bluuebunny/crossref_metadata_2025_split huggingface dataset:
DO RISK FACTORS DIFFER FOR CONCUSSION AND PROLONGED RECOVERY FOLLOWING CONCUSSION IN ELITE YOUTH ICE HOCKEY PLAYERS?
Authors: Blake T , Meeuwisse WH , Lemke N , Schneider K , Taylor K , Kang j , Emery CA 
Published: March 2014

BackgroundPediatric concussion risk factor identification will facilitate targeted injury prevention strategy development.ObjectiveTo examine risk factors for concussion and prolonged recovery amongst elite youth ice hockey players.DesignCohort study.SettingCommunity ice rinks and sport medicine clinic (2011/12 season).ParticipantsMale and female elite Bantam (13–14 years) and Midget (15-17 years) ice hockey players (n=780).Assessment of risk factorsBaseline age group, sex, previous concussion history and SCAT2 component scores [Total Symptom Score (TSS), Balance Error Score (BES) and Standardized Assessment of Concussion (SAC) score] were evaluated.Main outcome measurementsPlayers with a suspected concussion were referred to a sport medicine physician by team therapists/trainers (n=137). Concussions with time loss of >10 days were defined as prolonged recovery.ResultsConcussion incidence rate ratios (IRR) were estimated using multivariate (concussion) and univariate (prolonged recovery) Poisson regression analyses (cluster and exposure hours adjusted). Males were at greater risk than females [IRR=1.44 (95% CI: 1.09–1.90)]. In females with no concussion history, Bantam players were at greater risk than Midget players [IRR=4.04 (95% CI: 1.24–13.19)]. In Midget players, those with a history of concussion were at greater risk than those with no concussion history [IRR=2.68 (95% CI: 1.61–4.46)]. Players with baseline TSS in the lowest 25th%ile were at greater risk of concussion [IRR=1.50 (95% CI: 1.03–2.18)] and prolonged recovery [IRR=1.88 (95% CI: 1.18–2.99)]. Players with a history of concussion were at increased risk for prolonged recovery [IRR=2.02 (95% CI: 1.29–3.16)]. SAC and BES were not risk factors.ConclusionsAge group, sex, previous concussion history, and baseline symptom reporting affected the risk of concussion and prolonged recovery in elite youth ice hockey players. This study will inform the development of youth sport concussion prevention strategies.
RETURN-TO-PLAY FOLLOWING INJURY: WHOSE DECISION SHOULD IT BE?
Authors: Shrier I , Safai P , Charland L 
Published: March 2014

BackgroundReturn-to-play (RTP) decision-making is required for every injured athlete. However, conflict can and often does emerge between sport medicine clinicians, athletes, coaches and sport associations when engaging in recommended shared decision making processes.ObjectiveThis study explores differences in professionals' opinion about which criteria should be used for RTP decisions, and who is best able to evaluate them.DesignCross-sectional survey.SettingCanada.ParticipantsCanadian sport medicine physicians, physiotherapists, athletic therapists, chiropractors, massage therapists, athletes, coaches and representatives from the Canadian Olympic Committee, Canada Games, and Canadian Soccer Association.Risk factor assessmentNone.Main outcome measurementsDescriptive analysis of a 10-min online survey that asked respondents to rate criteria as mandatory to irrelevant on a 5-point Likert scale, and to indicate which profession was best able to evaluate the criteria.ResultsIn general, medical doctors, physiotherapists and athletic therapists were considered best able to assess factors related to risk of injury and complications from injury. Each clinician group (except sport massage therapists) generally believed their own profession has the best capacity to evaluate the criteria. Athletes, coaches and sport associations were considered to have the best capacity to assess factors related to competition (desire, psychological and financial impact, and loss of competitive standing). There remained considerable heterogeneity both between and within stakeholder groups.ConclusionsWe found that differences in approach to RTP decisions were generally greater within stakeholder groups compared to between stakeholder groups. If shared decision making is to become the norm in clinical sport medicine, we will need to begin a more fulsome discussion on which discrepancies can be addressed by education and research, and which simply reflect the divergence of values among different individuals.
PRIORITIZING CONCUSSION PREVENTION IN YOUTH ICE HOCKEY: AN ASSESSMENT OF ENGLISH-LANGUAGE CANADIAN NEWSPAPERS AS A VEHICLE FOR EVIDENCE-BASED KNOWLEDGE TRANSLATION
Authors: Blake T , Rock M , Emery CA 
Published: March 2014

BackgroundThe extent to which evidence-based injury prevention knowledge is conveyed to the public can have considerable impact on the implementation of injury prevention practice and policy change, which requires significant community engagement and mobilization. Media coverage has been shown to influence the amount of content regarding concussion on social media/networking sites, like Facebook© and Twitter©. Little is known about the extent to which news coverage of concussion reflects current evidence.ObjectiveTo examine the extent to which English-language Canadian newspaper coverage reflects evidence-based messages regarding the relationship between body checking policy and the burden of concussion in youth ice hockey players.DesignRetrospective study using qualitative content analysis.MethodsNews releases were collected for primary peer-reviewed research articles conducted through Canadian universities that evaluated the relationship between body checking policy and concussion among pediatric ice hockey players. Coverage of concussion and body checking in youth ice hockey was identified from the five English-language newspapers with the highest reported circulation figures from 2005 to June 2011. The presence of messages extracted from the news releases within the newspaper coverage was examined.ResultsFive research articles and 33 newspaper items were included. One clinical message frame (i.e., concussions in youth ice hockey are a serious clinical problem) and one public health message frame (i.e., concussions in youth ice hockey are a cause for concern) were identified. Every newspaper item contained at least one of the evidence-based messages, and 31 out of 33 (94%) contained both messages.ConclusionEvidence-based messages regarding the clinical and public health significance of concussion and the impact of body checking in youth ice hockey were accurately reported in Canadian newspaper coverage. The use of newspapers as a vehicle for knowledge translation would be a valuable addition to prevention implementation strategies requiring community engagement and support.
THE RELATIONSHIP BETWEEN MUSCULOSKELETAL STIFFNESS AND LOWER LIMB INJURY IN ATHLETES: A SYSTEMATIC REVIEW
Authors: Thomson, A 
Published: March 2014

BackgroundLower limb injuries are prevalent in sports involving running, hopping and jumping. Musculoskeletal lower limb stiffness is a modifiable mechanical property that may be related to injury risk in athletes.DesignSystematic Review.ObjectiveExamine the relationship between musculoskeletal stiffness and lower limb injury in athletes.MethodsLiterature searching was undertaken on 3 electronic databases (MEDLINE/SPORTDiscus/google scholar) up to September 2013. All prospective and case-control studies evaluating lower limb MSK stiffness and injury in athletes were included. Two researchers independently extracted outcome data and assessed the quality of included studies using a modified Downs and Black index. Effect sizes were calculated using RevMan software (version 5.2).Results11 studies (6 prospective and 5 case controlled) were identified, comprising a total of 474 participants (378 M, 96 F) with a mean age range of 13–39 years. The majority of studies (9 out of 11) were undertaken on international or elite athletes. Quality index scores ranged from 13 to 16 (max 19). Athletes with a history of unilateral lower limb injury displayed less stiffness when compared to their un-injured contralateral sides. Pooled data from three case control studies also found tendon stiffness was significantly lower in athletes with tendinopathy compared to un-injured matched controls (SMD 0.70, 95% CI 0.07–1.48). Data from prospective studies could not be pooled due to clinical heterogeneity. There was a clear trend that athletes with bilateral differences in leg stiffness or higher mean leg stiffness were more likely to develop a non-contact lower limb injury.ConclusionsCase controlled studies show a clear relationship between musculoskeletal stiffness and athletic injury. Prospective research provides further evidence that musculoskeletal stiffness may have an important causal role; however this may be implicated by previous injury.
THE IMPACT OF THE FIFA 11+ ON THE STRUCTURE OF SELECT TRUNK AND LOWER EXTREMITY MUSCLES IN ADOLESCENT FEMALE FOOTBALLERS
Authors: Whittaker J , Emery CA 
Published: March 2014

BackgroundThe FIFA 11+ is an injury prevention program found to reduce lower-extremity injury risk; however, the mechanisms behind this protective effect are not well understood. One possible explanation is the program addresses trunk and lower-extremity muscle deficits.ObjectiveTo determine the impact of FIFA 11+ exposure on the structure of select muscles in adolescent female footballers.SettingSport Medicine Clinic.DesignSub-study embedded within a cluster-randomized controlled trail (RCT).Participants23 female footballers (14–16 years) recruited from three teams that participated in a FIFA11+ implementation strategies RCT.Intervention:Participants were recruited from teams randomly assigned to one of two FIFA 11+ delivery groups; coach with unsupervised website access (control; n=11) or, coach with pre-season FIFA 11+ workshop and on-field physiotherapist supervision (comprehensive; n=12).Main outcome measurementsPre-post season bilateral sonographic measures of: resting Rectus Abdominis (RA), External/Internal Oblique, Transversus Abdominis, Lumbar Multifidus (MF), Gluteus Medius/Minimus (GMd/GMn), and Vastus Mediallis (VM) thickness; VM width and inter-recti distance (IRD); change in abdominal parameters during an Active Straight Leg Raise (ASLR) and gluteals during hip abduction. Mean (95% CI) pre-post season changes in sonographic parameters were calculated and group means compared with paired t-tests (=0.05).ResultsNo differences in 95% CIs existed for pre-post season change in sonographic parameters between participants with low (mean=149±9 exercises/year) and high (mean=314±15 exercises/year) FIFA 11+ exposure. Both groups exhibited significant within-group IRD decreases at rest (low t=8.20, P<.001; high t=5.90, P<.001) and with the ASLR (low t=5.66, P<.001; high t=5.04, P<.001). Further, the lower exposure group demonstrated decreased ASLR percent RA thickness change (t=3.19, P=.01) while the high exposure group exhibited increased resting MF thickness (t=2.26, P=.04).ConclusionsDifferent levels of FIFA 11+ exposure in this investigation were not associated with differential changes in the structure of the muscles investigated. Protective mechanisms underlying the FIFA11+ may be associated with alterations in neuromuscular control resulting in IRD and MF adaptations.
ACUTE INJURIES IN 35 SPORTS; INCIDENCES AND SEVERITY
Authors: Åman M , Henriksson-Larsén K 
Published: March 2014

BackgroundAcute injuries in sports are still a problem and the knowledge of incidences and severity in different sports at a national level are limited.ObjectiveThe aim of this study was to identify high-risk sports with respect to incidence of injury and severity of injuries in 35 sports.DesignA retrospective cohort study was set up based on a comprehensive database from an insurance company.SettingAlmost 90% of all athletes in Sweden (in 57/70 sports federations), in all ages and at all competitive levels, have their accident insurance in the same insurance company.ParticipantsAll licensed athletes in 35 sports during 2009–2011.Main outcome measurementsThe incidence of sport injuries as well as severe injuries (medical disability) were calculated for licensed athletes at a national level. Comparisons between sports, gender, and ages were made. Risk ratio was calculated with median injury incidence as the norm.ResultsEach year approximately 12 000 injuries (in total 35 971 injuries during 2009–2011) and 1 170 000 licensed athletes were eligible for analysis. The incidence of injury was higher in team sport compared to individual sports. Individual sports with highest incidence were motorcycle/snowmobile, skating, and wrestling. Team sports with highest incidence were handball, ice hockey, and rugby. Sports with a large number of injuries were soccer, ice hockey, floor ball, and handball. Highest proportions of medical disabilities were in motorcycle and then in team sports, such as soccer, basket, handball, and floor ball. Risk ratio for motorcycle was 15 and handball 14.ConclusionsSports with numerous acute injuries, high incidence and more severe injuries must be the target for prevention actions. This study suggests that team sports and motorcycle should be the object. Next step is to identify injury types, anatomical locations and injury mechanisms to understand how to prevent these injuries.
BETTER PLANNING REDUCES INJURY RISK IN SPORT STUDENTS
Authors: Brink M , Pots M , Lemmink K 
Published: March 2014

BackgroundFirst year sport students have a considerable risk of injuries. Self-regulatory skills may lower this risk by enabling students to better cope with a sudden increase in physical load (sport participation) and psychosocial stressors (i.e. exams, new social networks).ObjectiveThe aim of this study was to identify if better self-regulatory skills reduce the risk for athletic injuries in sport students.DesignProspective cohort study with seven months injury follow-up.SettingEducational setting for students in Physical Education and Sport, Health and Management.Participants341 freshmen sports students participated in the study.Assessment of risk factorsAnthropometric characteristics, sports participation, injury history, and self-regulatory skills (planning, self-monitoring, evaluation, reflection, effort and self-efficacy) were assessed at the start of the academic year by digitalized questionnaires.Main outcome measurementsThe dependent variables were coded as injured (acute or overuse) or non-injured over a seven months period after baseline measures. Data were analyzed using multinomial logistic regression.ResultsA total of 139 athletic injuries were reported. The injury incidence rate per 1000 hours of sports participation was 1.62. Sixty-four percent of the injuries were acute and 36% of the injuries a result of overuse. Increasing hours of sports participation led to a higher risk of overuse injuries (OR: 1.17 95% CI 1.04–1.32), whereas higher scores on planning led to a lower injury risk of overuse injuries (OR: 0.20 95% CI 0.07–0.58). For acute injuries, no significant predictors were found.ConclusionsSelf-regulation seems an important skill in reducing injury risk in sport students, because better planning is associated with a lower injury risk. Future research is needed to study the effects of prevention programs that focus on improving self-regulatory skills.
FACTORS INFLUENCING MUSCLE DAMAGE FROM ISOMETRIC EXERCISE
Authors: Allen T , Jones T , Tsay A , Morgan D , Proske U 
Published: March 2014

BackgroundMost studies of exercise-induced muscle injury have focussed on eccentric contractions, which are known to produce damage and delayed soreness. It is less well known that isometric contractions also produce damage and soreness. This is a study of the damaging effects of isometric exercise.ObjectiveTo investigate the contributions of factors such as muscle length, force level, duration of contraction and number of contractions to muscle damage following isometric exercise of elbow flexor muscles.DesignThe study comprised 6 separate experiments using a repeated measures design. One arm acted as the experimental arm, while the other acted as the control. Damage measures were obtained pre-exercise, then at 0h, 2h and 24h post-exercise.SettingExercise laboratory.Participants50 untrained adults (29 male, 21 female) with no previous upper limb injuries.InterventionsExercise with isometric maximum voluntary contractions (MVCs) by each arm. The control arm always performed 30 MVCs, each 4s duration at an included elbow angle of 155° (long muscle length), with 1 min rest between contractions. In 6 experiments, altered variables for the experimental arm included muscle length, number of contractions, duration of contractions and duration of relaxation.Main outcome measurementsDamage measures: MVC force, soreness rating, tenderness threshold. Exercise measures: muscle force, joint angle, contraction number, contraction duration, relaxation time, total contraction time.ResultsPost-exercise force deficit and muscle soreness were significantly greater for muscles exercised at longer length, despite force being significantly lower at these lengths. A longer relaxation phase did not significantly increase force deficit or soreness. The total contraction time had a greater influence on force deficit than either the number or duration of contractions.ConclusionsMuscle damage from isometric contractions was principally related to muscle length and total contraction time, not number of contractions. Damage predominantly occurred during the plateau phase of each contraction and not the relaxation phase.
SAFETY ANALYSIS OF SPORT IN SWITZERLAND
Authors: Brügger O 
Published: March 2014

BackgroundEvery year, around 400 000 Swiss residents are injured in sports accidents so severely that they need medical treatment. 170 people suffer fatal sports accidents in Switzerland. The bfu–Swiss Council for Accident Prevention–is legally mandated to prevent sports injuries.ObjectiveThe bfu will present a safety analysis of sport in Switzerland. The aim of a scientific approach is to ensure that decision-makers in the sports sector have a basis available for accident prevention planning.DesignThe method used covers three stages in accident research: in the accident analysis, the extent of accidents will be documented and focal points detected. The risk analysis will weight the factors relating to the focal points that are of relevance for accidents in Switzerland. The intervention analysis will evaluate prevention possibilities in terms of their effectiveness, efficiency and the degree to which they can be implemented to meet Swiss conditions.ResultsThe types of sports(-groups) that make up the focal points of accidents–snowsports, off-road biking, mountain sports, watersports (drowning) and football–are the main areas of activity for sports accident prevention. The risk factors identified in the risk analysis are largely specific to each type of sport. They can be allocated to the individual person (particularly risk competence, physical and physiological preconditions) or the setting and the activity respectively (including sports infrastructure, equipment, natural surroundings, official rules). The interventions with the potential for reducing the risk of accidents will be a conclusive list of prevention recommendations that are also specific in nature to the type of sport.ConclusionThe result of this safety analysis will be the basis for setting an agenda for Switzerland designed to enhance sports safety. Evidence-based recommendations for measures are not always possible given the major gaps in research.
ASSESSMENT OF HAMSTRING MUSCLE VOLUNTARY ACTIVATION: IMPACT OF CONTRACTION MODE AND PREVIOUS INJURY
Authors: Buhmann R 
Published: March 2014

BackgroundHamstring strain injury (HSI) burdens athletes due to high occurrence and recurrence rates. Previous surface EMG evidence suggests reduced voluntary activation (VA) may contribute to high recurrence rates however no studies have directly assessed VA in previously injured and uninjured hamstrings.ObjectiveTo determine the extent of hamstring VA in limbs with and without a history of HSI. It was hypothesised that previously injured hamstrings would display eccentric-specific VA deficits relative to uninjured contralateral hamstrings and hamstrings of uninjured controls.DesignRetrospective, cross-sectional study.SettingRecreationally trained males and sub-elite male footballers.Participants12 males, with (n=6), and without a unilateral HSI history (n=6) were recruited (average time of 7.7±7.4 months post injury, average age 24.0±2.6 years, stature 180.0±5.7 cm and mass 83.0±7.9 kg).Assessment of risk factorsTwitch interpolation and sEMG were used to measure hamstring VA during 5 sets of 2 maximal voluntary concentric and eccentric contractions, performed on an isokinetic dynamometer. Peak voluntary and evoked torque were recorded in both limbs.Main outcome measuresThe percentage value for VA calculated by comparing evoked and voluntary torque and surface EMG recordings.ResultsHealthy uninjured limbs displayed VA levels of 96.8%±2.4% during concentric contractions and 93.3%±6.1% during eccentric contractions. Previously injured limbs displayed VA levels of 98.0%±1.1% during concentric contractions and 83.4%±7.1% during eccentric contractions. Eccentric VA was significantly reduced in previously injured limbs compared to the uninjured control group (mean difference=−9.8%, CI=-18.9– −0.7%, P=.033) and uninjured contralateral limb (mean difference=−9.3%, CI=-18.4– −0.3%, P=.043).ConclusionsPreviously injured hamstrings are activated less completely than uninjured hamstrings, specifically during eccentric contractions. Such deficits exist despite successful rehabilitation and a return to sport.
A CASE STUDY OF TWO PREMIERSHIP FOOTBALLERS WITH SICKLE CELL TRAIT USING NOVEL TESTS OF REDOX HOMEOSTASIS
Authors: Catterson P , Moore B , Hodgson A , Lewis N , Newell J , Charles P 
Published: March 2014

BackgroundSickle cell trait (SCT) is considered a benign heterozygous carrier state (both normal haemoglobin and abnormal HbS) compatible with elite level sport, whereas the autosomal recessive state of sickle cell disease is considered incompatible with strenuous exercise. Increased production of reactive oxygen species occurs in sickle cell disease, evident as increased pro-oxidants (FORT) and reduced anti-oxidants (FORD). This has been demonstrated using a novel point-of-care test (Giziet al.2011). No FORT/FORD data exist in athletes with SCT.Objective and ParticipantsIt was hypothesized that premiership football players with SCT (n=2) would show altered redox homeostasis compared to non-SCT players (n=19). These data were compared to previously published data on patients with sickle cell disease and controls.SettingEnglish Premiership Football Team.Design and Arisk factor assessmentA cross sectional comparison study design was adopted, and descriptive data are reported. Resting whole blood samples were collected at pre-season and mid-season and analysed immediately for FORT and FORD values. Mean values for non-SCT players were plotted against mean SCT player values (Figure 1).ResultsFigure 1FORD/FORT values for all players (grey diamonds), SCT players (black squares) and previous data for sickle cell disease (black triangle) and controls (black diamond).ConclusionsThe 2 SCT players in this case study exhibited elevated FORT values, compared to non-SCT players, although they were not extreme outliers, perhaps because athletes are exposed to other sources of pro-oxidants such as exercise. Further research is necessary with a larger cohort in order to further establish the relationship between redox homeostasis and SCT in athletes.ReferencesGiziet al.(2011) Assessment of oxidative stress in patients with sickle cell disease: The glutathione system and the oxidant–antioxidant status.Blood cells, Molecules and Diseases46, pp. 220–225.