Sports Injury Risk Research Articles

Social inequalities in unintentional childhood injury incidence suggest subgroup identification and differentiation in the municipal planning of preventive efforts.

Aims: This registry-based study examined differences according to socio-economic factors in the incidence of unintentional childhood injuries involving main injury types. Methods: All children aged 0-15 years living in the municipality of Odense were followed from January 1 2006 to December 31 2010 (n=176,585). Injury outcome (n=27,745) was defined as visits to the local emergency department. Cohort data were transferred to Statistics Denmark and linked with socio-economic registry data based on unique personal identification numbers. Results: Children aged 10-15 years were at the highest risk for any injury (incidence rate ratio (IRR)=1.14), traffic injury (IRR=5.89) and sports injury (IRR=49.58) compared to children aged 0-4 years. Girls were at lower risk for any injury (IRR=0.85) and higher risk for sports injury (IRR=1.11) and home injuries (IRR=1.12) compared to boys. Children of parents with the lowest household income were at the highest risk for any injury (IRR=1.19) and traffic injury (IRR=2.16) compared to children of parents with the highest group. Children of parents with primary education were at the highest risk of any injury (IRR=1.22) and the lowest risk of traffic injury (IRR=0.80) and sports injury (IRR=0.75) compared to children of parents with tertiary education. Immigrants and descendants were at lower risk for any injury (IRR=0.75 and 0.79, respectively) and sports injury (IRR=0.81 and 0.68, respectively) compared to Danish children. Conclusions: Injury risk varied with socio-economic factors in a Danish municipal setting. The effect varied between specific injury types. Social and ethnic background is important in establishing targeted preventive efforts, but some aspects of selection bias may occur.

FUNCTIONAL MOVEMENT SCREEN™ in YOUTH SPORT PARTICIPANTS: EVALUATING the PROFICIENCY BARRIER for INJURY.

The number of youth participating in sport increases yearly; however, the evaluation of youths' movement ability and preparedness for sport remains inadequate or neglected. The Functional Movement Screen (FMS™) is an assessment of an individual's movement quality that has been utilized to evaluate risk of injury in collegiate and professional sport; however, there is minimal support regarding the predictive value of the screen in youth sport. The purpose of this study was to evaluate the mean and distribution of FMS™ performance in sport participants age 11-18, and to evaluate the existence of a composite FMS™ score proficiency barrier to predict injury risk. Prospective cohort study. One hundred, thirty-six participants (63 male, 73 female) age 11 to 18 years (16.01 + 1.35) were recruited from local schools and sport organizations. The FMS™ was administered prior to each participant's competitive season and scored by researchers who demonstrated reliability in assessments derived from the screen (κw = 0.70 to 1). Injury data were collected by the participants' Athletic Trainer over one season. An injury was defined as any physical insult or harm resulting from sports participation that required an evaluation from a health professional with time modified or time lost from sport participation. Females scored significantly higher than males for mean FMS™ composite score (t = 14.40; m = 12.62; p < 0.001), and on individual measures including: the hurdle step (t = 1.91; m = 1.65; p < 0.001), shoulder mobility (t = 2.68; m = 2.02; p < 0.001), active straight leg raise (t = 2.32; m = 1.87; p < 0.001), and the rotary stability components (t = 1.91; m = 1.65; p < 0.05). Two FMS™ composite scores (score < 14 and <15) significantly increased the odds of injury (OR = 2.955). When adjusting for sport, there was no score relating to increased odds of injury. Dysfunctional movement as identified by the FMS™ may be related to increased odds of injury during the competitive season in youth athletes. Consideration of an individual's movement within the context of their sport is necessary, as each sport and individual have unique characteristics. Addressing movement dysfunction may aid in injury reduction and potentially improve sport performance. 1b.

Factors Influencing the Relationship Between the Functional Movement Screen and Injury Risk in Sporting Populations: A Systematic Review and Meta-analysis.

Studies investigating the association between the Functional Movement Screen (FMS) and sports injury risk have reported mixed results across a range of athlete populations. The purpose of this systematic review was to identify whether athlete age, sex, sport type, injury definition and mechanism contribute to the variable findings. Systematic review and meta-analysis. A systematic search was conducted in October 2018 using PubMed, EBSCOhost, Scopus, EmBase and Web of Science databases. Studies were included if they were peer reviewed and published in English language, included athletes from any competition level, performed the FMS at baseline to determine risk groups based on FMS composite score, asymmetry or pain, and prospectively observed injury incidence during training and competition. Study eligibility assessment and data extraction was performed by two reviewers. Random effects meta-analyses were used to determine odds ratio (OR), sensitivity and specificity with 95% confidence intervals. Sub-group analyses were based on athlete age, sex, sport type, injury definition, and injury mechanism. Twenty-nine studies were included in the FMS composite score meta-analysis. There was a smaller effect for junior (OR = 1.03 [0.67-1.59]; p = 0.881) compared to senior athletes (OR = 1.80 [1.17-2.78]; p = 0.008) and for male (OR = 1.79 [1.08-2.96]; p = 0.024) compared to female (OR = 1.92 [0.43-8.56]; p = 0.392) athletes. FMS composite scores were most likely to be associated with increased injury risk in rugby (OR = 5.92 [1.67-20.92]; p = 0.006), and to a lesser extent American football (OR = 4.41 [0.94-20.61]; p = 0.059) and ice hockey (OR = 3.70 [0.89-15.42]; p = 0.072), compared to other sports. Specificity values were higher than sensitivity values for FMS composite score. Eleven studies were included in the FMS asymmetry meta-analysis with insufficient study numbers to generate sport type subgroups. There was a larger effect for senior (OR = 1.78 [1.16-2.73]; p = 0.008) compared to junior athletes (OR = 1.21 [0.75-1.96]; p = 0.432). Sensitivity values were higher than specificity values for FMS asymmetry. For all FMS outcomes, there were minimal differences across injury definitions and mechanisms. Only four studies provided information about FMS pain and injury risk. There was a smaller effect for senior athletes (OR = 1.28 [0.33-4.96]; p = 0.723) compared to junior athletes (OR = 1.71 [1.16-2.50]; p = 0.006). Specificity values were higher than sensitivity values for FMS pain. Athlete age, sex and sport type explained some of the variable findings of FMS prospective injury-risk studies. FMS composite scores and asymmetry were more useful for estimating injury risk in senior compared to junior athletes. Effect sizes tended to be small except for FMS composite scores in rugby, ice hockey and American football athletes. CRD42018092916.

Correlation of Physical Conditions and Anthropometric Factors for the Risk of Sports Injuries

Correlation of Physical Conditions and Anthropometric Factors for the Risk of Sports Injuries

Anterior Cruciate Ligament Injury Risk in Sport: A Systematic Review and Meta-Analysis of Injury Incidence by Sex and Sport Classification.

To evaluate sex differences in incidence rates (IRs) of anterior cruciate ligament (ACL) injury by sport type (collision, contact, limited contact, and noncontact). A systematic review was performed using the electronic databases PubMed (1969-January 20, 2017) and EBSCOhost (CINAHL, SPORTDiscus; 1969-January 20, 2017) and the search terms anterior cruciate ligament AND injury AND (incidence OR prevalence OR epidemiology). Studies were included if they provided the number of ACL injuries and the number of athlete-exposures (AEs) by sex or enough information to allow the number of ACL injuries by sex to be calculated. Studies were excluded if they were analyses of previously reported data or were not written in English. Data on sport classification, number of ACL injuries by sex, person-time in AEs for each sex, year of publication, sport, sport type, and level of play were extracted for analysis. We conducted IR and IR ratio (IRR) meta-analyses, weighted for study size and calculated. Female and male athletes had similar ACL injury IRs for the following sport types: collision (2.10/10 000 versus 1.12/10 000 AEs, IRR = 1.14, P = .63), limited contact (0.71/10 000 versus 0.29/10 000 AEs, IRR = 1.21, P = .77), and noncontact (0.36/10 000 versus 0.21/10 000 AEs, IRR = 1.49, P = .22) sports. For contact sports, female athletes had a greater risk of injury than male athletes did (1.88/10 000 versus 0.87/10 000 AEs, IRR = 3.00, P < .001). Gymnastics and obstacle-course races were outliers with respect to IR, so we created a sport category of fixed-object, high-impact rotational landing (HIRL). For this sport type, female athletes had a greater risk of ACL injury than male athletes did (4.80/10 000 versus 1.75/10 000 AEs, IRR = 5.51, P < .001), and the overall IRs of ACL injury were greater than all IRs in all other sport categories. Fixed-object HIRL sports had the highest IRs of ACL injury for both sexes. Female athletes were at greater risk of ACL injury than male athletes in contact and fixed-object HIRL sports.

Rethinking Dynamic Knee Valgus and Its Relation to Knee Injury: Normal Movement Requiring Control, Not Avoidance.

The risk of knee injury in sport may be related to deviations in lower-limb alignment. An example of biomechanical deviation is dynamic knee valgus, considered by many to be one of the most important predictors of serious knee injury; however, the predictive validity of commonly used screening tests for dynamic knee valgus has recently been questioned. In this Viewpoint, the authors argue that assessing the risk of knee injury is complex and endeavor to present pelvic pronation and system tension as a 3-D construct to consider during physical assessments and exercise design, and to recognize dynamic knee valgus as a normal and necessary response to ground reaction forces. J Orthop Sports Phys Ther 2019;49(4):216-218. doi:10.2519/jospt.2019.0606.

INFLUENCE OF A PRE-SEASON COACHES’ EDUCATION WORKSHOP STRATEGY ON ATHLETE INJURY RISK ASSESSMENT

Background: Evidence-based preventive training programs (PTPs) used as a pre-participation warm-up for sport have been shown to reduce injury risk in youth athletes; however, injury risk improvements depend on PTP dosage and fidelity, where increased levels of PTP compliance facilitate and sustain greater reductions in injury risk. While coaches represent the best option to facilitate PTPs long term, it is unknown how to best train coaches to ensure effective PTP implementation behavior. In other areas of health behavior research, education strategies tailored specifically to an individual’s needs and interests increase the likelihood of adopting a given behavior. To encourage youth sport coaches to implement PTPs, it may be beneficial to tailor workshops. One way to gauge the impact of an education strategy is to look at end-user outcomes. Therefore, the purpose of this study was to evaluate changes in athlete injury risk, as measured by the Landing Error Scoring System (LESS), between adolescent basketball and soccer athletes whose coach attended a General pre-season education workshop on PTP implementation compared to a Tailored pre-season education workshop. Methods: A cluster randomized control trial was utilized. Youth soccer and basketball organizations were contacted to participate in a pre-season coaches’ education workshop on PTP implementation. Organizations were randomized into either a General or Tailored workshop. All participating coaches within a given organization attended the same workshop. General workshops contained standardized content including: youth sport injury epidemiology, injury rate and risk reduction benefits of PTPs, and hands-on instruction on how to implement a PTP. Coaches in Tailored workshops completed pre-workshop surveys. The pre-workshop survey contained Likert-style questions on knowledge of and experience with implementing PTPs. Researchers used the results to prioritize and inform content emphasis within the Tailored workshop. For example, if an organization had a high frequency of coaches who reported that they were particularly interested in the sport performance benefits of PTPs, the research team would devote increased time to discussing that particular component. Both the General and Tailored workshop were approximately 1-hour in length but varied in the amount of time spent on different topic areas. Athletes completed a PRE and POST season baseline assessment of injury risk. The injury risk assessment included three trials of a jump-landing task that was evaluated using the Landing Error Scoring System (LESS). The LESS is a valid and reliable clinical movement assessment used to identify high-risk movement patterns during a jump-landing task. LESS scores are based on observable errors, where a higher score indicates a greater number of movement errors and an increased risk of sustaining a lower extremity injury. To complete the task, participants jumped off a 30-cm high box to a distance half of their height and immediately rebounded straight in the air for maximum vertical height. A single, reliable rater graded all trials for PRE and POST. All three trials were averaged together for one composite LESS score at each time point. A mixed model analysis of variance (ANOVA) was used to evaluate differences in composite LESS score over time (PRE, POST) between educational workshops (General, Tailored). All data were analyzed using SPSS Version 21.0 with an a priori alpha level of p&lt;0.05. Results: Seventy-seven athletes on 9 teams across 6 different organizations (Coaches’ Workshops: General=5 teams from 4 organizations; Tailored=4 teams from 2 organizations) completed both PRE and POST testing sessions. There were no significant differences between workshop (General, Tailored) and LESS scores at POST (P&gt;0.05). Regardless of workshop LESS scores improved over time ((Mean±SD [95%CI]) Generalized PRE: 5.46±0.10 [4.84, 6.08], Generalized POST: 4.62±0.10 [4.00, 5.25], Tailored PRE: 5.99±0.09[5.40, 6.59], Tailored POST: 5.66±0.09[5.06, 6.25])(P=0.03). Conclusions: Regardless of coaches’ educational workshop strategy, athletes improved movement technique from PRE to POST across a single sport season. These findings suggest that any level of exposure to PTP-related content could have beneficial downstream effects for the end user, or in this case reduced injury risk for youth athletes. Future studies should look to evaluate the content of pre-season coach education workshops in conjunction with tracking fidelity of program delivery in order to optimize efforts to disseminate and implement PTPs for youth sport coaches. [Figure: see text]

Beighton scoring of joint laxity and injury incidence in Middle Eastern male youth athletes: a cohort study

ObjectivesTo examine the association between generalised joint laxity (GJL) and injury rates in Middle Eastern male youth athletes.DesignProspective observational study consisting of GJL screen and injury audit (season 2009/2010).SettingAspire Sports...

Training Volume and Intensity of Physical Activity among Young Athletes: The Health Promoting Sports Club (HPSC) Study

Both training volume and overall physical activity (PA) play a role in young athletes’ sports performance and athletic development. The purpose of this study was to describe the training volume and PA of young athletes in endurance, aesthetics, ball games, and power sports. Questionnaire data (n = 671) were obtained from 15-year-old Finnish athletes on sports participation, along with accelerometer data (n = 350) assessing the amount and intensity of their PA. The athletes’ mean weekly training volume was 11 h 41 min. Objectively assessed PA amounted to 4 h 31 min daily, out of which 1 h 31 min was at a level of moderate-to-vigorous intensity (MVPA). Among 24% of the athletes, the weekly training volume (in hours) exceeded the recommended level of age-in-years, which might increase their risk of sports injuries. At the same time, one in six athletes (16%) did not—on average—reach the internationally recommended threshold level of at least 60 minutes of MVPA per day. Compared to girls, boys averaged 2.5 more hours of training per week, and had 21 more minutes of MVPA per day. Moreover, boys had a higher goal orientation than girls, with 52% of the boys and only 29% of the girls focused on success at adult level. Although total training volume and PA did not differ among sports types, there were differences in training forms, and in the proportions of MVPA. The young athletes were found to vary greatly in training forms, training volumes, MVPA, and goal orientation; hence, training should be planned individually, both for team sports and individual sports.

A Descriptive Study of Self-Reported Injury in Non-elite Adaptive Athletes.

Adaptive sports programs are increasing across the country and there is a paucity of research investigating the epidemiology and sports injury risk factors in non-elite athletes. To assess the demographics, training regime, and injuries incurred by adaptive athletes participating in local adaptive sports clubs and to assess the athletes' type of medical care and prevalence of those with spasticity. Descriptive cross-sectional study. Local area adaptive sports teams and programs. Sixty-one athletes participating in wheelchair basketball, wheelchair rugby, sled hockey, and adaptive rowing were surveyed, with a response rate of 70.5%. Completion of self-report survey. Report of injury prevalence, injury characteristics, type of medical care, and assessment of frequency and severity of spasticity using the Penn Spasm Frequency Scale. Most athletes (86%) trained or competed in their main sport 9-12 months per year. Most athletes (79.1%) trained at least 4 hours per week. In the past 12 months, 39.5% of athletes surveyed sustained an injury that required them to miss practice or a competition, with 58.8% of these athletes having sustained a significant injury. Many of those injured (64.7%) had never participated in an injury prevention or conditioning program. Injury prevalence by sport was 42.9% in wheelchair rugby, 60% in sled hockey, 44% wheelchair basketball, and 0% in adaptive rowing. The most commonly injured body parts were the shoulder (52.9%) and wrist (52.9%). This study shows that non-elite adaptive sports athletes sustain similar types of injuries as noted in published reports of elite athletes but could be provided with less injury prevention education and access to medical care. This area will require future study, especially investigating injury risk factors within specific sports and diagnoses. III.

Genetic Testing by Sports Medicine Physicians in the United States: Attitudes, Experiences, and Knowledge.

It remains unknown whether and how sports medicine physicians currently utilize genetic testing in their clinical practice. This study sought to assess knowledge of, experience with, and attitudes towards genetic testing by sports medicine physicians in the United States (US). An email with a survey hyperlink was distributed twice to members of the American Medical Society for Sports Medicine (AMSSM) listserv in September 2016, with approximately a 10% response rate. Questions focused on knowledge of, experience with, and attitudes towards testing for different genes related to sports proficiency, injury risk, and disease risk. Few AMSSM physicians believe that genetic testing to adapt training (12%) or to choose a sport (2%) is ready for clinical adoption. Most respondents self-reported minimal knowledge about, and limited experience with, genetic testing. The main exception was screening for sickle cell trait (SCT) for which most (84%) reported moderate/significant/expert knowledge and over two-thirds had ordered testing. Although most respondents thought it appropriate to counsel and test for health conditions associated with cardiac and connective tissue disorders in the setting of a positive family history, only a minority had been asked to do so. Five or fewer respondents (2%) had been asked to test for performance-associated variants (Angiotensin Converting Enzyme (ACE) II and Alpha-Actinin 3 (ACTN3)), and five or fewer (2%) would recommend changes based on the results. Our study provides a baseline of current US sports medicine physicians’ minimal experiences with, and knowledge of, genetic testing. The findings of our study indicate that sports medicine physicians require further genetics education as it relates to sports and exercise in order to be prepared to competently engage with their patients and to develop sound professional organizational policies.

OR-007 Identification of Early Predictive Biomarkers for Exercise-induced Immunodepression by Urinary iTRAQ-proteomic Analysis

Objective Exercise-induced immunodepression is a common medical problem in competitive sports, leading to upper respiratory tract infection, affecting sports training and sports performance, and increasing athletes' sports disease and injury risk. Finding non-invasive early predictive biomarkers of exercise-induced immunodepression and giving corresponding preventive measures is therefore an important issue in sports training. iTRAQ is an important method that currently looking for and discovering disease-specific protein biomarkers of disease prevention, diagnosis, prognosis, and efficacy monitoring. In this study, early predictive biomarkers of exercise-induced immunodepression will be identified through the iTRAQ proteomics technique, which helps to prevent the occurrence of exercise-induced immunodepression.&#x0D; Methods Fifteen healthy males were recruited from the student cohort of Guangzhou Sport University. Subjects performed four-week incremental load running exercise. The weekly running load intensity was 60% VO2max, 70% VO2max, 80% VO2max, 90% VO2max respectively, 5d/w, and 1h/d. The fasting venous blood and urine of the subjects was collected in the morning before the start of the training intervention and at the end of each training week. The white blood cells of the whole blood and the levels of the lymphocyte subtypes CD4+ and CD8+ were tested to monitor the immune function status of the subjects. iTRAQ proteomics technology was used to test and identify differential proteins and their characteristics in urine.&#x0D; Results During the four weeks of increasing running load, the subject’s immune function was progressively reduced. Whole blood white blood cells, and CD4+ and CD8+ lymphocyte fell by more than 10% at the end of the fourth week, showing exercise-induced Immunodepression. Using iTRAQ to test urine proteomes, there were as many as 1854 proteins in the urine during the incremental loading process. The relative molecular weights of most of the proteins were between 10-80 kDa, and the isoelectric point was between 4.5 and 7. During the four weeks of incremental loading running, there were 89, 52, 77, and 148 differential proteins up-regulated, and 66, 27, 68, and 114 differential proteins downregulated respectively in the urine of each week. The differential proteins were mostly found in extracellular and plasma membranes. It is mainly involved in the in vivo biological process, the immune system process, the material transport, and is related to the positive regulatory pathways and immune regulatory pathways for stress response. The up-regulation multiples of four up-regulated proteins such as Semenogelin-1, Prolactin-inducible protein, Platelet-derived growth factor receptor-like protein, and Nucleoside diphosphate kinase increased with increasing exercise intensity. The up-regulated multiples of Glycerol-3-phosphate phosphatase, Secretogranin-1, Prosaposin, and Nephronectin (Fragment) increased with increasing exercise intensity from the second week of exercise. The down-regulation multiples of Ig kappa chain C region, Immunoglobulin lambda variable 3-21 of CUB and EGF-like domain-containing protein 2 and Uromodulin decreased further with the increase of exercise intensity from the second week of exercise, which was consistent with the change of immune function.&#x0D; Conclusions Urine iTRAQ proteomics technique is an important method to identify early predictive biomarkers of exercise-induced immunodepression, which helps to prevent the occurrence of exercise-induced immunodepression. In this study, the differential proteins in urine, such as Semenogelin-1, Prolactin-inducible protein, Platelet-derived growth factor receptor-like protein, and Nucleoside diphosphate kinase can be considered as early predictive biomarkers of exercise-induced immunodepression.

Foot typology, body weight distribution, and postural stability of adolescent elite soccer players: A 3-year longitudinal study.

ObjectiveThe unique foot morphology and distinctive functions facilitate complex tasks and strategies such as standing, walking, and running. In those weight-bearing activities, postural stability (PS) plays an important role. Correlations among foot type, PS, and other musculoskeletal problems that increase sport injury risk are known. However, long-term associations among the foot type, the PS, and body weight (BW) distribution are lacking. Thus, the purpose of this study was to longitudinally identify changes in foot morphology, PS, and symmetry in BW distribution during adolescence among elite male soccer players.MethodsThirty-five Czech elite male soccer players (age, 15.49 ± 0.61 years; BW, 64.11 ± 6.16 kg; body height, 174.62 ± 5.71 cm) underwent foot type, PS, and BW distribution measurements during 3 consecutive years (T1, T2, T3). The Chippaux-Smirak index (CSI), BW distribution, and centre of pressure (COP) displacement (total traveled way [TTW]) of each player for the preferred (PL) and non-preferred leg (NL) were acquired. Repeated-measures analysis of variance (RM ANOVA), Bonferroni´s post hoc tests, and partial eta-squared (ηp2) coefficient were used for investigating the effect of time on selected variables and effect size evaluation.ResultsStatistically significant effect of time on CSI values (PL: F2,68 = 5.08, p < 0.01, ηp2 = 0.13 and NL: F2,68 = 10.87, p < 0.01, ηp2 = 0.24) and COP displacement values (PL: F2,68 = 5.07, p <0.01, ηp2 = 0.13; NL: F2,68 = 3.53, p <0.05, ηp2 = 0.09) for both legs over 3-years period was identified. Furthermore, the Bonferroni´s post hoc analysis revealed a significant improvement of PS values in the PL (TTWT1 = 1617.11 ± 520.22 mm vs. TTWT2 = 1405.29 ± 462.76, p < 0.05; and between TTWT1 = 1617.11 ± 520.22 mm vs. TTWT3 = 1370.46 ± 373.94, p < 0.05). Only BW distribution parameter showed no significant differences, although slightly improved over time.ConclusionsWe observed changes in foot typology, PS, and BW distribution in young elite male soccer players during 3 consecutive years. Results demonstrated that changes in PS and body weight distribution under the high-load sport conditions during adolescence may improve with aging, except for foot morphology. Therefore, foot morphology should be carefully monitored to minimize sport injury risk in professional young soccer players during adolescence. Further research is necessary to determine more clear associations between these parameters, soccer-related injuries, and sport performances.

Coordination and variability during anticipated and unanticipated sidestepping

BackgroundNumerous investigations have attempted to link the incidence and risk of non-contact anterior cruciate ligament injuries to specific intrinsic and extrinsic mechanisms. However, these are often measured in isolation. Research questionThis study utilizes a dynamical systems approach to investigate differences in coordination and coordination variability between segments and joints in anticipated and unanticipated sidestepping, a task linked to a high risk of non-contact anterior cruciate ligament injuries. MethodsFull body, three-dimensional kinematics and knee kinetic data were collected on 22 male collegiate soccer players during anticipated and unanticipated sidestepping tasks. A modified vector coding technique was used to quantify coordination and coordination variability of the trunk and pelvis segments and the hip and knee joints. ResultsSagittal and frontal plane trunk-pelvis coordination were more in-phase during unanticipated sidestepping. Sagittal plane hip-knee and hip (rotation)-knee (flexion/extension) coordination were more in-phase with the knee dominating the movement during unanticipated sidestepping (P < 0.05). Coordination variability was greater in unanticipated sidestepping for trunk (flexion)-pelvis (tilt), trunk (lateral flexion)-pelvis (obliquity), hip (flexion/extension)-knee (flexion/extension) and hip (rotation)-knee (flexion/extension) (P < 0.05). In unanticipated sidestepping where there is limited time to pre-plan the movement, multiple kinematic solutions and high coordinative variability is required to achieve the task. SignificanceOur results suggest that coordination becomes more in-phase and the variability of this coordination increases as a function of task complexity and reduced planning time as that which occurs in unanticipated sporting task scenarios. Consequently, injury prevention programs must incorporate perceptual components in order to optimise planning time and coordinate appropriate postural adjustments to reduce external knee joint loading and subsequent injury risk in sport.

Prevalence and behavioural associations of unintentional injuries among Chinese college students: a 50-University population-based study

ObjectiveTo assess the prevalence, demographic characteristics and behavioural correlates of unintentional injuries among Chinese college students.MethodsA cross-sectional multistage survey sampling process was conducted among 11 770 undergraduates from 50 universities...

La prévention des blessures sportives : modèles théoriques et éléments-clés d’une stratégie efficace

Research topic about sport injury prevention has importantly increased these last years. Several theoretical models have been developed with the aim of helping sport and medical staffs with preventive strategies, and many studies have demonstrated the high efficacy of preventive programs if quality conditions are met. Among these models, at least two “sports injury risk management approaches” have been recently described and their relevance needs to be confirmed by further research. In order to maximize efficacy, preventive strategies should include: pre-competition medical assessment, actions to decrease multiple risk factors at the same time, maximal compliance, training load quantification and monitoring.

Strength-Endurance Training Reduces the Hamstrings Strength Decline Following Simulated Football Competition in Female Players.

Hamstring strains are the most common injury in multiple sprint sports, with inadequate eccentric hamstring strength and fatigue identified as important risk factors. Resistance training interventions aimed at reducing injury risk typically focus on the development of maximum strength, while little is known about the impact of training on hamstring fatigue resistance. The present study compared the effects of strength endurance (SE) with a strength intervention (S) on the eccentric hamstring strength decline induced by a simulated soccer match. Twenty-one female soccer players were randomly assigned to a S group (n = 10) or a SE group (n = 11). Hamstrings and quadriceps isokinetic concentric and eccentric peak torque (PT) were assessed at 120°.s-1 and hamstrings-to-quadriceps ratio (HEcc:QCon) calculated, pre- and immediately post a 90-min simulated match (BEAST90). This was repeated following a 7-week intervention of either three to five sets of 6RM leg curl and stiff-leg deadlift with 3-min inter-set rest (S), or the same exercises performed using three sets of 12–20 RM with 45–90 s inter-set rest (SE). At baseline, the simulated match led to significant declines in hamstrings eccentric peak torque (EccPT) in both groups in both dominant (D) and non-dominant (ND) legs [SE: (D: -15.5, ND: -15.6%), P = 0.001 to 0.016; S: (D: -12.3%, ND: -15.5%), P = 0.001 to 0.018]. After the 7-week intervention, we observed a group∗intervention∗match interaction such that there was no significant decline in EccPT in the SE group following the simulated match (D: 5.3%, ND: 2.0%), but there remained significant declines in the S group (D: -14.2%, ND: -15.5%, P = 0.018–0.001). Similarly, in the SE group, there was a significant decrease in the HEcc:QCon in D before (-14.2%, P = 0.007), but not after the training intervention, whereas declines were observed in the S group both at baseline, and following the intervention (D: -13.9%, ND: -15.6%, P = 0.045). These results demonstrate that SE training can reduce the magnitude of the EccPT decline observed during soccer competition. As inadequate eccentric strength and fatigue are both risk factors for hamstring injury, SE training should be considered along with the development of peak eccentric strength, as a component of programs aimed at reducing injury risk in multiple-sprint sports.

Quantitative and non-invasive measurement of exercise-induced fatigue

Prolonged exercise-induced muscular fatigue adversely affects physical performance. The fatigue increases the risk of sport injuries, whereas early fatigue detection and assessment can prevent injuries. An assessment of the most crucial impacts of fatigue on physical performance leads to the development of an accurate, non-invasive and objective muscular fatigue measurement method. The most common manifestation of exercise-induced fatigue is a significant decline in force produced by the muscles that in turn affects motion characteristics. This directly alters body postural behaviour and decreases the amount of kinetic energy produced by the subject. The current non-invasive and objective methods to measure fatigue and analyse motion characteristics cannot provide a comprehensive information about muscular fatigue because of their limited ability to record different aspects of motion. An objective and non-invasive assessment method of exercise-induced fatigue, in which the variations in postural behaviour and kinetic energy are quantified to determine the fatigue effects on the motion characteristics, is proposed. The inertial parameters associated with 23 body segments of 20 healthy subjects (males and females) were measured during stair climbing tests before and after a fatigue protocol. The degree of fatigue was assessed by a score measuring the total differences in kinetic energy and postural behaviour between the first and second stair climbing tests. A Gaussian mixture model was used to classify the body postures and the total variation in postural behaviour caused by the two stair climbing tests was determined. The validity of the method to measure the degree of fatigue induced by this fatigue protocol was ascertained by benchmarking it against the degree of fatigue experienced by the subjects during fatigue protocol and reported in a questionnaire based on the Rate of Perceived Exertion Scale. A Pearson product-moment correlation measuring the linear correlation between the objective and subjective fatigue scores shows a strong correlation of 0.95 for male subjects and 0.70 for female subjects. The findings demonstrate that inertial motion analysis proposed in this study provides a reliable, non-invasive and accurate fatigue measurement tool.

The risk of snow sport injury in pediatric patients

PurposeIn 2015, approximately 13,436 snowboarding or skiing injuries occurred in children younger than 15. We describe injury patterns of pediatric snow sport participants based on age, activity at the time of injury, and use of protective equipment. MethodsA retrospective analysis was performed of 10–17 year old patients with snow-sport related injuries at a Level-1 trauma center from 2005 to 2015. Participants were divided into groups, 10–13 (middle-school, MS) and 14–17 years (high-school, HS) and compared using chi-square, Student's t-tests, and multivariable logistic regression. ResultsWe identified 235 patients. The HS group had a higher proportion of females than MS (17.5% vs. 7.4%, p = 0.03) but groups were otherwise similar. Helmet use was significantly lower in the HS group (51.6% vs. 76.5%, p < 0.01). MS students were more likely to suffer any head injury (aOR 4.66, 95% CI: 1.70–12.8), closed head injury (aOR 3.69 95% CI: 1.37–9.99), or loss of consciousness (aOR 5.56 95% CI 1.76–17.6) after 4 pm. HS students engaging in jumps or tricks had 2.79 times the risk of any head injury (aOR 2.79 95% CI: 1.18–6.57) compared to peers that did not. HS students had increased risk of solid organ injury when helmeted (aOR 4.86 95% CI: 1.30–18.2). ConclusionsInjured high-school snow sports participants were less likely to wear helmets and more likely to have solid organ injuries when helmeted than middle-schoolers. Additionally, high-schoolers with head injuries were more like to sustain these injures while engaging in jumps or tricks. Injury prevention in this vulnerable population deserves further study. Level of evidenceLevel III (Retrospective Comparative Study).

PRESEASON LOWER EXTREMITY FUNCTIONAL TEST SCORES ARE NOT ASSOCIATED WITH LOWER QUADRANT INJURY – A VALIDATION STUDY WITH NORMATIVE DATA ON 395 DIVISION III ATHLETES

Preseason performance on the lower extremity functional test (LEFT), a timed series of agility drills, has been previously reported to be associated with future risk of lower quadrant (LQ = low back and lower extremities) injury in Division III (D III) athletes. Validation studies are warranted to confirm or refute initial findings. The primary purpose of this study was to examine the ability of the LEFT to discriminate injury occurrence in D III athletes, in order to validate or refute prior findings. It was hypothesized that female and male D III athletes slower at completion of the LEFT would be at a greater risk for a non-contact time-loss injury during sport. Secondary purposes of this study are to report other potential risk factors based on athlete demographics and to present normative LEFT data based on sport participation. Two hundred and six (females = 104; males = 102) D III collegiate athletes formed a validation sample. Athletes in the validation sample completed a demographic questionnaire and performed the LEFT at the start of their sports preseason. Athletic trainers tracked non-contact time-loss LQ injuries during the season. A secondary analysis of risk based on preseason LEFT performance was conducted for a sample (n = 395) that consisted of subjects in the validation sample (n = 206) as well as athletes from a prior LEFT related study (n = 189). Prospective cohort. Male athletes in the validation sample completed the LEFT [98.6 ( ± 8.1) seconds] significantly faster than female athletes [113.1 ( ± 10.4) seconds]. Male athletes, by sport, also completed the LEFT significantly faster than their female counterparts who participated in the same sport. There was no association between preseason LEFT performance and subsequent injury, by sex, in either the validation sample or the combined sample. Females who reported starting primary sport participation by age 10 were two times (OR = 2.4, 95% CI: 1.2, 4.9; p = 0.01) more likely to experience a non-contact time-loss LQ injury than female athletes who started their primary sport at age 11 or older. Males who reported greater than three hours per week of plyometric training during the six-week period prior to the start of the preseason were four times more likely (OR = 4.0, 95% CI: 1.1, 14.0; p = 0.03) to experience a foot or ankle injury than male athletes who performed three or less hours per week. The LEFT could not be validated as a preseason performance measure to predict future sports injury risk. The data presented in this study may aid rehabilitation professionals when evaluating an injured athlete's ability to return to sport by comparing their LEFT score to population norms. 2.