bluuebunny/crossref_metadata_2025_split huggingface dataset:
THERE'S AN APP FOR THAT: RELIABILITY OF AN IPHONE APP TO ASSESS UPPER EXTREMITY PROPRIOCEPTION AND STABILITY
Authors: Lynch James , Smith Keeley , Patel Vrund , Luchan Kayla 
Published: August 2017

BackgroundThe ability to maintain joint stability and motion control of the extremities is important in injury prevention and recovery. Quantitative measurement of proprioception, especially the upper extremity, is difficult and requires expensive equipment.ObjectiveWe investigated the reliability of a custom iPhone app to compile accelerometer data and calculate a path length of movement during 20 second trials.DesignThis study used a prospective test-retest design. Subjects completed three trials on each upper extremity (RA and LA) 48 hours apart (MWF). A convenience sample of subjects was used.SettingThe study was conducted at a small liberal arts undergraduate institution.Patients (or Participants)Subjects were students associated with exercise science or athletic training programs. The activity level ranged from recreational athlete to NCAA Division II athletes. Twenty-three subjects started with 15 completing all upper extremity trials. Exclusion criterion was an upper extremity injury in the last month.Interventions (or Assessment of Risk Factors)An iPhone 6 app was developed to utilize accelerometer data in a Cartesian grid. Data was obtained at 20 Hz to calculate a path length of motion for each trial. Each subject stood, holding the iPhone in the palm of the hand directly in front of the shoulder with palm up, attempting to minimize motion for 20 seconds.Main Outcome MeasurementsReliability measures were calculated between trials using the path length of motion in each trial.ResultsThe mean path length for RA was 2669 with a standard error of 372, with LA being 2774 and 424. The intraclass correlation coefficient was 0.86 for the right arm and 0.74 for the left across three trials.ConclusionsThe accelerometer in an iPhone 6 is a moderately reliable instrument for assessing motion control stability in the upper extremity. We plan to add additional data filtering to the app.
JUMPER'S KNEE: A PROSPECTIVE EVALUATION OF RISK FACTORS IN VOLLEYBALL PLAYERS USING AN OVERUSE MEASURE OF INJURY
Authors: MacDonald Kerry , Palacios-Derflingher Luz , Kenny Sarah , Emery Carolyn , Meeuwisse Willem H. 
Published: August 2017

BackgroundA multitude of risk factors have been reported to increase an athlete's risk of developing jumper's knee. An overuse injury definition has been cited as more sensitive in capturing knee injuries when compared to a time-loss injury definition. To date, risk factors for jumper's knee have not been assessed for the development of knee problems captured by an overuse injury definition.ObjectiveTo assess a multitude of potential intrinsic risk factors for jumper's knee in volleyball players.DesignProspective Cohort.SettingCollegiate and national team training facilities.Patients (or Participants)Sixty elite adult male volleyball players were recruited from collegiate and national team programs in Canada.Interventions (or Assessment of Risk Factors)Participants completed risk factor assessments at the commencement of the season including: vertical jump ability (cm), weight bearing ankle dorsiflexion range (degrees), dynamic balance (cm), dynamic knee alignment (degrees) and landing mechanics (degrees).Main Outcome MeasurementsSelf-reporting knee problems utilizing an overuse injury questionnaire collected via short message service (SMS) was completed prospectively over one season. Substantial knee problems were identified and logistic regression was used to estimate odds ratios for each risk factor independently.ResultsThe season prevalence of knee problems was 75.0% (95% CI: 62.2 to 84.6) and the incidence proportion of those rated as substantial was 30.0% (95% CI: 19.5 to 43.1). The SMS system of tracking overuse injuries demonstrated 98.2% completeness. No single risk factor was found to predict substantial knee problems. All odds ratios were close to unity with narrow confidence intervals (0.91–1.07) and p>0.05.ConclusionsA more sensitive capture of overuse knee injuries did not result in the identification of distinct risk factors for the development of jumper's knee. These findings bring question to the utility of field based pre-season risk factor assessment for the identification of at risk athletes.
IS SHOE DROP A KEY FACTOR FOR INJURY PREVENTION IN RUNNING? PART 1: AN RCT ON INJURY RISK
Authors: Malisoux Laurent , Chambon Nicolas , Urhausen Axel , Theisen Daniel 
Published: August 2017

BackgroundModern running shoes come in variable heel-to-toe drops, but it is currently unknown if this feature plays a role in the prevention of injuries.ObjectiveTo determine if the drop of conventional cushioned running shoes influences injury risk and whether running regularity (>6 months of regular practice over the previous year) modifies this association.DesignDouble-blind randomised controlled trial, with a 6-month follow-up.SettingLeisure-time distance runners.ParticipantsStudy participants (n=553) were recruited via advertisements in local newspapers. They were required to report any running activity, sport practice and injury using a dedicated internet platform.InterventionRunning shoes with a drop of 10 mm (D10, n=176), 6 mm (D6, n=190) or 0 mm (D0, n=187). Apart from the shoe drop, the 3 versions were strictly identical. A stratified analysis was conducted according to the participants' running regularity.Main Outcome MeasurementsFirst running-related injury self-reported by the participants, and systematically verified by email or phone call. Cox regression analyses were used to compare injury risk between exposure groups.Results136 of the participants (25%) sustained at least one injury. The proportion of injured participants were 21.6%, 27.4% and 24.6% in the D10, D6 and D0 groups, respectively. The overall injury risk was not different among the participants who had received the D6 version (hazard rate ratios – HR=1.30; 95% confidence intervals −95% CI=0.86–1.98) or the D0 version (HR=1.17; 95% CI=0.76–1.80) when compared to the conventional D10 version. The stratified analysis revealed that low drop shoes (D6 and D0 grouped together) were associated with a lower injury risk in occasional runners (HR=0.48; 95% CI=0.23–0.98), and with a higher injury risk in regular runners (HR=1.67; 95% CI=1.07–2.62).ConclusionsOverall, injury risk was not influenced by the drop of conventional cushioned running shoes, yet this association may be modified by the runner's profile.
CONGENITAL HEART DISEASES AND SPORT ACTIVITY: AN OBSERVATIONAL STUDY
Authors: Rosselli Martina , Toncelli Loira , Giannelli Chiara , Mascherini Gabriele , Galanti Giorgio 
Published: August 2017

BackgroundRegular physical activity promotes the cardiovascular fitness and the physical and psychological health. However, exercise can acutely increase the cardiovascular risk in athletes with congenital and acquired heart disease. In Italy, pre-participation cardiovascular screening to obtain eligibility is mandatory for both agonistic and non-agonistic sports, whereas in the United States it is not requested.ObjectiveIn this study, we aimed at investigating the clinical characteristics of subjects with congenital heart diseases who requested the judgment of eligibility to sport practice at the Sport Medicine Center, University of Florence.ParticipantsOver the period 2010–2016 approximately 3000 athletes aged 6–50 year-old per year underwent eligibility visits at our Center. We found 227 patients with Congenital Heart Disease.InterventionsThe eligibility visits included an accurate familiar and personal history and physical examination, basal ECG interpretation, Stress Test with treadmill or cycle-ergometer and basal echocardiography. The stress echocardiography can be especially helpful in athletes with cardiovascular disease, evaluating directly the effect of physical effort on heart by ultrasound.Main Outcome MeasurementsWe considered age and sex, the presence of cardiovascular risk factors or familiarity for cardiovascular, the type of congenital disease, the type of sport and the ECG/echocardiography findings.ResultsOver the period 2010–2016 we assessed 227 athletes with congenital heart diseases, most of which were Bicuspid aortic valve (n=94), Ventricular Septal Defect (n=43); Atrial Septal Defect (n=27), Pulmonary Stenosis (n=15), Patent Ductus Arteriosus (n=14). The median age was 23.4 years (M/F=176/51).ConclusionsWe found a remarkable amount of patients with congenital heart disease who apply to obtain the judgement of fitness to practice sport. We are evaluating the data and deepening the study to comprehensively assess the demographical and clinical characteristics of these subjects and to evaluate the predictors of eligibility to sport practice in safety.
I WAS AN ACROBAT. AM I IN PAIN?
Authors: Martins Úrsula , Cunha João , França Lourenço , Amaro João , Gomes Joana , Aguiar Branco Catarina 
Published: August 2017

BackgroundAcrobatic Gymnastics is a competitive discipline where gymnasts work together, perform acrobatic moves, dance and tumbling.ObjectiveInvestigate the prevalence of musculoskeletal (MS) disorders in former gymnasts.DesignSurvey of MS disorders (past and present), sent to former gymnasts.SettingThis study included former gymnasts.ParticipantsRetired gymnasts of national teams (n=200) and clubs (n=390) from all over the world (16 countries, 4 continents); 612 responders, 590 included according to the inclusion criteria.InterventionsThe survey included questions on country, gender, position, years of practice, hours of training/week and competition level, as well as medical information: reason for stopping practice (medical/nonmedical, specify the problem), injuries during practice years, present impact in daily life.Main Outcome MeasurementsProportion (%) who stopped practicing as a consequence of a serious MS injury. Proportion (%) having any current MS disorder. Pre-specified analysis of relationship between training hours/week, competition level, position and % with current MS disorders in the present.ResultsOf 590 gymnasts, 294 (50%) reported having suffered a training injury, while 166 (28%) reported still having current medical problems as result of these. A total of 131 gymnasts (22%) reported having stopped practicing because of a medical problem and 121 (21%) reported having a current MS disorder. The most common injury was a traumatic fracture (n=125), most commonly affecting the knee (n=74) and ankle/foot (n=73). As a consequence of the training period, the most common current problems were spine pathology (n=43) and tendinopathies(n=38). Concerning actual symptoms, 402 (68%) reported low back pain, 320 (54%) knee and 219 (37%) shoulder disorders.ConclusionsThis is the first study of former gymnasts, allowing us to evaluate the impact of training on the future life quality of the athletes, to identify the most frequent injuries, as well as those with the greatest impact. This may lead to improvements in the treatment of acute injuries, as well as to monitor the level and quality of training, to prevent and also to rehabilitate injuries.
THE RISK FACTORS OF 5TH METATARSAL STRESS FRACTURE IN FOOTBALL PLAYERS
Authors: Matsuda Sho , Hirose Norikazu , Fukubayashi Toru 
Published: August 2017

BackgroundNo firm consensus has been established regarding the risk factors for stress fracture of the 5th metatarsal because of a lack of large-scale prospective studies.ObjectiveThe purpose of this study was to clarify the risk factors for a stress fracture of the 5th metatarsal.DesignCohort study.SettingProspective study with well-trained varsity players.ParticipantsOne hundred and sixty healthy collegiate male football (soccer) players.Assessment of Risk FactorsThe medial lateral arch ratio of the foot, leg-heel alignment with weight-bearing (WLHA), LHA without weight-bearing (NLHA), relative angle of the forefoot to the hindfoot (FA-H), and plantar pressure during the heel raise position were measured. Rearfoot and forefoot alignment were evaluated from images using Image J. The plantar pressure distribution was measured using a plate-type lower limb GP-6000 weighted meter and pressure distribution-measuring MD-1000 device from Anima Co., Ltd.Main Outcome MeasurementsThe measurements from players who were diagnosed with a stress fracture of the 5th metatarsal were compared with the measurements from non-injured players.ResultsFour players were diagnosed with a stress fracture of the 5th metatarsal. The arch ratio, WLHA, and FA-R of the injured players were higher than those of the non-injured players (17.8±0.21 vs. 1.68±0.26, −3.79±2.5° vs. −4.24±2.93°, 4.34±3.62° vs. 3.19±5.18°). The NLHA of the injured players was lower than that of the non-injured players (3.08±2.29° vs. 6.03±4.51°). The plantar pressure of the injured players tended to be located in a more lateral position compared with the non-injured players during heel raise (55.41±1.59% vs. 47.93±4.59%).ConclusionsStress on the lateral side of the foot during heel raise may cause stress fractures of the 5th metatarsal.
INJURY SURVEILLANCE OF AN ENGLISH PREMIER LEAGUE FOOTBALL CLUB ACADEMY BETWEEN 2012–2014
Authors: Bacon Christopher , Petersen Carl 
Published: August 2017

BackgroundPublished research into injury surveillance at English Premier League club (EPL) academies is scarce.ObjectiveTo investigate the injury incidence rate (IIR) across two EPL U21 seasons.DesignRetrospective observational epidemiological cohort study.SettingAn EPL academy.ParticipantsForty-one male professional football players (Age 17.8±1.1 y; Mass 73.7±5.9 kg; Height 178.3±5.3 cm).Risk factor assessmentOver two seasons, 2012–2014, injuries were diagnosed by a qualified physiotherapist. Each season consisted of 42-weeks, with ∼6×1-hour training sessions plus 1-fixture per week, with an accumulated squad total of 8054 hours on-legs exposure. Injury variables included; site, type, contact/non-contact, activity at onset and severity classification (days lost; £7,38£14,315).Main Outcome MeasurementsIIR was defined as the number of injuries per 1000 hours of training and matches. Inter-season comparisons were completed through X2analysis.ResultsEighty-three injuries occurred across two seasons; 2012–13 n=27 and 2013–14 n=56 (10.3 IIR). The ankle (n=26, 3.2 IIR) was the highest recorded injury site. Muscular overuse and sprains both had equivalent IIR (n=16, 2.0 IIR). Over half (57%) of all injuries were sustain in matches (n=47, 5.8 IIR). High severity injuries (n=28) had 7 and 12 times the total days lost of Medium (n=22) and Low (n=33) severity injuries, respectively. Injuries classed as non-contact occurred 8% more often than those involving contact (54% vs. 46%). Statistically significant differences resulted between seasons only for muscle strains (1 vs. 11, P=0.02), training (7 vs. 23, P=0.01) and low severity injuries (10 vs. 23, P=0.01).ConclusionsWe recommend cost effective targeted injury prevention programs for ankles, muscular overuse, muscular sprains and high severity injuries.
CAN ULTRASOUND IMAGING PREDICT THE DEVELOPMENT OF ACHILLES AND PATELLAR TENDINOPATHY? A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Auliffe Sean Mc , Creesh Karen Mc , O'Sullivan Kieran , Purtill Helen , Culloty Fiona 
Published: August 2017

BackgroundUltrasound [US] imaging is commonly used to visualise tendon structure. It is not clear whether the presence of structural abnormalities in asymptomatic tendons predicts the development of future tendon symptoms in the Achilles or patellar tendon. This led to considerable uncertainty in the management of sporting populations with a high prevalence of tendon related injuries.ObjectiveTo investigate the ability of US imaging to predict future symptoms of patellar or Achilles tendinopathy.DesignA systematic review and meta-analysis.SettingProspective imaging in a range of clinical settings.Patients (or Participants)The majority of the participants involved athletic populations ranging from volleyball, basketball, soccer players, fencing, badminton, ballet dancing, running.Interventions (or Assessment of Risk Factors)Prospective studies that performed US imaging of Achilles OR patellar tendon structure among asymptomatic subjects at baseline and a clinical measure of pain and/or function at follow-up were included.Main Outcome MeasurementsTendon abnormalities were described as any deviation in tendon structure; e.g. hypoechogenicity, increased thickness, or increased vascularity as seen on power doppler US.ResultsThe majority of participants in the review were from sporting populations. Meta-analysis revealed tendon abnormalities on US are associated with future symptoms of both patellar and Achilles tendinopathy [RR =4.97, 95% CI: 3.20–7.73]. Subgroup analysis indicated tendon abnormalities at baseline were associated with an increased risk of both Achilles [RR=7.33, 95% CI: 2.95–18.24] and patellar [RR=4.35, 95% CI: 2.62–7.23] tendinopathy.ConclusionsThis review indicates that tendon abnormalities US in asymptomatic tendons are predictive of future tendinopathy and are associated with at least a 4-fold increased risk. Identification of at risk athletes using screening tools such as US may allow preventative programs to be implemented. However, it is clear other factors beyond tissue structure are involved in the development of lower limb tendinopathy.
PADDED HEADGEAR IN CONTACT FOOTBALL – INERTIA OR MOMENTUM?
Authors: McIntosh Andrew , Patton Declan 
Published: August 2017

BackgroundRegarding padded headgear worn in contact football (excluding American football), little has changed in terms of game laws, technical specifications or market supplied models over the last 15 years.ObjectiveAssess the impact performance and potential for padded headgear to protect the head.DesignBiomechanical. Impact energy attenuation drop tests with ISO “M” headform onto a rigid flat anvil and linear impactor tests on a Hybrid III head and neck.SettingAustralian rules football, rugby union and rugby league.PatientsNone.InterventionsLaboratory testing of eight padded headgear models – six commercial and two prototypes.Main Outcome MeasurementsThe primary study outcome measures include peak headform linear (PLA) and peak angular (PAA) accelerations and the Head Injury Criterion (HIC).ResultsIn centre-front 0.2 m drop tests, PLA values ranged from 367 to 592 g and HIC ranged from 780 to 2064 in commercial models. In contrast a prototype “Hexlid” model produced PLA of 53 g in the same tests and 172 in 0.3 m drop tests. In 4 m/s lateral linear impacts the bare headform PLA was 107 g and PAA 7.1 krad/s2. Commercial headgear PLA's ranged from 91 to 100 g and PAA 6.0 to 6.8 krad/s2for the same tests. In contrast the “Hexlid” model produced PLA of 65 g and PAA of 4.8 krad/s2. PLA in 0.2 m drop tests on commercially available headgear ranged from 251 to 538 g compared to 64 to 483 g in eight models tested under equivalent conditions and available in the late 1990s.ConclusionsThere is no indication that the commercially available headgear would be effective in reducing concussion risk. The performance of commercially available headgear has not improved since the 1990s. Prototype headgear show how impact performance can be improved. The test methods provide the basis for technical specifications.
METHODS TO ASSESS WEARABLE HEAD IMPACT RESPONSE DEVICES
Authors: McIntosh Andrew , Willmott Catherine , Mitra Biswadev , Brennan James , Dimech-Betancourt Bleydy , Howard Teresa , Rosenfeld Jeffrey , Patton Declan 
Published: August 2017

BackgroundThere is a growing range of wearable non-helmet mounted devices on the market and/or in use that purport to measure head impact responses. There is potential for these devices to be useful tools in research and injury management programs.ObjectiveDescribe methods for assessing the validity of wearable head impact response devices.DesignLaboratory and qualitative observational methods. Tests on an exemplar wearable head impact response measurement “device” were undertaken in a laboratory using an instrumented Hybrid III head and neck and linear impactor. Football players in competitive matches wore the device and games were videoed. A qualitative protocol was applied to correlated device head impact events were those observed on video to examine sensitivity and specificity.SettingContact sport.ParticipantsCommunity level Australian football players.InterventionsNone.Main Outcome MeasurementsHead impact responses in vitro (linear and angular accelerations) and vivo (observed head impact characteristics).ResultsLaboratory head impacts were performed at a number of impact sites and velocities. Laboratory tests identified significant correlations (p<0.05) between in-headform measured peak resultant linear and resultant angular accelerations and HIC with the device measured parameters. However, the device estimates of HIC were incorrect by a factor of 2 and angular acceleration by a factor of 0.7. Linear acceleration measurement was more accurate, but lacked precision. Qualitative video analysis showed approximately 60% correlation of device measured >30 g in game head impact events with observed head impacts, but in 18% events were not correlated with any head impact, and there were other errors.ConclusionsA combination of laboratory and field tests are critical in establishing the validity of wearable head impact response devices and should be performed as the first stage of research with these devices.
ADAPTED EVALUATION PROTOCOLS FOR TEENAGE ATHLETES COMPETING AT YOUTH OLYMPIC GAMES: SAFEGUARDING AND PROTECTING YOUNG CHAMPIONS
Authors: Adami Paolo Emilio , Squeo Maria Rosaria , Quattrini Filippo Maria , Paolo Fernando Maria Di , Pisicchio Cataldo , Ciardo Roberto , Verdile Luisa , Caselli Stefano , Maestrini Viviana , Spataro Antonio , Pelliccia Antonio 
Published: August 2017

BackgroundCurrently no clear indication are present for the pre-participation evaluation of adolescent elite athletes.ObjectiveOur objective was to assess the efficacy of a tailored pre-participation evaluation protocol to assess health and eligibility of adolescent athletes, shortlisted for participation in the Youth Olympic Games.Design Setting and PatientsBetween 2010 and 2014, 247 adolescent elite athletes (53% females), mean age 16.3±1.01 years, competing in 22 summer and 15 winter sport disciplines, were evaluated through a tailored pre-participation protocol, which included 10 different health specialists.Main Outcome MeasurementsIn 36 of the 247 athletes (14.5%), the pre-participation evaluation led to the final diagnosis of a pathological condition, including CV in 17 (6.8%), pulmonary in 11 (4.5%), endocrine in 5 (2.0%), infectious, neurological and psychiatric disorders in 1 each (0.4%). Among CV abnormalities, atrial septal defects were observed in 9 (3.6%), valvular diseases in 5 (2.0%), primary tachyarrhythmias in 2 (0.8%) and hypertension in 1 (0.4%). Pulmonary diseases consisted of allergic asthma, diagnosed in 11. Endocrine diseases included Hashimoto's Thyroiditis in 2, Hypothyroidism in 2 and Androgen Insensitivity Syndrome in the remaining subject. Hepatitis B, Epilepsy Syndrome and Panic Disorder represented the remaining diagnoses, each in one individual.ResultsBased on current National and International Recommendations, none of the athletes was considered at high risk for acute events and all were eligible to compete at the Youth Olympic Games. All athletes with pathological conditions or abnormal findings were required to undergo a periodic follow up.ConclusionsThe specific pre-participation evaluation protocol implemented proved to be effective in identifying a wide range of disorders, in a significant proportion (14.5%) of adolescent Olympic athletes. The presented protocol should be considered for early identification of a wide spectrum of diseases in this population of athletes, allowing prompt treatment and minimising health consequences.