Preseason Assessment Research Articles

Comparison of Inter-Rater and Intra-Rater Reliability of Raters with Different Levels of Experience When Using Landing Error Scoring System (LESS) in Field-Based Screening of Professional Football Players.

It is essential for physical sports therapists to use reliable field-based tests to identify potential injury risk factors in athletes. The purpose of this study was to compare the inter- and intra-rater reliability of experienced and novice raters during use of the Landing Error Scoring System (LESS) in a field-based examination of professional football athletes. Thirty-seven male football athletes underwent pre-season LESS assessment. Two raters independently evaluated the recorded landing techniques at two separate intervals, two months apart, following the LESS standard protocol. Inter-and intra-rater values were calculated for the LESS total scores and individual scoring items. The overall LESS scores had excellent intra-rater reliability values for both the experienced (interclass correlation coefficient (ICC) = 0.95, 95% CI, 0.89-0.97; p < 0.001) and novice rater (ICC = 0.95, 95% CI, 0.90-0.97; p < 0.001), and very good to excellent inter-rater values for the first (ICC = 0.90, 95% CI, 0.77-0.95; p < 0.001) and second (ICC = 0.86, 95% CI, 0.71-0.93; p < 0.001) evaluation. Most of the individual scoring items ranged from moderate to perfect agreement. In conclusion, sports physical therapists, regardless of experience, can reliably use the LESS's total score, through video analysis of the regime. Individual scoring items can inform clinicians about impairments in the landing mechanism but data should be interpreted cautiously.

Increased humeral retrotorsion is not a risk factor for overuse injury of the throwing shoulder in elite youth handball athletes

PurposeTo identify the potential role of humeral retrotorsion (HRT) and range of motion (ROM) as a risk factor for shoulder overuse injury in elite youth handball players. The hypothesis was that increased HRT is associated with an increased risk of shoulder overuse injury. MethodsOver two seasons, 258 elite youth handball players (52% boys; age:14±0.8years) were included. Pre-season assessment included HRT and glenohumeral internal (IR) and external (ER) rotational ROM using ultrasound and a manual goniometer. Sports-specific adaptations between male and female athletes and the dominant and nondominant shoulder were calculated. In addition, players completed standardized questionnaires over the 2018-2019 or 2019-20 season and reported any shoulder overuse symptoms using the Western Ontario Shoulder Index questionnaire. ResultsComparing male and female players showed significantly decreased HRT and decreased internal ROM in the dominant side of male athletes (p≤0.027). No other difference was found. Significant side-to-side differences between the dominant and non-dominant shoulder were found for HRT, IR, and ER, regardless of sex (p<0.001). For total range of motion (TROM), only female athletes showed a significant increase in the dominant arm (p=0.032). The dominant side showed a significantly higher glenohumeral internal rotation deficit (GIRD) in male athletes than in female athletes (10°±17° vs. 5°±10°, p=0.011). Adaptations in HRT, ER gain, and TROM gain were not significant. Over the course of the two seasons, 20 athletes reported shoulder overuse injuries. Although GIRD was borderline non-significant (p=0.056), none of the parameters tested were significantly associated with shoulder overuse injuries. ConclusionDespite significant side-to-side differences and sport-specific adaptations, individual pre-season screening of humeral retrotorsion and soft tissue adaptations does not identify elite youth handball athletes at increased risk of shoulder overuse injury.

The impact of decreased tibial torsion angle on ankle sprain in football

Objective: Ankle sprains are one of the most common sports-related injuries. Among them, lateral ankle sprains (LAS) predominantly occur as inversion-type injuries. As a result of LAS, athletes are required to stay away from training/competitions for a certain period, which leads to a decline in their athletic performance. While the injury mechanisms for inversion-type injuries have been elucidated, it is imperative to investigate anatomical risk factors associated with these injuries. Material and Methods: This study aimed to examine the influence of tibial torsion angle (TTA) in lateral ankle sprains. In the study, the TTA of 67 male football players was recorded during pre-season evaluations. Among these players, 23 experienced LAS, while 44 did not. Results: A statistically significant difference in TTA was observed between players who suffered LAS during the season and those who did not (p&lt;0.05). The findings indicate that individuals with lower TTA are more likely to experience LAS. In addition, a cutoff value analysis revealed that football players with right TTA&lt;11° and left TTA&lt;10° are at an increased risk of injury. Conclusion: In conclusion, the tibial torsion angle should be included as a risk factor in pre-season assessments for lateral ankle sprains, and athletes with low TTA should be integrated into injury prevention programs targeting LAS.

Sport-related concussion alters cerebral hemodynamic activity during controlled respiration.

Sport-related concussion (SRC) is known to disrupt neurohemodynamic activity, cardiac function, and blood pressure (BP) autoregulation. This study aims to observe changes in cerebrovascular and cardiovascular responses during controlled respiration after sustaining an SRC. University varsity athletes (n = 81) completed a preseason physiological assessment and were followed up within 5 days of sustaining an SRC. During preseason and follow-up assessments, participants' continuous beat-to-beat BP was collected by finger photoplethysmography, and right prefrontal cortex oxygenation was collected using near-infrared spectroscopy (NIRS). Participants completed 5 min of seated rest and 5 min of a 6-breaths per minute controlled breathing protocol (5 s inhale and 5 s exhale; 0.10 Hz). Wavelet transformation was applied to the NIRS and BP signals, separating them into respiratory (0.10-0.6 Hz) and cardiac (0.6-2 Hz) frequency intervals. Of the 81 participants, 74 had a usable BP signal, 43 had usable NIRS signals, and 28 had both usable BP and NIRS signals. Wavelet amplitudes were calculated and coherence between NIRS and BP on the 28 participants were assessed. There was a significant (P < 0.05) decrease in oxygenated hemoglobin amplitude from 0.062 to 0.054 Hz and hemoglobin difference amplitude from 0.059 to 0.051 Hz, both at the respiratory (0.10-0.6 Hz) frequency interval, from preseason to acute SRC, respectively. Therefore, during controlled respiration, there was a reduction in intensity at the respiratory band, suggesting a protective, reduced respiratory contribution to cerebral hemodynamic activity following acute SRC.NEW & NOTEWORTHY This study investigated cerebral hemodynamic activity following sport-related concussion. Prefrontal cortex oxygenation was assessed by near-infrared spectroscopy (NIRS) during a controlled breathing protocol. Wavelet transformation of the NIRS signals showed significant decreases in HbO2 and HbD amplitude at the respiratory frequency interval (0.10-0.6 HZ) from preseason baseline to acute concussion. These results suggest a decreased respiratory contribution to cerebral hemodynamic activity following acute concussion.

Current practices in physical fitness assessment and monitoring among coaches of individual and team sports: a survey in Portugal, Spain, and Romania.

The objective of this study was to characterize surveyed coaches and elucidate the practices of physical fitness assessment and monitoring for both male and female athletes across three countries. A total of 165 coaches participated by completing a comprehensive 32-question survey. Pre-season assessments are a priority for coaches, with a significant range from 60.5% to 87.7% in Romania, while Portuguese and Spanish coaches tend to prefer testing during the competition (26.3% and 16.9%, respectively). Portuguese and Spanish coaches predominantly favor aerobic tests (50% and 46.8% respectively), whereas Romanian coaches exhibit a preference for sprint (56.9%) and skill tests (52.3%). Notably, change of direction tests are less commonly employed, ranging from 10.5% to 21% across the countries. In terms of exercise intensity determination, Portuguese coaches predominantly employ maximal heart rate (31.6%), while Spanish coaches often rely on the 220-age formula or perceived exertion (27.4%). For strength assessment, Portuguese coaches lean towards direct (34.2%) or estimated (31.6%) maximal repetition methods. When it comes to maximal speed sprint, Portuguese and Romanian coaches show preference (50% and 43.1% respectively), while Spanish coaches exhibit a relative lack of emphasis on individualized speed measures (37.1%). Perceptual scales are the preferred method for recovery monitoring, with adoption rates of 57.9% in Portugal, 53.2% in Spain, and 44.6% in Romania. In summary, this study underscores the distinct assessment and monitoring practices employed by coaches in Portugal, Spain, and Romania. These findings are in alignment with established literature standards, highlighting the diversity of approaches used in different countries.

Sex Differences in Recovery Trajectories of Assessments for Sport-Related Concussion Among NCAA Athletes: A CARE Consortium Study.

The purpose of this study was to determine sex differences in recovery trajectories of assessments for sport-related concussion using Concussion Assessment, Research and Education (CARE) Consortium data. National Collegiate Athletic Association athletes (N = 906; 61% female) from sex-comparable sports completed a pre-season baseline assessment and post-sport-related concussion assessments within 6h of injury, 24-48h, when they initiated their return to play progression, when they were cleared for unrestricted return to play, and 6months post-injury. Assessments included the Standardized Assessment of Concussion, Balance Error Scoring System, Brief Symptom Inventory-18, Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), Sport Concussion Assessment Tool-3 symptom evaluation, Clinical Reaction Time, King-Devick test, Vestibular Ocular Motor Screen, 12-item Short-Form Health Survey, Hospital Anxiety and Depression Scale, and Satisfaction with Life Scale. Only the Vestibular Ocular Motor Screen Total Symptom Score at the 24-48h timepoint (p = 0.005) was statistically significantly different between sexes. Specifically, female athletes (mean = 60.2, 95% confidence interval [CI] 51.5-70.4) had higher Vestibular Ocular Motor Screen Total Symptom Scores than male athletes (mean = 36.9, 95% CI 27.6-49.3), but this difference resolved by the time of return-to-play initiation (female athletes, mean = 1.8, 95% CI 1.1-2.9; male athletes, mean = 4.1, 95% CI 1.5-10.9). Sport-related concussion recovery trajectories for most assessments were similar for female and male National Collegiate Athletic Association athletes except for Vestibular Ocular Motor Screen symptoms within 48h of sport-related concussion, which was greater in female athletes. Female athletes had a greater symptom burden across all timepoints, suggesting that cross-sectional observations may indicate sex differences despite similar recovery trajectories.

Exploring the Dynamics of Athletes' Enjoyment and Self-Determined Motivation, and of the Motivational Climate in Youth Football: A Longitudinal Perspective.

We aimed to explore a short period longitudinal interplay between athletes' enjoyment and their self-determined motivation and motivational climate in youth football. We recruited 109 youth football athletes (79 males, 30 females) through a convenient sampling method. We included individuals within the 12-17-year-old age range, with a mean age of 14.31 (SD = 1.46) years. To examine these proposed associations, we performed hierarchical multiple regression analyses and found that enjoyment at pre-season assessment (T1) and self-determined motivation and a task-involving sport climate at mid-season (T2) were significant predictors of mid-season enjoyment (at T2). However, self-determined motivation and task-involving climate at T1 did not significantly contribute to the model. These findings emphasize the importance of initial enjoyment and an evolved self-determined motivation, and task-involving climate in understanding later enjoyment in sport. Coaches, practitioners, and policymakers should prioritize strategies that enhance intrinsic motivation, provide opportunities for autonomy, and cultivate a supportive and growth-oriented environment.

Baseline ImPACT Composite Scores in Student-Athletes With Attention-Deficit/Hyperactivity Disorder.

Athletes who are diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of concussion compared to other athletes. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a widely used concussion tool, but it relies on pre-injury baseline testing that can be affected by psychiatric conditions. This research aims to determine if there are differences in pre-injury testing composite scores in student-athletes with ADHD compared to those without ADHD diagnosis. We obtained 11,563 pre-season ImPACT assessments of 7,454 student-athletes (ages: 12-22) from 2009 to 2019. After exclusions, there were 6,920 control and 276 ADHD subjects. Multivariable linear regression analyses compared the independent effect of ADHD on the six ImPACT composite score metrics with Bonferroni correction for multiple comparisons with a = 0.008. Univariate analyses indicated ADHD is associated with more symptoms as measured by the Post-Concussion Symptom Scale (PCSS) (β = 2.67, 95% CI: 1.47-3.87, p < .0001) and worse Impulse Control scores (β = 0.93, 95% CI: 0.33-1.53, p = .002). In multivariate analysis, this association was the same for symptom score (β = 2.48, 95% CI: 1.22-3.74, p < .0001), but Impulse Control was not significantly different after multiple comparison adjustment (β = 0.87, 95% CI: 0.22-1.15, p = .009). The ADHD subjects reported worse symptoms at baseline and had worse Impulse Control in univariate analysis, but not multivariate analysis. These results can further guide clinicians in concussion diagnosis and test interpretations for student-athletes with ADHD, considering the symptom burden at baseline.

An integrated public health response to an outbreak of Murray Valley encephalitis virus infection during the 2022-2023 mosquito season in Victoria.

Murray Valley encephalitis virus (MVEV) is a mosquito-borne flavivirus known to cause infrequent yet substantial human outbreaks around the Murray Valley region of south-eastern Australia, resulting in significant mortality. The public health response to MVEV in Victoria in 2022-2023 included a climate informed pre-season risk assessment, and vector surveillance with mosquito trapping and laboratory testing for MVEV. Human cases were investigated to collect enhanced surveillance data, and human clinical samples were subject to serological and molecular testing algorithms to assess for co-circulating flaviviruses. Equine surveillance was carried out via enhanced investigation of cases of encephalitic illness. Integrated mosquito management and active health promotion were implemented throughout the season and in response to surveillance signals. Mosquito surveillance included a total of 3,186 individual trapping events between 1 July 2022 and 20 June 2023. MVEV was detected in mosquitoes on 48 occasions. From 2 January 2023 to 23 April 2023, 580 samples (sera and CSF) were tested for flaviviruses. Human surveillance detected 6 confirmed cases of MVEV infection and 2 cases of "flavivirus-unspecified." From 1 September 2022 to 30 May 2023, 88 horses with clinical signs consistent with flavivirus infection were tested, finding one probable and no confirmed cases of MVE. The expanded, climate-informed vector surveillance system in Victoria detected MVEV in mosquitoes in advance of human cases, acting as an effective early warning system. This informed a one-health oriented public health response including enhanced human, vector and animal surveillance, integrated mosquito management, and health promotion.

Effects of sociodemographic and player characteristics on baseline cognitive performance in 1000 rugby players: A retrospective 8-year follow-up study

ObjectivesTo analyze the effects of sociodemographic and player characteristics on the Sport Concussion Assessment Tool and neuropsychological scores over 8 years in a large sample of rugby players. DesignAn 8-year retrospective study of preseason clinical assessments of professional rugby players and players enrolled in training academies at professional clubs. MethodsThe Sport Concussion Assessment Tool-3 or -5, Trail Making Test and Digit Symbol Substitution Test were administered prior to the start of the competition season for each player. Statistical analyses included: (i) descriptive analyses of sociodemographic, player and neuropsychological characteristics; (ii) multivariate models to identify factors influencing cognitive scores at the first visit; and (iii) linear mixed models to assess the evolution of the scores over the years. ResultsOne thousand players were included (mean age: 22.8, males: 92 %). Twenty-two percent of the athletes reported baseline symptoms. A higher level of education was associated with better cognitive scores at the first visit and over the years. Forwards had poorer processing speed performances compared to backs at the first visit and over repeated assessments. Finally, the number of examinations was associated with improved cognitive scores showing a practice effect on all the neuropsychological tests, except for the Standardized Assessment of Concussion 5th edition. ConclusionsResults from this retrospective study could help to improve the management of athletes and return-to-play decision-making in collision sports.

Analysis of Accumulated Workloads and Performance Testing Across a Collegiate Women's Lacrosse Season.

Fields, JB, Kuhlman, NM, Jagim, AR, Dulak-Sigler, C, and Jones, MT. Analysis of accumulated workloads and performance testing across a collegiate women's lacrosse season. J Strength Cond Res 37(11): 2213-2221, 2023-Monitoring accumulated workloads, acute:chronic workload ratios (ACWR), and training monotony (TM) are practical methods for monitoring athlete physical stress. Performance testing provides useful information about the changing nature of physical abilities. Therefore, the purpose was to examine differences in accumulated workloads based on session type, explore seasonal trends in ACWR and TM, and assess changes in performance assessments in collegiate women's lacrosse athletes. Athletes, who were identified as starters ( n = 12), wore positional monitoring technology during training sessions ( n = 61) and games ( n = 17) and completed preseason and postseason assessments of speed, agility, power (jump tests), strength, aerobic capacity, and body composition. Separate 1-way analyses of variance were used to determine differences in accumulated workloads for session type and differences in performance assessments from preseason to postseason ( p < 0.05). When compared with games, practice sessions elicited greater ( p < 0.001) accumulated total distance, player load, repeated high-intensity efforts, accelerations, change of direction, explosive efforts, high-speed efforts ( p = 0.002), and high-speed distance ( p = 0.002). Throughout the season, ACWR and TM ranged from 0.16 to 1.40 AU and 0.68-1.69 AU, respectively. The 40-yd sprint ( p < 0.001) and pro-agility ( p < 0.001) improved from preseason to postseason, whereas no changes in aerobic capacity, lower-body power, or strength were observed ( p > 0.05). The monitoring of accumulated loads, ACWR and TM, and performance tests revealed novel information about the seasonal demands of collegiate women's lacrosse. Women lacrosse players are able to improve speed and agility throughout the season, while maintaining strength, power, and endurance, with minimal reductions in fat-free mass.

Pre-Season ACL Risk Classification of Professional and Semi-Professional Football Players, via a Proof-of-Concept Test Battery

This study aimed to identify football players at high risk (HR) for anterior cruciate ligament (ACL) injury via a four-test battery and assess possible factors affecting classification. Ninety-one professional and semi-professional male athletes participated in a field-based pre-season screening. The cut-off points of the test battery were 10% acknowledged inter-limb asymmetry limit for quadriceps and hamstring isometric strength and single-leg triple hop for distance, in addition to the upper limit of 6 errors in the landing error scoring system (LESS). Additional assessment of hip adductors and core stability completed the global functional profile of the players. Sixty-one players were identified as HR and thirty as low-risk (LR) for ACL injury. Discriminant analysis showed that the proposed test battery classified accurately 78.0% of them, with 91.8 sensitivity and 61.9% specificity. Only four misclassified players in the LR group were at risk of inadequate treatment. All participants were considered healthy, and history of a previously rehabilitated injury did not interfere with the results. LESS seems to be the best predictor for injury-risk grouping. Prone bridge time was also a whole-body variable discriminating between groups. The proposed test battery provides a promising option for field-based pre-season ACL risk assessment of football players and needs to be studied prospectively.

Pre-Season Screening Assessments: Normative Data for Pre-Professional Ballet Dancers.

Pre-professional dance is high-risk, with injury incidence up to 4.7 injuries/1000 dance hours. Pre-season screening measures have been utilized to assess risk factors for dance-related injury, however normative values haven't been established for a pre-professional ballet population. The purpose of this study was to establish normative values of ankle and hip joint range of motion (ROM), lumbopelvic control, and dynamic balance pre-season screening measures for pre-professional ballet dancers. 498 adolescent pre-professional ballet dancers [n = 219 junior division (194 female, 25 male; mean age: 12.9±0.9 year); n = 281 senior division (238 female, 41 male; mean age: 16.8±1.5 year)] participated in baseline screening tests across 5 seasons (2015-2019). Baseline measures took place at the beginning of each academic year: ankle ROM [dorsiflexion (deg); plantarflexion (PF) (deg)], total active turnout (TAT) (deg), lumbopelvic control [active straight leg raise (ASLR) (score); one leg standing test (OLS) (score)], and dynamic balance [unipedal balance (sec); Y-Balance Test (cm)]. Percentiles for ankle dorsiflexion ranged from 28.2° (male senior division, 10th percentile) to 63.3° (female junior division, 100th percentile). For PF, percentiles ranged from 77.5 to 111.8° (male junior division, 10th percentile; male senior division, 100th percentile). Percentiles for TAT for all participants ranged between 121.1° and 131.0°. For the ASLR, the proportion of participants moving with compensation (pelvis shifting) was between 64.0% and 82.2%. For OLS, 19.7% to 56.1% of dancers had a positive score (hip hiking). Percentiles for dynamic balance ranged from 3.5 to 17.1 seconds (unipedal dynamic balance) and 75.8 to 103.3 cm (YBT composite reach score) across all groups. The establishment of normative values of pre-season screening measures among a pre-professional ballet population can be used to determine areas to target during training, recognize individuals with possible injury risk, and inform return to dance protocols following injury. Comparison with other dancer/athletic populations will also provide insight into the performance of dancers and identify areas in need of improvement.

Preseason Assessment for Throwing Shoulders in Korean Professional Baseball League Pitchers and Factors Affecting Kerlan-Jobe Orthopaedic Shoulder and Elbow Scores

Preseason Assessment for Throwing Shoulders in Korean Professional Baseball League Pitchers and Factors Affecting Kerlan-Jobe Orthopaedic Shoulder and Elbow Scores

Preseason lower extremity range of motion, flexibility, and strength in relation to in-season injuries in NCAA division I gymnasts

ABSTRACT Objectives To determine if preseason lower extremity ROM, flexibility, and strength differ in collegiate gymnasts (NCAA Division 1) who do or do not sustain an injury during the competitive season. Methods Over four seasons, a total of 15 female gymnasts (age = 20.5 ± 1.0 years) underwent preseason screening (30 gymnast-season). We tested joint ROM (hip: flexion, internal and external rotation; ankle: weightbearing dorsiflexion), muscle flexibility (passive straight leg raise, Thomas,’ Ober’s, Ely’s tests) and strength (hip extensors, abductors, and flexors isometric strength via a handheld dynamometer; knee: quadriceps and hamstring isokinetic strength at 60°/sec). The team athletic trainer tracked overuse lower extremity injuries (restricted gymnasts from full participation, occurred as from participation in organized practice or competition, and required medical attention) during each season. For athletes that tested multiple seasons, each encounter was considered independent, and each preseason assessment was linked to overuse injuries sustained during the same competitive season. Gymnasts were dichotomized into injured and non-injured groups. An independent t-test was used to measure differences in preseason outcomes between injured and non-injured groups. Results During four years, we recorded 23 overuse lower extremity injuries. Gymnasts that sustained an in-season overuse injury demonstrated significantly lower hip flexion ROM (mean difference: −10.6°; 95% confidence interval: −16.5, −4.6; p < 0.01) and lower hip abduction strength (mean difference: −4.7% of body weight; 95% confidence interval: −9.2, −0.3; p = 0.04). Conclusion Gymnasts who sustain an in-season overuse lower extremity injury have significant preseason deficit of hip flexion ROM and weakness in the hip abductors. These findings indicate potential impairments in the kinematic & kinetic chains responsible for skill performance and energy absorption during landing.

Low Pre-Season Hamstring-to-Quadriceps Strength Ratio Identified in Players Who Further Sustained In-Season Hamstring Strain Injuries: A Retrospective Study from a Brazilian Serie A Team

A common pre-season injury prevention assessment conducted by professional football clubs is the hamstring-to-quadriceps (H:Q) strength ratio calculated by peak torque (PT). However, it is debatable whether players that present low pre-season H:Q ratios are more susceptible to further sustaining in-season hamstring strain injuries (HSI). Based upon retrospective data from a Brazilian Serie A football squad, a particular season came to our attention as ten out of seventeen (~59%) professional male football players sustained HSI. Therefore, we examined the pre-season H:Q ratios of these players. H:Q conventional (CR) and functional (FR) ratios, and the respective knee extensor/flexor PT from the limbs of players further sustaining in-season HSI (injured players, IP) were compared to the proportional number of dominant/non-dominant limbs from uninjured players (UP) in the squad. FR and CR were ~18-22% lower (p < 0.01), whereas quadriceps concentric PT was ~25% greater for IP than UP (p = 0.002). Low scores of FR and CR were correlated (p < 0.01) with high levels of quadriceps concentric PT (r = -0.66 to -0.77). In conclusion, players who sustained in-season HSI had lower pre-season FR and CR compared to UP, which appears to be associated with higher levels of quadriceps concentric torque than hamstring concentric or eccentric torque.

Organizational risk profiling and education associated with reduction in professional pitching arm injuries: a natural experiment

Risk profiling and education are strategies implemented to help reduce injury risk; however, currently. there is little evidence on the effect of these interventions on injury incidence. The purpose of this study was to evaluate the influence of risk profiling and education on upper extremity injury incidence in minor league (MiLB) pitchers and to stratify by injury severity. A prospective natural experiment study was conducted from 2013 to 2019 on MiLB pitchers. Beginning in the 2015 season, pitchers were examined and risk profiled for upper extremity injury. Shoulder external, internal, total range of motion, horizontal adduction, and humeral torsion were measured. Organizational risk profiling and education was implemented starting in 2015, based on preseason assessments. Chi-squared test was performed to investigate potential differences between shoulder range of motion risk categories between 2013-2014 (pre) and 2015-2019 (post) seasons. Interrupted time series analyses were performed to assess the association between organizational risk profiling and education on arm injury in MiLB pitchers and were repeated for 7-27 and 28+ day injury severity. 297 pitchers were included (pre: 119, post: 178). Upper extremity injury incidence was 1.5 injuries per 1000 athletic exposures. Pitchers in the 2015-2019 seasons demonstrated increased preseason shoulder injury risk for internal (P= .003) and external (P= .007), while the 2013-2014 seasons demonstrated greater horizontal adduction risk (P= .04). There were no differences between seasons for total range of motion risk (P=.76). Risk profiling and education resulted in an adjusted time loss upper extremity injury reduction for the 2015-2019 seasons (0.68 (95% CI: 0.47, 0.99)), which impacted 7-27 days (0.62 (95% CI: 0.42, 0.93)) but not for 28+ days (0.71 (95% CI: 0.47, 1.06)) time loss. There was no reduction in combined trunk and lower extremity injuries for the 2015-2019 seasons (1.55 (95% CI: 0.79, 3.01)). Organizational risk profiling and education appear to reduce professional pitching overall and 7-27-day upper extremity injury risk by 33%-38%. There was no difference in trunk and lower extremity injuries over the period, strengthening the reduction in upper extremity injury risk results. This suggests that while injury risk increased over time, organizational risk profiling mitigated the expected increase in upper extremity injury rates. Risk profiling and education can be used as a clinical screening and intervention tool to help decrease upper extremity injuries in professional baseball populations.

Predicting injury risk using machine learning in male youth soccer players

The aim of this study was twofold: a) to build models using machine learning techniques on data from an extensive screening battery to prospectively predict lower extremity soft tissue (LE-ST) injuries in non-elite male youth soccer players, and b) to compare models' performance scores (i.e., predictive accuracy) to select the best fit. A sample of 260 male youth soccer players from the academies of five different Spanish non-professional clubs completed the follow-up. Players were engaged in a pre-season assessment that covered several personal characteristics (e.g., anthropometric measures), psychological constructs (e.g., trait-anxiety), and physical fitness and neuromuscular measures (e.g., range of motion [ROM], landing kinematics). Afterwards, all LE-ST injuries were monitored over one competitive season. The predictive ability (i.e., area under the receiver operating characteristic curve [AUC] and F-score) of several screening models was analysed and compared to select the one with the highest scores. A total of 45 LE-ST injuries were recorded over the season. The best fit screening model developed (AUC = 0.700, F-score = 0.380) allowed to successfully identify one in two (True Positive rate = 53.7 %) and three in four (True Negative rate = 73.9 %) players at high or low risk of suffering a LE-ST injury throughout the in-season phase, respectively, using a subset of six field-based measures (knee medial displacement in the drop jump, asymmetry in the peak vertical ground reaction force during landing, body mass index, asymmetry in the frontal plane projection angle assessed through the tuck jump, asymmetry in the passive hip internal rotation ROM, and ankle dorsiflexion with the knee extended ROM). Given that these measures require little equipment to be recorded and can be employed quickly (approximately 5–10 min) and easily by trained staff in a single player, the model developed might be included in the injury management strategy for youth soccer.

Current Concepts in Prevention of Sports Injuries

Introduction: The contemporary surge in sports participation, from recreational to professional levels, has brought forth an undeniable enthusiasm for physical activity. However, this heightened engagement comes with an inherent risk of sports-related injuries, spanning various nature and severity. This article introduces the imperative need for a systematic and practical approach to prevent sports injuries, emphasizing the age-diverse demographic involved and the multifaceted motivations driving sports participation. Materials and Methods: The “Rule of 10,” presented in this paper, serves as a comprehensive guideline for sports injury prevention. The methodology encompasses a range of proactive measures addressing pre-season preparation, athlete education, and holistic strategies to mitigate injury risks. Each facet of the rule, from pre-season physical check-ups to emphasizing psychological preparedness, contributes to a cohesive and multifaceted injury prevention framework. Conclusion: We through our review article have focused on the “Rule of 10” which advocates a holistic approach to sports injury prevention, integrating pre-season assessments, diverse training, and technology. It emphasizes resilience, education, and collective responsibility for athlete well-being. Keywords: Agility, Endurance, Prevention, Sports, Strength.

Shoulder Internal Rotator Strength as Risk Factor for Shoulder Pain in Volleyball Players.

The aim of this study was to identify the intrinsic factors that could increase risk of shoulder pain in adolescent volleyball players. Twenty-eight young male volleyball players (between 14 and 18 years old) participated in this study. Athletes were submitted to: isokinetic muscle strength assessment of shoulder rotator muscles, ball service speed assessment, anterior and posterior drawer test, apprehension test, groove sign and scapular dyskinesia test. Athletes were followed for 16 weeks to monitor the presence of shoulder pain. All athletes were submitted to the same training protocol. During the 16 weeks, 28.5% of the athletes (n=8) experienced shoulder pain in the dominant limb higher than 3 according to Numerical Rating Scale criteria; 71.5% of the athletes (n=20) did not experience pain, or pain equal or lower than 3. The main result of our study was that the odds of feeling pain higher than 3 was significantly higher among players who presented higher values for internal rotation peak torque (OR=1.113, CI 95%=1.006 to 1.232 and p=0.038). The odds of feeling pain increased by 11% for every N·m of the internal rotator muscles. Pre-season isokinetic rotator strength assessments can help identify adolescent volleyball players at increased risk of a shoulder injury.