Sports Trauma Research Center Questionnaire Research Articles

Incidence and prediction of ankle injury risk: a prospective cohort study on 91 contemporary preprofessional dancers

ObjectivesThis study examines the incidence of ankle injuries and identifies ankle injury risk among contemporary preprofessional dancers.MethodsA total of 91 first-year contemporary preprofessional dancers were prospectively followed during one academic...

An Examination of Training Load, Match Activities, and Health Problems in Norwegian Youth Elite Handball Players Over One Competitive Season

Talent development is integral to the policy and organizational practice of competitive sport, but has also been associated with excessive amounts of training and competition, and athlete injuries and illnesses. The lack of available prospective data on the training and match activities of youth athletes and their health problems is therefore of concern. The aim of this study was two-fold: (a) to examine the amount and frequency of training load, match activities, injury and illness incidence, and prevalence among Norwegian youth elite handball players over the course of the 2018–2019 competitive season; and (b) to explore whether the injury rates are related to the sex or competition level of players, or their membership of the youth international team. We recruited 205 handball players (64% female, 36% male), aged 15–18 years (17.2 years ± 0.9) from five different sport school programs in southeast Norway. Data were collected daily from September 2018 to May 2019, during the competitive handball season. The variables included types of athlete activities, the number of activities, the rating of perceived exertion (RPE), and the duration of training and matches. Injury and illness data were collected weekly using the Oslo Sports Trauma Research Center (OSTRC) questionnaire. The mean number of matches per week per player was 0.9 ± 1.29; the number of weekly training events was 6.1 ± 4.4; and the mean weekly session RPE was 986 ± 1 412 arbitrary units. The players reported a total of 472 injuries, and the mean number of injuries per player was 2.3 ± 2.9. The results demonstrated a 53% weekly injury prevalence, of which 38% were categorized as substantial injuries. Male players and players who participated at the highest level of senior competition and/or the youth international team reported significantly lower weekly incidences of health problems, compared to other players. Our findings showed that players enrolled in sport school programs are exposed to high training and competition loads, and that both general and substantial health problems are common. The potential implications for talent development and future research are discussed.

Generalized Joint Hypermobility and Injuries: A Prospective Cohort Study of 185 Pre-Professional Contemporary Dancers.

Generalized joint hypermobility (GJH) has been mentioned as one of the factors associated with dance injuries, but the findings are inconclusive. This study aims to investigate whether GJH, based on different Beighton score cut-off points, is a potential risk factor for injuries in pre-professional dancers. Four cohorts of first-year pre-professional dancers (N = 185), mean age 19.1 ± 1.3 years, were screened on musculoskeletal functioning at the start of their academic year. The Beighton score was used to measure GJH. During the academic year, the dancers completed monthly questionnaires about their physical and mental health. Based on the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC), three injury definitions were used (i.e., all complaints, substantial injury, and time-loss injury). To examine potential risk factors for injuries, univariate and multivariate regression models were applied. The response rate of monthly completed questionnaires was 90%. The overall mean (SD) Beighton score was 2.8. The 1-year injury incidence proportion was 67.6% (n = 125), 43.2% (n = 80), and 54.6% (n = 101) for all complaint injuries, substantial injuries, and time-loss injuries, respectively. The multivariate analyses showed a significant association between a previous long lasting injury in the past year and the three injury definitions (p < 0.05). Pre-professional contemporary dancers are at high risk for injuries and hypermobility. However, these two variables are not associated with each other. Health professionals should take injury history into account when assessing dance students, because this variable is associated with increased injury risk.

Personalized machine learning approach to injury monitoring in elite volleyball players

ABSTRACT We implemented a machine learning approach to investigate individual indicators of training load and wellness that may predict the emergence or development of overuse injuries in professional volleyball. In this retrospective study, we collected data of 14 elite volleyball players (mean ± SD age: 27 ± 3 years, weight: 90.5 ± 6.3 kg, height: 1.97 ± 0.07 m) during 24 weeks of the 2018 international season. Physical load was tracked by manually logging the performed physical activities and by capturing the jump load using wearable devices. On a daily basis, the athletes answered questions about their wellness, and overuse complaints were monitored via the Oslo Sports Trauma Research Center (OSTRC) questionnaire. Based on training load and wellness indicators, we identified subgroups of days with increased injury risk for each volleyball player using the machine learning technique Subgroup Discovery. For most players and facets of overuse injuries (such as reduced sports participation), we have identified personalized training load and wellness variables that are significantly related to overuse issues. We demonstrate that the emergence and development of overuse injuries can be better understood using daily monitoring, taking into account interactions between training load and wellness indicators, and by applying a personalized approach. Highlights With detailed, athlete-specific monitoring of overuse complaints and training load, practical insights in the development of overuse injuries can be obtained in a player-specific fashion contributing to injury prevention in sports. A multi-dimensional and personalized approach that includes interactions between training load variables significantly increases the understanding of overuse issues on a personal basis. Jump load is an important predictor for overuse injuries in volleyball.

Injuries and illnesses among competitive Norwegian rhythmic gymnasts during preseason: a prospective cohort study of prevalence, incidence and risk factors

ObjectivesRhythmic gymnastics is an Olympic sport that demands high training volume from early age. We investigated the extent of, and risk factors for, injuries among competitive Norwegian rhythmic gymnasts.MethodsOne hundred...

Prevalence and burden of health problems in competitive adolescent distance runners: A 6-month prospective cohort study

ABSTRACT To describe all health problems (injuries and illnesses) in relation to type, location, incidence, prevalence, time loss, severity, and burden, in competitive adolescent distance runners in England. Prospective observational study: 136 competitive adolescent distance runners (73 female athletes) self-reported all health problems for 24-weeks between May and October 2019. Athletes self-reported health problems using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. The incidence of running-related injury per 1,000 hours of exposure was markedly higher, compared to previous research. At any time, 24% [95% Confidence Intervals (CI): 21–26%] of athletes reported a health problem, with 11% [95% CI: 9–12%] having experienced a health problem that had substantial negative impact on training and performance. Female athletes reported noticeably more illnesses, compared to male athletes, including higher prevalence, incidence, time loss, and severity. The most burdensome health problems, irrespective of sex, included lower leg, knee, and foot/toes injuries, alongside upper respiratory illnesses. The mean weekly prevalence of time loss was relatively low, regardless of health problem type or sex. Competitive adolescent distance runners are likely to be training and competing whilst concurrently experiencing health problems. These findings will support the development of injury and illness prevention measures.

Validity and Reliability of the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on Overuse Injury and Health Problem in Thai Version

Background: The Oslo Sports Trauma Research Center (OSTRC) questionnaires on overuse injury and health problem were developed to register overuse injury and health problems. However, this questionnaire has not been translated or validated in Thai. Objective: To develop the original edition of the OSTRC Questionnaire on overuse injuries and health problems into Thai language and to examine the validity and reliability of the adapted scale. Materials and Methods: The development of the questionnaire followed the steps of translation, which included forward translation, translation merging, backward translation, and critique by the researcher, health professionals, speech professionals, athletes, and the translators for semantic and conceptual equivalence. A cohort of 65 Thai athletes were recruited. Cross-sectional surveillance data were used to record overuse injury and health problem. Throughout the 12-week surveillance period, all participants were assigned to complete the questionnaire within three days after receiving a questionnaire by e-mail. Robustness and reliability process was seen in the 57 athletes who completed their 12 weeks of surveillance period. Results: The OSTRC on overuse injuries and health problems Thai version (OSTRC-OT and HT) showed a high internal consistency. Cronbach’s α of the OSTRC-OT for ankle, knee, and hip regions was 0.919, 0.973, and 0.976, respectively, and the OSTRC-HT was 0.959 and an excellent test-retest reliability with intraclass correlation coefficient of the OSTRC-OT for ankle, knee, and hip regions at 0.994, 0.970, and 0.991, respectively, and the OSTRC-HT at 0.970; all p-values&lt;0.001. Known-groups validity, the severity scores of the OSTRC-OT for ankle, knee, and hip regions, and the OSTRC-HT scores were statistically significant different between injury and non-injury groups. Conclusion: The validity and reliability of both questionnaires, the OSTRC-OT and the OSTRC-HT were at an excellent level. Moreover, the OSTRC-OT and OSTRC HT have an excellent ability to separate athletes who have an injury and health problem for those who do not. Keywords: Questionnaire, Sport, Overuse injury, Health problem

Does load management using the acute:chronic workload ratio prevent health problems? A cluster randomised trial of 482 elite youth footballers of both sexes

BackgroundThe acute:chronic workload ratio (ACWR) is commonly used to manage training load in sports, particularly to reduce injury risk. However, despite its extensive application as a prevention intervention, the effectiveness...

Japanese translation and validation of web-based questionnaires on overuse injuries and health problems

This study aimed to translate and culturally adapt the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O) and the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H) into the Japanese context. The validity and reliability of these translated questionnaires examining overuse injuries and health problems among Japanese university athletes were also examined. The translation was performed following an internationally recognized methodology. A total of 145 athletes were tracked over 10 consecutive weeks and four questions were added in the 10th week to examine the questionnaires’ content validity. Test-retest analysis for reliability was performed 24–72 hours after the 10th week of registration. Internal consistency was determined by calculating Cronbach’s a during the cohort study. No major disagreements were found in the translation process. The translated questionnaires had high acceptance and compliance, with an average response rate of over 80% throughout the 10-week cohort study. Most participants reported that the questionnaires were not difficult to complete, there were no items they wanted to change or add, and that the web-based technique worked effectively. Good test-retest reliability and high internal consistency was observed in the translated questionnaires. The translated questionnaires were found to be valid, reliable, and acceptable for medically monitoring Japanese athletes.

Managing Load to Optimize Well-Being and Recovery During Short-Term Match Congestion in Elite Basketball

First, to compare load during short-term match congestion (ie,≥2-match weeks) with regular competition (ie,1-match weeks) in elite male professional basketball players. Second, to determine changes in well-being, recovery, neuromuscular performance, and injuries and illnesses between short-term match congestion and regular competition. Sixteen basketball players (age 24.8 [2.0]y, height 195.8 [7.5]cm, weight 94.8 [14.0]kg, body fat 11.9% [5.0%], VO2max 51.9 [5.3]mL·kg-1·min-1) were monitored during a full season. Session rating of perceived exertion (s-RPE) was obtained, and load was calculated (s-RPE × duration) for each training session or match. Perceived well-being (fatigue, sleep quality, general muscle soreness, stress levels, and mood) and total quality of recovery were assessed each training day. Countermovement jump height was measured, and a list of injuries and illnesses was collected weekly using the adapted Oslo Sports Trauma Research Center Questionnaire on Health Problems. Total load (training sessions and matches; P < .001) and training load (P < .001) were significantly lower for ≥2-match weeks. Significantly higher well-being (P = .01) and less fatigue (P = .001) were found during ≥2-match weeks compared with 1-match weeks. Total load and training load were lower during short-term match congestion compared with regular competition. Furthermore, better well-being and less fatigue were demonstrated within short-term match congestion. This might indicate that coaches tend to overcompensate training load in intensified competition.

Limited Coping Skills, Young Age, and High BMI Are Risk Factors for Injuries in Contemporary Dance: A 1-Year Prospective Study.

This study investigated potential risk factors (coping, perfectionism, and self-regulation) for substantial injuries in contemporary dance students using a prospective cohort design, as high-quality studies focusing on mental risk factors for dance injuries are lacking. Student characteristics (age, sex, BMI, educational program, and history of injury) and psychological constructs (coping, perfectionism, and self-regulation) were assessed using the Performing artist and Athlete Health Monitor (PAHM), a web-based system. Substantial injuries were measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on Health Problems and recorded on a monthly basis as part of the PAHM system. Univariate and multivariate logistic regression analyses were conducted to test the associations between potential risk factors (i.e., student characteristics and psychological constructs) and substantial injuries. Ninety-nine students were included in the analyses. During the academic year 2016/2017, 48 students (48.5%) reported at least one substantial injury. Of all factors included, coping skills (OR: 0.91; 95% CI: 0.84–0.98), age (OR: 0.67; 95% CI: 0.46–0.98), and BMI (OR: 1.38; 95% CI: 1.05–1.80) were identified as significant risk factors in the multivariate analysis. The model explained 24% of the variance in the substantial injury group. Further prospective research into mental risk factors for dance injuries with larger sample sizes is needed to develop preventive strategies. Yet, dance schools could consider including coping skills training as part of injury prevention programs and, perhaps, providing special attention to younger dancers and those with a higher BMI through transitional programs to assist them in managing the stress they experience throughout their (academic) career.

Health problems in youth competitive alpine skiing: A 12-month observation of 155 athletes around the growth spurt.

Alpine ski racing is known as a high-risk sport; however, little is known on the health problems occurring at youth level. The purpose of this study was to investigate the prevalence of health problems in youth competitive alpine skiers with respect to sex, age, and season differences, to describe their severity and location and to assess the influence of biological maturation. Over a 12-month period, 155 youth competitive alpine skiers around the growth spurt were prospectively monitored for health problems using the Oslo Sports Trauma Research Centre (OSTRC) questionnaire. These data were verified by supplemental interviews at the end. Biological maturation was estimated by a non-invasive, anthropometric-based assessment method. During competition season, 42.2% of the skiers suffered from health problems and 19.8% reported their problem being substantial. Females had significantly higher rates of acute and overuse injuries compared to males, while there was no sex difference in duration, severity, and time loss. Skiers of the category U15 showed higher prevalence of acute and overuse injuries than U14 skiers. During preparation season, health problem prevalence was substantially lower. The knee was found to be the most affected body part for both acute and overuse injuries. There was a direct association between the offset to the age at peak height velocity (APHV) and the occurrence and severity of acute injuries. In conclusion, youth competitive alpine skiers suffer from a large number of health problems. Since sex, age, and biological maturation are important, effective injury prevention should already start before reaching the APHV.

Injury risks among elite competitive alpine skiers are underestimated if not registered prospectively, over the entire season and regardless of whether requiring medical attention.

Prospective studies assessing the injuries occurring in elite competitive alpine skiers are lacking, and a full picture of all injuries, including those not requiring medical attention, is absent. Likewise, little is known about the sex-specific injury risks and patterns of elite skiers throughout an entire season (i.e. an off-season preparation period and a competition period). Accordingly, this study investigated the injuries of a national team cohort with respect to season period and sex. Over an entire season, all injuries occurring in 44 SwissNational Ski Team members (25 females and 19 males) were registered, regardless of whether they required medical attention. Skiers were prospectively monitored by the Oslo Sports Trauma Research Centre (OSTRC) questionnaire and by continuously updated team medical records. Finally, these data were used as a reference for supplemental interviews, in which the correctness and completeness of the prospective data were verified. The risk of suffering at least one injury during an entire season was 75.0% with a 95% confidence interval (73.1%, 76.9%) for traumatic injuries, and 52.3% (50.0%, 54.5%) for overuse injuries. Traumatic injuries concerned the head, lower leg and knee, while overuse injuries affected the lumbar spine, knee and hip. During the competition period, skiers were more prone to traumatic injuries, while during the off-season preparation period, skiers' risk was higher for overuse injuries. Over an entire season, there were no sex differences. However, females were more vulnerable to traumatic injuries during the preparation period and overuse injuries during the competition period, while males had a higher risk for overuse injuries during the preparation period. When prospectively registering injuries among elite competitive alpine skiers over an entire season, regardless of whether the injuries required medical attention, the injury risks were alarmingly high and substantially larger than those previously reported. Moreover, since injury risks and patterns are season period and sex dependent, it is strongly recommended that (1) injury registration focuses on both the off-season preparation period and the competition period and (2) prevention efforts are specifically tailored to the sex of the athletes. II.

Characteristics, Properties, and Associations of Self-Assessed Pain Questionnaires: A Literature Review and Prospective Cohort Study Among Dance Students

To provide an overview of measurement properties of the Oslo Sports Trauma Research Center Questionnaire (OSTRCQ), pain visual analogue scale (VAS-pain) and Self-Estimated Functional Inability Because of Pain (SEFIP) scale in dance populations, and to investigate the relationship between these questionnaires in pre-professional contemporary dancers. A search of PubMed was conducted and studies were included if they 1) used one of the three questionnaires within a dance population and 2) assessed the reliability, validity, or responsiveness of the questionnaire(s). 134 dance students (67.5% female; 19.4±1.5 yrs) were prospectively followed during 1 academic year. The OSTRCQ, VAS-pain, SEFIP, and injuries were self-assessed on a monthly basis. Pearson correlation analyses and repeated measures correlation analyses were performed to identify possible associations. The literature overview resulted in two studies describing measurement properties of the SEFIP (n=1) and OSTRCQ (n=1). Prevalence of injuries ranged from 23.1 to 42.6%. Weak monthly correlations (r=0.14-0.50) were found between OSTRCQ and SEFIP. Moderate monthly correlations (r=0.54-0.71) were found between OSTRCQ and VAS-pain, and weak/moderate monthly correlations (r=0.30-0.62) were found between SEFIP and VAS-pain. Repeated measures correlation demonstrated a moderate overall correlation between ORSTCQ and VAS-pain (r=0.57), with weak overall correlations between ORSTCQ and SEFIP (r=0.26) and SEFIP and VAS-pain (r=0.34). Studies on measurement properties of questionnaires in dance are scarce. Weak/moderate associations were found between the OSTRCQ, SEFIP, and the VAS-pain questionnaires. Future high-quality research should investigate measurement properties of these questionnaires within dance populations. The results contribute by substantiating choices when developing a surveillance system.

High Rates of Overuse-Related Structural Abnormalities in the Lumbar Spine of Youth Competitive Alpine Skiers: A Cross-sectional MRI Study in 108 Athletes.

Background:Alpine ski racing is known as a sport with unfavorable spinal loads and high rates of back overuse injuries at the elite level. However, little is known about overuse-related structural abnormalities occurring in the spine of youth athletes.Purpose:To describe the prevalence of abnormal magnetic resonance imaging (MRI) findings in the lumbar spine of youth competitive alpine skiers within the U16 category (under 16 years) with respect to sex, height growth, multifidus size, increasing age, and clinical relevance.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 108 youth competitive alpine skiers aged 13 to 15 years underwent MRI examination of the lumbar spine and measurement of the multifidus cross-sectional area on a 3-T Magnetom Prisma scanner. Complementary assessments included the determination of anthropometrics and biological maturation. Athletes were classified as symptomatic when, pursuant to the Oslo Sports Trauma Research Center questionnaire on health problems, at least 1 substantial back overuse–related health problem episode had been registered during the 12 months before the MRI examination.Results:Of the analyzed youth skiers, 37.0% presented with ≥1 abnormal MRI finding in the lumbar spine. The most prevalent findings in both sexes were disc degeneration (23.1%), Schmorl nodes (19.4%), end plate changes (10.2%), and pars interarticularis anomalies (10.2%); the pars interarticularis anomalies occurred exclusively in males. A smaller relative lumbar multifidus cross-sectional area was related to more frequent occurrence of disc protrusions (P = .018; R2 = 0.116) and end plate changes (P = .024; R2 = 0.096). Overall, the occurrence of abnormal MRI findings in the lumbar spine increased with age (P = .034; R2 = 0.054). Disc degeneration (particularly disc dehydration and disc protrusion) were significantly more prevalent in symptomatic versus asymptomatic athletes (P < .05 for all).Conclusion:As early as age 15 years or younger, competitive alpine skiers demonstrated distinct overuse-related structural abnormalities in the lumbar spine, with some of them being clinically relevant and restrictive of sports participation. As sex, height growth, multifidus size, and increasing age seem to play an important role for the occurrence of such abnormalities, considering these factors might be essential for prevention.

Remarkably high prevalence of overuse-related knee complaints and MRI abnormalities in youth competitive alpine skiers: a descriptive investigation in 108 athletes aged 13–15 years

Background/aimCompetitive alpine skiing is known to be associated with a high risk of traumatic knee injuries. However, little is known about the exact prevalence of knee overuse injuries and their...

Incidence, prevalence and consequences of illness in academy rugby league players

ObjectivesTo assess the incidence, prevalence and consequences of illness in one professional academy rugby league club during an in-season period. DesignObservational prospective cohort study. MethodSeventeen male rugby league players (age 17.7±0.7 years, stature 178.8±5.1cm, body mass 87.2±9.6kg) completed a weekly self-report illness questionnaire using an amended version of the Oslo Sports Trauma Research Centre (OSTRC) questionnaire on health problems. ResultsA total of 24 new illnesses were reported over the 25-week study period. 65% of players experienced at least one illness during the study. The incidence of illness in this cohort was 14.3 per 1000-player days, with the respiratory system being most commonly affected (n=15; 62.5%). The average weekly illness prevalence was 10.3%. Time-loss illness incidence was 1.4 per 1000-player days. Loss of body mass and sleep disruptions were the most commonly reported consequences of illness episodes. Mean body mass loss during a period of illness was 2.2±0.6kg. ConclusionsAcademy rugby league players are most commonly affected by respiratory illness with a total of nineteen training and competition days lost to illness. Associated consequences of illness, such as loss of body mass and sleep disruptions may present a challenge and negatively impact a rugby league player’s development. Appropriate medical provisions should be provided for Academy rugby league players to support them during periods of illness to limit the impact of these consequences.

Improved reporting of overuse injuries and health problems in sport: an update of the Oslo Sport Trauma Research Center questionnaires

In 2013, the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O) was developed to record the magnitude, symptoms and consequences of overuse injuries in sport. Shortly afterwards, a modified...

Prevalence and Burden of Health Problems in Male Elite Ice Hockey Players: A Prospective Study in the Norwegian Professional League.

Background:As previous epidemiological studies in elite ice hockey have focused on acute time-loss injuries, little is known about the burden of overuse injuries and illnesses in ice hockey.Purpose:To report the prevalence and burden of all health problems in male professional ice hockey players in Norway during a single competitive season.Study Design:Descriptive epidemiological study.Methods:A total of 225 male ice hockey players in the GET League (the premier professional league) in Norway reported all health problems (acute injuries, overuse injuries, and illnesses) during the 2017-2018 competitive season. Players reported all injuries and illnesses for 31 weeks using the Oslo Sports Trauma Research Center Questionnaire on Health Problems.Results:At any given time, 40% (95% CI, 37%-43%) of players reported symptoms from an injury or illness, and 20% (95% CI, 19%-22%) experienced health problems with a substantial negative impact on training and performance. Acute injuries represented the greatest incidence, prevalence, and burden (defined as the cross-product of severity and incidence). The most burdensome acute injuries were to the head/face, shoulder/clavicle, knee, and ankle. The most burdensome overuse injuries were to the knee, lumbar spine, and hip/groin.Conclusion:This registration captured a greater burden from overuse injuries than traditional injury registration, but acute injuries did represent a major problem. These data provide guidance in the development of prevention programs for both acute and overuse injuries, which should focus on the lumbar spine, hip/groin, and knee.

Preventing injuries among recreational adult volleyball players: Results of a prospective randomised controlled trial

ABSTRACT The objective was to evaluate the effectiveness of an exercise-based warm-up programme (“VolleyVeilig”) on the one-season occurrence of musculoskeletal injuries among recreational adult volleyball players. A prospective randomised controlled trial was conducted over the 2017–2018 volleyball season. Recreational adult volleyball players were allocated either to an intervention or control group. The Dutch version of the Oslo Sports Trauma Research Centre questionnaire was used to register and monitor acute and overuse injuries. A total of 672 volleyball players were enrolled: 348 in the intervention group (mean age: 30) and 324 in the control group (mean age: 27). The incidence rate of acute injury was 21% lower in the intervention group, namely 8.9 versus 11.3 per 1,000 h in the control group (Cox mixed effects crude model: hazard ratio = 0.82 [95%CI: 0.69–0.98]; Cox mixed effects adjusted model: 0.85 [95%CI: 0.71–1.02]). No significant difference in mean prevalence of overuse injury was found between the intervention (4.8%) and control (4.2%) groups. The severity of injuries was not significantly different between groups, while injury burden was slightly lower in the intervention group. The exercise-based warm-up programme led to a trend in less acute injuries among recreational adult volleyball players.