bluuebunny/crossref_metadata_2025_split huggingface dataset:
A reliability assessment examining the inter- and intraobserver reliability of the current england and wales cricket board musculoskeletal profiling protocol
Authors: Dacombe Peter , Ranson Craig , McCaig Steve , Young Mark 
Published: January 2011

BackgroundThe England and Wales Cricket Board (ECB) musculoskeletal profiling was first introduced in 2005 and has been developed over the past four seasons with the aim of identifying risk factors for injury in elite level cricketers aiding both injury prevention and rehabilitation. The ECB Physiotherapy Team carries it out at six monthly intervals. The ability of such a tool to accurately predict injury risk, and to provide useful information for rehabilitation is entirely dependent on the ability to produce valid and reliable results.Study aimTo examine the inter- and intraobserver reliability of the current system in the hands of two experienced sports physiotherapists examining elite level cricketers.MethodsUsing the prescribed testing protocol eight members of the England under 19 cricket squad were examined on two occasions by two sports physiotherapists who have worked in elite level cricket. Statistical analysis was carried out to determine the inter- and intraobserver reliability of the tests.ResultsOf seven range of motion tests included in the study four showed ‘almost perfect’ reliability, an intraclass correlation coefficient of greater than 0.8, this level is reported to be an acceptable for screening in an elite sport setting. Only two of the tests examined demonstrated inter-rater reliability of greater than 0.8.ConclusionThe ECB musculoskeletal profiling system is crucial to early identification and modification of injury risk factors. It is well-designed and based on current sports injury literature, but can not be efficacious in the absence of reliable testing. Only two of the current tests have sufficient inter-observer reliability for use in screening elite sportsman, four demonstrating acceptable intraobserver reliability. One of the tests (modified Thomas test) demonstrated such poor reliability to question it's inclusion, this study highlights the need to investigate ways to improve the reliability of other tests in the profiling system.
Training risk factors associated with wrestling injury
Authors: Stanev S , Dimitrova E 
Published: January 2011

IntroductionWrestling is strength sport that requires a large amount of muscle stamina superior flexibility, control and intensive training. The incidence of traumatic and overuse injury is high.1 2 The purpose of this study is to determine injury risk factors associated with wrestling training.Methods120 (male and female) wrestling students aged 18–26.5 years were recruited from National Sports Academy. We retrieved through injury survey, information regarding chronic injuries, most recent wrestling related injuries as well as treatments, training history and awareness of injury prevention strategies. Risk factors were analysed by Pearson's correlation, ANOVA and t tests.ResultsThe results indicate that 45.8% of wrestlers had sustained an injury within the past 6 months. The majority of wrestlers (52.5%) reported being affected by chronic injuries at the time of the survey. Age of onset for wrestling-related and chronic injuries averaged 15 and 17 years. The knee and ankle3 were the most common sites of injury (35%). Arms, shoulders, and hands injuries account for 20% of all injuries. The majority of participants (82%) who required treatment for their most recent wrestling-related injuries consulted a physiotherapist.4 Two of the significant risk factors for injuries were training over 8 h per week (p<0.001) and the training methodology.ConclusionsAn individual training threshold may exist for wrestlers, which if exceeded, increases the risk of injuries. In freestyle wrestling these injuries most commonly affect the knee and ankle. A well-planned weekly training load may reduce injuries. As participation in sport activity does not increase injury risk, cross-training may improve these athletes’ fitness during competition period. Physiotherapists and coaches have a role in developing such a training program.
Accelerated rehabilitation following bilateral consecutive matrix autologous chondrocyte implantation in the knees of an elite skier
Authors: Epaminontidis K , Papacostas E , Koutloumpasis A , Ziogas G , Terzidis J 
Published: January 2011

PurposeTo present our experience with an interesting case of bilateral consecutive matrix autologous chondrocyte implantation (MACI) in the knees of an Olympic level skier. The rehabilitation protocol applied had a few but significant differences compared to other protocols, regarding the rate and methods of increasing joint loading during the early phases of rehabilitation.Methods and materialsA 29-year-old, alpine skier with bilateral chondral lesions of the trochleas and the left lateral femoral condyle. Preoperative International Knee Documentation Committee subjective score was 58(L) and 62 (R). In October 2007, he underwent bilateral knee arthroscopic evaluation and cartilage biopsy. In November 2007 the first MACI was conducted in his left knee, and the second MACI in the right knee in March 2008. A second look arthroscopy took place in the left knee. The rehabilitation protocol followed the guidelines outlined by Hamblyet al(2006) with a few modifications:–Non-weight bearing(left knee): 4 weeks (right knee): 1 week–Full weight bearing(left knee): 6 weeks (right knee): 4 weeks–Closed kinetic chain exercise (rowing-free handed)(left knee): 6 weeks (right knee): 6 weeks–Intermmitent compression of repair site with use of dynamometer Controlled isometric contractions in angles that engaged the repaired sites. The applied load was controlled via optical biofeedback from dynamometer.(left knee): 8 weeks (right knee): 10 weeksResultsThe athlete was able to returned to acceptable performance levels on the exercise physiology lab at 8 months. He was able to participate in high level races by 12 months. His 12 month IKDC score reached 94 (L) and 88 (R).ConclusionsAccelerated rehabilitation with the inclusion of controlled intermmitent compression of the repair sites early in the rehabilitation process is safe and may promote tissue regeneration at a faster rate than previously thought.
Back and leg pain and directional preference exercises
Authors: May Stephen 
Published: January 2011

Lecture 13Directional preference exercises are determined during the physical examination of patients with back pain and referred pain from the spine with the use of repeated movements by the patient. There maybe clues to this found during the history taking, such as the patient indicates they are better when walking and worse when sitting – this could be a clue to a favourable response to extension activity and negative response to flexion activity. This would be explored in the physical examination by testing out the response to repeated extension exercises. If the patient reported centralisation of pain, which is the abolition of distal symptoms, or a decrease in symptom intensity or abolition of symptoms in response to the repeated movement they would be deemed to have a directional preference for extension exercises. These would prescribed for the patient self-management exercises. There is considerable evidence supporting the favourable long-term prognosis associated with centralisation. Furthermore there is evidence to support the use of directional preference exercises in favour of non-specific exercises. This presentation will examine the evidence for directional preference in general, but also specifically as it relates to patients who present with back pain and referred symptoms. The evidence provided will demonstrate the value of directional preference exercises for this group of patients in the athletic and non-athletic populations.
The use of prolotherapy injections for elite athletes
Authors: Petrides Simon 
Published: January 2011

Lecture 14The clinic embraces all aspects of sports and exercise medicine from ‘exercise on prescription’ and ‘functional rehab programmes’ to specialist image guided spinal injections.Simon has a special interest in prolotherapy injections as an adjunct to intense rehab programmes for unremitting low back pain. This has culminated in successful treatment of many elite athletes and footballers.Most clinical trials on the treatment have shown significant benefits but no prominent trials have used patients with specific back pain diagnoses using selective block injections to determine which patients are most likely to benefit.Rowing has a low back pain incidence of 100% and over 20 GB rowers have been successfully treated using this technique.The lecture will summarise his experience in the use of prolotherapy in these athletes.
Achilles tendon overuse injuries: risk factors and biomechanics
Authors: Alt Wilfried , Reule Claudia , Hochwald Harald 
Published: January 2011

Lecture 16IntroductionMany studies have been published concerning overuse and acute injuries of the lower extremity with respect to individual risk factors.1 Based on the studies by Isman and Inman2 it has been speculated that inclination and deviation of subtalar joint axes (STA) could be used to estimate the risk to chronic or acute injury. In this novel approach a method has been used to determine a set of parameters, describing the axes of rear foot movement with respect to the tibia. The aim of the study was to measure STA of runners with and without chronic symptoms of Achilles tendon (AT).MethodsThe Zebris motion analysis system has been adapted for STA estimations. By postulating a pure rotational movement arround the STA the system could be reduced to only one ultrasound marker which was fixed rigid to the rear foot complex by a special mountig device. The ankle has been moved to maxium dorsiflexion. Then rearfoot has been moved from inversion to eversion six times. A set of six finite axes between the end positions was calculated in real time and then averaged in order to minimise errors from data capturing. A total of 614 axes were calculated from 307 high level runners.Results and discussionData of this study revealed an average inclination of 42° and an average deviation of 11° from 614 ankles. Significant differences have been found between deviation angles from ankles with AT problems (18° ± 23°) compared to those without AT problems (10° ± 23°). Compared to data of Isman and Inman2 (23° ± 11°) it seems that the average deviation of the STA is smaller and therefore more parallel to the longitudinal axis of the foot, which is also in line with the findings of Lewiset al3 (18° ± 10°). It has been speculated that AT problems might be related to asymmetrical loading during running and this is supported by the findings of this study. However, the range of data and SDs are actually higher than published in previous studies. Further investigations are necessary to shed light on anatomical factors and other reasons for AT problems in runners.ConclusionsThis method can be used to estimate a functional joint axis which is closely related to STA orientation. This might be useful, especially to investigate large sample sizes in order to detect individual risk factors to chronic AT overuse in running.
Hamstring injuries
Authors: Malliaropoulos N G 
Published: January 2011

Lecture 17Muscle injuries are among the most common, most misunderstood, and inadequately treated conditions in sports. According to some studies, muscle injuries account for 10–30% of all injuries in sport.1 Hamstring injuries are the commonest muscle injury in all sports.Hamstrings function is complex. Depending on leg positioning and relationship to the ground it can serve as a hip extensor, knee flexor and external rotator of the hip and knee. Long head receives innervations via a tibia portion of the sciatic nerve, the short head receives innervations from the common personal nerve.The mechanism of the injury is very important to know. Contraction injuries occurring during running at maximal or near-maximal speed primary involve biceps femoris, long head and they heal faster comparing to stretching injuries occurring in dancing or kicking and primary involving semimembranosus, proximal tendon.2Various systems have been used to classify the severity of the injury. They classify them in three grades, as mild, moderate, severe, according to imaging findings, time to walk pain-free.3 Our Clinical classification is based on estimating the knee active range of motion deficit between the injured and the healthy side.1 Ultrasound is used to image the muscle lesion.4 Following this clinical classification we are able to decide for the treatment, to design the rehabilitation protocol to predict the time to full rehabilitation and to assess the reinjure rate.We must always keep in mind to differentiate common signs and symptoms of a hamstring strain injury compared to those referred to the posterior thigh from another source.5Rehabilitation is one of the key points dealing with hamstring injuries. We as clinicians have to prescribe the right clinical application correlated to each healing process phase operative intervention is reserved only for severe injuries, such as complete rupture of the hamstring muscles, either at the insertion or at the origin (avulsion).The reinjure rate for hamstring injuries has been found to be 12–31% early return to sport and poor rehabilitation programme met with a high risk of reinjure according to our clinical classification. Objective clinical findings can provide an effective clinical tool to assess the risk of re-injury following acute hamstring muscle strains in elite track and field athletes.6 In terms of prognosis the following factors have been shown to require a greater convalescent period: injury involving a proximal free tendon, proximity of the injury to the ischial tuberosity, increased length and cross-sectional area of injury.Past history of hamstring injury is the main risk factor for the next injury.3 Being unable to walk at a normal pacepain-free within 24 h of injury was independent predictor of being unable to return to play in less than 4 weeks from the time of injury. Defining the severity of the injury enable us to assess the expected return to play timescale which is important in guiding rehabilitation and in team planning.6
ESWT in the management of patella tendinopathy
Authors: Motto Stephen 
Published: January 2011

Lecture 21Patella tendinopathy is still a potentially career ending injury if not accurately diagnosed and actively managed. Prevalence has been reported to be in the range of 7–40% in the athletic population. There are still concerns regarding the aetiology, although the mechanical strain theory is the most accepted – repeat heavy loading initiating pathological extracellular and cellular dysfunction with eventual collagen disruption and tendon degeneration.Musculoskeletal extracorporeal shockwave therapy (ESWT) involves the use of low, medium and high energy focused or non-focused (radial) sound waves that have been shown to have a therapeutic value for certain orthopaedic conditions. ESWT in patella tendinopathy ‘seems to be a safe and promising treatment’ was the conclusion reached by Leeuwenet alin a review of the literature which appeared in theBJSMlast year (BJSM2009;43:163–8).The mechanism of action of shockwaves remains unknown. It has been postulated that shockwaves induce hyperstimulation analgesia by increasing the threshold of pain. It also seems to increase vascularity and leads to increases in cellular signalling. Focused shockwave therapy has been used in my practice with good results in a number of mild to moderately severe cases.
Predictive genomics profiling in athletics and sports performance
Authors: Kambouris Marios 
Published: January 2011

Lecture 27Genes control biological systems such as muscle, cartilage and bone formation, muscle energy production and metabolism (mitochondriogenesis, lactic acid removal), blood and tissue oxygenation (erythropoiesis, angiogenesis, vasodilatation) all essential in Athletics and Sports. DNA sequence variations in these genes confer genetic advantages that can be exploited and genetic ‘barriers’ that could be overcome to achieve optimal athletic performance.The four ‘P's of Predictive Genomics (Personalization, Prediction, Prevention, Participation) are not only applicable but rather essential in athletics. Predictive genomic profiling for athletics reveals genetic variations that determine suitability for sports requiring either endurance or strength and speed, determine vulnerability to sports-related traumas as well as individualised nutritional requirements. Knowledge of genetic ‘suitability’ in respect to endurance capacity or strength and speed would lead to appropriate sport and athletic activity selection. Knowledge of genetic advantages and barriers would ‘direct’ an individualised training programme and nutritional plan and supplementation to achieving optimal performance, overcome the ‘pain barriers’ that results from intense exercise and pressure under competition with minimum waste of time and energy and avoidance of health risks (hypertension, cardiovascular disease, inflammation and injuries in tendons and bones) related to exercise, training and competition.Genetic ‘profiling’ for Athletics and Sports performance is an essential tool for proper Athletic activity and Sport selection as well as for the formulation of Individualized and Personalized training and nutritional programmes for optimising health and performance for the athlete.
So what's really new about the ACL
Authors: King John 
Published: January 2011

Lecture 3This talk will be a look at the origins of anterior cruciate ligament (ACL) mythology; a snapping noise, haemarthrosis and loss of function are characteristic of ligamentous injury; 1845!Testing for ACL laxity in near extension; 1875Why do we test for laxity in the sagittal plane when the ACL is oblique?Why there are thousands of papers on PubMed if the problem is solved?So what is new, what is hidden because we don't read a foreign language and what does the future hold?
Predisposing factors for anterior cruciate ligament injury
Authors: Papoutsidakis Antonis 
Published: January 2011

Lecture 5In sports, especially in football, one of the most common knee injuries is the anterior cruciate ligament (ACL) tear, which usually (70%) occurs through non-contact mechanisms that include; sudden deceleration, landing and pivoting manoeuvres which are repeatedly performed. Studies have shown that the incidence of ACL tear in female athletes is two to eight times higher than in men athletes. The research effort to determine the risk factors for sustaining non-contact ACL injuries is increasing as concerns grow about the larger number of incidents, the greater treatment costs and the serious consequences of those injuries.Mechanically, ACL injury occurs when an excessive tension force is applied on the ACL. A non-contact ACL injury occurs when a person generates great forces or moments at the knee that apply excessive loading on the ACL.There are number of studies that show that the anterior shear force at the proximal end of the tibia is a major contributor to ACL loading, while there are valgus, varus and internal rotation moments at the knee. According to these ACL loading mechanisms, a small knee flexion angle, a strong quadriceps muscle contraction or a great posterior ground reaction force can increase ACL loading.The literature also shows that individuals at high risk have a smaller knee flexion angle during athletic tasks than individuals at low risk. Recent biomechanical studies demonstrated that female recreational athletes exhibited small knee flexion angles in running, jumping and cutting tasks. The results of other studies showed that the peak ACL strain occurred at the impact peak vertical ground reaction force shortly after initial contact between the foot and the ground.The risk factors for non-contact ACL injuries fall into four distinct categories: environmental, anatomic, hormonal and biomechanical.Recently, a high level of friction between shoes and the playing surface has been identified as a major risk factor for a non-contact ACL injury in the sport of the team handball. In football, there are studies that show that more non-contact ACL injuries occur when the surface is dry. Higher levels of friction between the shoe and the surface are generally associated with better performance but a higher injury risk. That's why we see an increase of ACL tears in areas with artificial grass in football grounds.There is a need to continue to define specific, neuromuscular, proprioceptive and motor control factors associated with injury. However, until specific predictive and protective factors are identified, training and prevention programmes should continue to be implemented, assessed and improved. There is a pressing need to improve public and participant awareness of the risk of ACL injury and the possibilities for prevention.
MPFL reconstruction
Authors: Maffulli Nicola 
Published: January 2011

Lecture 6Primary patellofemoral dislocations are common. It results from quadriceps contraction across a flexed, valgus knee with the weightbearing tibia externally rotated compared to the femur. The dislocation usually reduces spontaneously or with muscle relaxing drugs. In most patients, non-operative management produces satisfactory outcome. Conservative management focuses on concentric exercises to strengthen the quadriceps, and especially the vastus medialis, to prevent further instability. If the dislocation recurs after a trial of rehabilitation, operative intervention should be considered, with the aim of restoring the soft tissue anatomy to normal. Ninety-four per cent of patients suffer a tear to the medial patellofemoral ligament (MPFL) following a patellar dislocation. We perform transverse patella double tunnel technique to reconstruct the MPFL using a free autologous gracilis or semitendinous graft. MPFL reconstruction using hamstring tendon passed through a double patellar transverse bony tunnel technique is a safe, reliable management option for recurrent patellar dislocation in patients without any predisposing anatomic factors.
Medial tibial stress syndrome
Authors: Batt Mark E , Batt Mark 
Published: January 2011

Lecture 9Medial tibial stress syndrome (MTSS) is an enigmatic condition with confusing terminology, the term often being used interchangeably with shin splints. It is suggested that MTSS and shin splints be used as generic rather than diagnostic terms. On account of variable definitions, the reported incidence rate varies from 4 to 35% in military and athletic populations. Broadly, it represents exertional lower leg pain centred on the posteromedial tibial border and being diffuse/linear (greater than 5 cm) rather than focal. Presentations of acute shin splints should be regarded as bone stress injuries until proven otherwise and not treated as periostitis with anti-inflammatory modalities/drugs. Chronic presentations are more likely in females, those with a running history less than 5 years, increased body mass index, larger calf girth, increased hip rotation, standing foot pronation and a history of orthotics use, MTSS or stress fracture. Muscle hernia, stress fracture and chronic exertional compartment syndrome should be ruled out. The differential diagnosis also includes radiculopathy, nerve entrapment syndromes and the possibility of an accessory muscle should not be overlooked. There are few randomised controlled trials (RCTs) that have studied treatment and prevention and those available suggest that rest is probably as beneficial as any other form of intervention. Prevention may be afforded by either shock absorbing insoles or more formal orthotics. The pathophysiology would seem to be related to diffuse bone stress with resultant periostalgia. Thus rest and the possible use of compressive splints are advised with a graduated return to running activities once risk factors have been addressed.