male football. Proximal neuromuscular control (‘core stability’) is considered to be of key importance in hamstring injury prevention, although scientific evidence regarding the exact nature of the core-hamstring association is non-existing at present.ObjectiveTo investigate whether core muscle activation patterns during sprinting are associated with hamstring injury risk.DesignCohort study.SettingAmateur football division.Participants60 male football players with no recent history of hamstring injury were recruited for the multi-muscle EMG time series analysis during sprint.AssessmentHamstring-, gluteal and trunk muscle activity time-series during the airborne- and stance phases of over-ground sprint acceleration were collected prior to follow up (1.5 seasons).Main Outcome MeasurementsEMG signals of the above-mentioned muscles were processed and explored in function of (1) the time within the running cycle and (2) injury occurrence during follow up.ResultsPlayers that remained injury free, presented significantly higher amounts of gluteal muscle activity during the front swing phase (p=0.018), and higher amounts of trunk muscle activity during the backswing phase of sprinting (p=0.0011). In particular, the risk of sustaining a hamstring injury during follow up lowered 87% and 46%, with each increment in normalized muscle activity of the Gluteus Maximus during front swing and the trunk muscles during backswing, respectively (p<0.02).ConclusionsMuscle activity of the proximal core unit during explosive running presented to be associated with hamstring injury occurrence. Higher amounts of gluteal – and trunk muscle activity during the airborne phases of sprinting were able to protect participants against injury during follow up. Hence, the present results provide a basis for improved, evidence based, rehabilitation and prevention, particularly focusing on increasing neuromuscular control of the gluts and trunk muscle during sport specific activities (eg. sprint drills, agility drills).
THE INCIDENCE OF ILLNESS DECREASES OVER A 6-YEAR PERIOD DURING THE SUPER RUGBY TOURNAMENTS: A PROSPECTIVE COHORT STUDY INVOLVING 96 959 PLAYER DAYS
Authors: Schwellnus Martin , van Rensburg Audrey Jansen , van Rensburg Dina Christina Janse , van Rensburg Charl Janse , Jordaan Esme , Derman Wayne , Readhead Clint 
Published: August 2017

BackgroundIllness accounts for a significant proportion of consultations with team physicians. Furthermore, intercontinental travel is a risk factor for illness in teams participating in the annual 16-week Super Rugby Tournament.ObjectiveTo determine if the incidence of illness in players participating in the Super Rugby Tournaments changed after illness prevention strategies were recommended before the 2013 tournament.DesignProspective cohort study.SettingSuper Rugby Tournaments from 2010 to 2015 (6-year period).ParticipantsElite rugby players from five South African Super Rugby teams (average squad size=30 players).AssessmentParticipating teams and players were followed daily during the ≈16 week competition period for 6 years (96 959 player days). Team physicians recorded daily squad size and completed a daily illness log using an online injury and illness registration system (100% compliance). Following data analysis of the 2010 tournament resulting in two publications in 2012, recommendations to prevent illness were introduced before the 2013 tournament. Furthermore, in 2014, detailed written illness prevention guidelines were distributed to all team physicians.Main Outcome MeasurementsIncidence of illness (illness per 1000 player days).ResultsThe incidence of illness (per 1000 player days; 95% CI) for each year was as follows: 2010 (14.3; 12.2–16.8), 2011 (12.2; 10.3–14.3), 2012 (12.4; 10.6–14.3), 2013 (4.8; 3.8–5.9), 2014 (6.5; 5.3–7.9) and 2015 (6.1; 5.1–7.2). The incidence of all illness in the period 2013 to 2015 was significantly lower in each year compared to the incidence of illness in each year during the period 2010 to 2012.ConclusionsIn this 6-year prospective cohort study, there was a significant reduction in the incidence of illness in the years following the publication of illness data in 2012. We suggest that the illness prevention recommendations, introduced from 2013, could account for this reduction in illness incidence.
A DOWNWARD HEAD POSTURE LEADS TO HIGHER CERVICAL SPINE LOADING DURING HEAD-FIRST IMPACTS IN SIMULATED RUGBY TACKLES
Authors: Seminati Elena , Preatoni Ezio , Trewartha Grant , Stokes Keith , Williams Sean , Cazzola Dario 
Published: August 2017

BackgroundA rugby tackle is an open and unpredictable event, which can lead to intentional or unintentional head-first impacts rather than the preferred ‘shoulder first’ technique.ObjectiveTo identify the effect of head-neck orientation as well as collision speed on the loads experienced at the upper cervical spine and the relevance in terms of injury risk from head-first impacts.DesignRepeated ‘tackles’ were simulated using a 40 kg punch bag (simulated ball carrier) making contact against a fixed instrumented head and neck anthropometric test device (ATD).SettingBiomechanics laboratory.Patients (or Participants)A single head-neck ATD was used to complete all the trials.Interventions (or Assessment of Risk Factors)10 repetitions were recorded in each of two speed ranges (low and high) and 3 ATD sagittal plane orientations (head-up [+20°], neutral [0°], and head-down [-20°]), 60 trials in total.Main Outcome MeasurementsForces experienced at the equivalent of the C1 vertebra were measured by a load cell at the head joint of the ATD. ANCOVA (covariate=punch bag speed) and effect sizes were used to assess differences between tackle conditions.ResultsLow speed (2.34±0.18 m/s) tackles resulted in 37% lower peak impact forces compared with high speed (3.43±0.17 m/s) tackles. Total force on neck acted in multiple directions (75% in compression; magnitude of total force was 2.37±0.18 kN in neutral high speed condition) and it was substantially higher in the head-down orientation compared with the neutral (13%) and head-up orientation (17%).ConclusionsOur findings support the idea that: 1) collision speed during a tackle affects the load experienced by the head-neck structures; 2) a neutral or head-up orientation of the head is preferred to a head-down orientation in the event of head-first impacts during simulated rugby tackle, which aligns with current Rugby Union coaching recommendations.
RISK FACTORS FOR NON-CONTACT ANTERIOR CRUCIATE LIGAMENT INJURY IN JAPANESE FEMALE HIGH SCHOOL BASKETBALL AND HANDBALL PLAYERS. A PROSPECTIVE THREE-YEAR COHORT STUDY
Authors: Shima Yosuke , Nakase Junsuke , Kitaoka Katsuhiko , Numata Hitoaki , Oshima Takeshi , Takata Yasushi , Kobayashi Takashi , Tsuchiya Hiroyuki 
Published: August 2017

BackgroundMany studies have explored the risk factors for noncontact anterior cruciate ligament (ACL) injuries.ObjectiveTo prospectively evaluate risk factors for noncontact ACL injury in Japanese female high school basketball and handball players. We hypothesized those female high-school athletes suffering non-contact ACL injuries would demonstrate weaker hip abductor and knee flexor muscle strength, when compared to those without injury.DesignProspective cohort study.Setting & ParticipantsA 3-year prospective cohort study was conducted using 317, 15-year-old high school female athletes between 2009 and 2014. At baseline, they underwent detailed examinations for various parameters that were documented at their first-year of high school.Assessment of Risk FactorsThe parameters assessed were height, weight, body mass index, general joint laxity, navicular drop measurement, anterior laxity of the knee, and angle of femoral anteversion, and strength assessment included knee extensor/flexor muscle strength and hip abductor strength. All ACL injuries that occurred during these 3 years were recorded. The parameters were compared using the Studentt-test. Parameters with P values<0.2 were considered independent variables by logistic regression analysis (simultaneous). The level of significance for all statistical analyses was set at α=0.05.ResultsOf the 317 players, 27 were excluded because they either had a history of ACL injury or could not complete the study. A total of 30 ACL tears occurred. Three of the ACL injuries were contact injuries, whereas the remaining 27 were noncontact ACL injuries. Muscle strength of hip abduction (P=0.001, 95% CI, 1.793–67.534) and femoral anteversion (P=0.037, 95% CI, 0.759–0.991) were found to be independent risk factors in logistic regression analysis.ConclusionsWe found that increased hip abductor muscle strength and decreased femoral anteversion were risk factors for noncontact ACL injury. However, there was only a little difference.
WHAT DOES RETURN TO PRE-INJURY RISK MEAN?
Authors: Shrier Ian , Zhao Meng , Piché Alexandre , Slavchev Pavel , Steele Russell J. 
Published: August 2017

BackgroundPrevious injury is the strongest predictor of subsequent injury. Some authors suggest injury always causes permanent structural damage, or that rehabilitation programs are grossly inadequate.ObjectiveTo describe the limitations of commonly used analyses assessing subsequent injury risk, and to explicitly define what “100% effective rehabilitation” means.DesignSimulated studies based on observed data professional sport and performing arts.SettingSimulations were conducted with 100% rehabilitation post first injury (return to pre-injury state), in contexts where injury risk was stable over the season, and increased over the season.Patients (or Participants)Simulated data.Interventions (or Assessment of Risk Factors)The main independent variables are previous injury, time of first injury, and position. We included “participant” as a random effect.Main Outcome MeasurementsInjury risk expressed as injuries per games played.ResultsWhen our simulated data with 100% effective rehabilitation was based on constant injury risk during the season, traditional analyses found that previous injury was still strongly associated with subsequent injury. A causal analysis that included the participant as a random effect correctly showed that the injury risk for participants remained constant. When injury risk increased over the season, the traditional analysis found that previous injury was even more strongly associated with subsequent injury. A causal analysis that only included the participant as a random effect also suggested a higher injury risk. However, when the appropriate control group was chosen for comparison, the causal analysis correctly illustrated that pre-injury risk did not increase following an initial injury.ConclusionsConclusions about the effectiveness of rehabilitation programs using traditional risk factor analysis will always show an increased risk of subsequent injury even if none exists. A causal analytical approach correctly identifies when the risk is present, but requires careful consideration about what is the appropriate control group for the given question.
THE INCIDENCE OF SWIMMING-INDUCED PULMONARY OEDEMA DURING MASS-PARTICIPATION TRIATHLON RACES: OPTIMISING ATHLETE SAFETY
Authors: Smith Ralph , Parkin James , Knight Nick , Kipps Courtney 
Published: August 2017

BackgroundSwimming Induced Pulmonary Edema (SIPE) is life-threatening condition that can affect healthy triathletes. There have been several reported cases amongst triathletes, however the current estimation of incidence is derived from a survey of triathletes with self-reported symptoms suggestive of SIPE.ObjectiveTo investigate the incidence of SIPE and associated risk factors in mass participation Triathlon Competitions (TC).DesignA retrospective analysis of Competitors' Medical Records (CMR).Setting11 consecutive UK-based TCs between 2011 and 2016. The competitions involved elite and non-elite competitors who raced Super Sprint, Sprint, Olympic and Olympic Plus distances.ParticipantsCMR of patients presenting to Triathlon Medical Team (TMT) with medical complaints/injuries were analysed. Those diagnosed with SIPE were included. Diagnostic criteria included absence of water aspiration, acute onset of dyspnoea, cough and/or expectoration of frothy sputum, with evidence of pulmonary oedema on physical examination.Assessment of Risk FactorsPatients' Age, gender, race distance, co-morbidities and medical management were recorded.Main Outcome MeasurementsThe incidence of SIPE in TCs.Results68557 competitors started the TCs and 429 competitors presented to the TMT. Five case of SIPE were recorded, giving rise to an incidence of 0.73/10,000 competitors and 1.2% of all presentations to the TMT. Mean age was 42 (21–58) and a third were female. All were non-elite athletes competing in a variety of race distances; one patient had pre-existing cardiac comorbidities; and in 3 cases participants were competing in their first triathlon. All required supplementary oxygen and transfer to hospital for definitive management.ConclusionThis report is the first to describe the incidence of SIPE in mass participation triathlon competitions. Event organisers and TMTs should be prepared for competitors developing SIPE which appears not to be bound by age, gender, race distance or co-morbidities. Further research is required to identity those who are at risk of SIPE.
NO ASSOCIATION BETWEEN STATIC AND DYNAMIC POSTURAL CONTROL AND ACL INJURY RISK AMONG FEMALE ELITE HANDBALL AND FOOTBALL PLAYERS
Authors: Steffen Kathrin , Nilstad Agnethe , Krosshaug Tron , Pasanen Kati , Bahr Roald 
Published: August 2017

BackgroundLittle research exists quantifying balance measures as potential risk factors for ACL injury.ObjectiveTo assess whether static and dynamic postural control were associated with an increased risk for ACL injury in female elite handball and football players.DesignProspective cohort study.ParticipantsFrom 2007 through 2015, 838 female premier league players participated in pre-season testing and were prospectively followed for ACL injury risk.Assessment of risk factors and main outcome measuresAt baseline, we recorded player demographics, playing experience, ACL and ankle injury history. We measured the mean velocity of COP in medio-lateral (ML) and anterior-posterior (AP) directions (mm/s), as well as the area of the 95% confidence ellipse area (mm2). We used the Star Excursion Balance Test to measure anteromedial, medial and posteromedial reach directions (cm). To examine the stability of postural control measures over time, we examined long-term and short-term reproducibility. We followed a pre-defined statistical protocol with logistic regression models, one for each of the proposed risk factors.ResultsA total of 55 (6.6%) players (age: 20±4 yrs; height: 171±7 cm; body mass: 68±9 kg) sustained a non-contact ACL injury after baseline testing (1.8±1.8 yrs). When comparing height and leg-length normalized balance measures between injured and uninjured players in univariate analyses, none of the variables were statistically associated with an increased risk of ACL rupture. Short- and long-term reproducibility of the selected variables was poor. Players with a previous ACL injury had a 3-fold higher risk of sustaining a new ACL injury compared to previously uninjured players (OR 2.9, CI 1.4 to 5.7).ConclusionsNone of the static and dynamic postural control measures examined were associated with increased ACL injury risk among female elite handball and football players. Hence, the variables included in the current investigation cannot be used to predict injury risk.
INJURY PREVENTION IN YOUNG ATHLETES: INFLUENCE OF PREVENTION-SUPERVISION ON COMPLIANCE
Authors: Stoll Josefine , Mueller Juliane , Mueller Steffen , Cassel Michael , Mayer Frank 
Published: August 2017

BackgroundPrevention programs are reducing the risk of injuries. The success of these programs is dependent on a high compliance. However, it is unclear which kind of supervision lead to a high compliance in young athletes.ObjectiveTo compare the influence of different kinds of prevention-supervision during prevention training on compliance in young athletes.DesignControlled trial.SettingUniversity Potsdam, Medical Examination Center of the German Olympic Sports Federation.Patients (or Participants)173 young athletes (m/f: 108/68; 13.4±0.4 yrs, 164.±58.6 cm, 52.3±9.0 kg) from different sports were included.Interventions (or Assessment of Risk Factors)Athletes participated in a back pain prevention program (duration: 45 weeks; 4 exercises, 3 times/week, progression every 15 weeks). Following the initial introduction to the program, athletes were divided into 3 groups (G1: N=30; G2: N=54; G3: N=89). In G1 the coach, in G2 the coach and the athlete was responsible to execute the prevention program. In addition to G2, a therapist supervised the program once per week in G3. The number of prevention sessions was documented (paper & pencil) by coach (G1), athlete (G2) and athlete/therapist (G3).Main Outcome MeasurementsThe number of response per athlete (documented sessions) and the training-sessions per week was analysed. Data are presented descriptively followed by analysis of group differences (ANOVA; post-hoc Tukey, α =0.05).ResultsAll athletes in G1 responded and documented the training-session/week with a frequency of 2.0±0.4 sessions/week. In G2 53 athletes (2.5±0.7 sessions/week) and in G3 75 athletes (2.7±0.8 sessions/week) responded. Statistically significant differences could be shown between G1 and G2 (p=0.0005) and between G1 and G3 (p=0.058). There were no group differences between G2 and G3 (p=0.15).ConclusionsFor a targeted high compliance in prevention training, a supervised implementation seems necessary. Good teamwork between coach, athlete and therapist seems to be mandatory. A personal responsibility of the athlete is relevant.
IN-SEASON ARCHITECTURAL ADAPTATIONS OF THE BICEPS FEMORIS LONG HEAD IN ELITE AUSTRALIAN FOOTBALLERS
Authors: Timmins Ryan , Bourne Matthew , Williams Morgan , Opar David 
Published: August 2017

BackgroundHamstring strain injuries (HSI) are the predominant injury in the elite Australian Football League (AFL). Athletes who possess short biceps femoris long head (BFlh) fascicle lengths have an increased risk of future HSI than those who have longer fascicles. Fascicle length can be altered following interventions, however it is unknown what alterations occur in-season. It is also unknown if this may differ between those with and without a history of HSI.ObjectiveDetermine what architectural changes occur during an AFL season. Identify if these changes are different between those with and without a history of HSI.DesignCross-sectional retrospective injury study.SettingElite Australian Football.ParticipantsThirty elite AFL players with (n=12) and without (n=18) a unilateral history of HSI.Assessment of Risk FactorsBFlh architecture was assessed once a month on six separate occasions during the 2016 AFL season using two-dimensional ultrasound.Main Outcome MeasurementsBFlh fascicle length.ResultsLimbs with a history of HSI possess shorter fascicles than previously uninjured limbs at the start and throughout the season. From time point 1 to time point 2, previously injured BFlh fascicle lengths did not significantly change (p=0.247,d=0.23), whilst the contralateral uninjured BFlh(p=0.009,d=0.56) and athletes with no history of injury (p=0.002,d=0.75), significantly increased BFlh fascicle length. All athletes, independent of injury history, had a significant reduction in fascicle length at time point 6 compared to time point 2.ConclusionsFascicle lengths of BFlh vary across the in-season period in elite AFL players and the extent of these alterations appears to be influenced somewhat by HSI history. However, independent of injury history, there was a gradual decay in fascicle length as the season progresses.