Aerobic training protects cardiac function during advancing age : A meta-analysis of four decades of controlled studies
- Beaumont, Alexander, Grace, Fergal, Richards, Joanna, Campbell, Amy, Sculthorpe, Nicholas
- Authors: Beaumont, Alexander , Grace, Fergal , Richards, Joanna , Campbell, Amy , Sculthorpe, Nicholas
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 49, no. 2 (2019), p. 199-219
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- Description: Background: In contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny. Objectives: We conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age. Methods: Electronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic. Results: Overall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age. Conclusions: Athletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing. © 2018, The Author(s).
- Authors: Beaumont, Alexander , Grace, Fergal , Richards, Joanna , Campbell, Amy , Sculthorpe, Nicholas
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 49, no. 2 (2019), p. 199-219
- Full Text:
- Reviewed:
- Description: Background: In contrast to younger athletes, there is comparatively less literature examining cardiac structure and function in older athletes. However, a progressive accumulation of studies during the past four decades offers a body of literature worthy of systematic scrutiny. Objectives: We conducted a systematic review, meta-analysis and meta-regression of controlled echocardiography studies comparing left ventricular (LV) structure and function in aerobically trained older athletes (> 45 years) with age-matched untrained controls, in addition to investigating the influence of chronological age. Methods: Electronic databases were searched from inception to January 2018 before conducting a random-effects meta-analysis to calculate pooled differences in means, effect size and 95% confidence intervals (CIs). Study heterogeneity was reported using Cochran’s Q and I2 statistic. Results: Overall, 32 studies (644 athletes; 582 controls) were included. Athletes had greater LV end-diastolic diameter (3.65 mm, 95% CI 2.66–4.64), interventricular septal thickness (1.23 mm, 95% CI 0.85–1.60), posterior wall thickness (1.20 mm, 95% CI 0.83–1.56), LV mass (72 g, 95% CI 46–98), LV mass index (28.17 g·m2, 95% CI 19.84–36.49) and stroke volume (13.59 mL, 95% CI 7.20–19.98) (all p < 0.01). Athletes had superior global diastolic function [ratio of early (E) to late (A) mitral inflow velocity (E/A) 0.18, 95% CI 0.13–0.24, p < 0.01; ratio of early (e′) to late (a′) diastolic annular tissue velocity (e′/a′) 0.23, 95% CI 0.06–0.40, p = 0.01], lower A (−8.20 cm·s−1, 95% CI −11.90 to −4.51, p < 0.01) and a′ (−0.72 cm·s−1, 95% CI −1.31 to −0.12, p = 0.02), and more rapid e′ (0.96 cm·s−1, 95% CI 0.05–1.86, p = 0.04). Meta-regression for chronological age identified that athlete–control differences, in the main, are maintained during advancing age. Conclusions: Athletic older men have larger cardiac dimensions and enjoy more favourable cardiac function than healthy, non-athletic counterparts. Notably, the athlete groups maintain these effects during chronological ageing. © 2018, The Author(s).
The effects of sprint training and the Nordic hamstring exercise on eccentric hamstring strength and sprint performance in adolescent athletes
- Freeman, Brock, Young, Warren, Talpey, Scott, Smyth, Andrew, Pane, Calvin, Carlon, Todd
- Authors: Freeman, Brock , Young, Warren , Talpey, Scott , Smyth, Andrew , Pane, Calvin , Carlon, Todd
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Sports Medicine and Physical Fitness Vol. 59, no. 7 (2019), p. 1119-1125
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- Description: BACKGROUND. Hamstring strain injuries (HSI) are among the most common injuries in field-based team sports with a high-speed running component. The implementation of the Nordic hamstring exercise (NHE) is a well-documented method of improving eccentric hamstring strength to mitigate the risk of HSI occurrence. Sprint training is specific to the injury mechanism and is thought to activate the hamstrings through maximal eccentric contractions. The purpose of this study was to compare the effects of sprint training and the NHE on eccentric hamstring strength and sprint performance. METHODS. Twenty-eight participants (mean +/- SD age=16.21 +/- 1.34 years; height=1.75m +/- 0.10m; body mass=68.5kg +/- 12.1kg) completed an eccentric hamstring strength assessment and 40m sprint to assess acceleration and maximum speed. Participants were randomly allocated to either a NHE training or sprint training group. Two sessions per week for four-weeks of training was performed with baseline testing procedures repeated in the week following the intervention. Perceptions of soreness were recorded following the warm-up in each training session. RESULTS. Both the NHE (effect size=0.39, P<0.05) and sprint training (effect size=0.29, P<0.05) groups displayed significant gains in eccentric hamstring strength. The NHE group reported trivial improvements in sprint performance, whilst the sprint training group experienced a moderate improvement, specifically in maximum speed (ES=0.83 Moderate). Sprint training also produced greater perceptions of soreness than the NHE following a four-week training intervention, specifically before the start of the last session (P<0.05). CONCLUSIONS. These findings indicate that sprint training had a beneficial effect for both eccentric hamstring strength and sprint performance, whilst also producing greater soreness than the NHE following the final training session. It was concluded that a four-week block of maximum speed training may have both an injury prevention and performance enhancement benefit.
- Authors: Freeman, Brock , Young, Warren , Talpey, Scott , Smyth, Andrew , Pane, Calvin , Carlon, Todd
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Sports Medicine and Physical Fitness Vol. 59, no. 7 (2019), p. 1119-1125
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- Description: BACKGROUND. Hamstring strain injuries (HSI) are among the most common injuries in field-based team sports with a high-speed running component. The implementation of the Nordic hamstring exercise (NHE) is a well-documented method of improving eccentric hamstring strength to mitigate the risk of HSI occurrence. Sprint training is specific to the injury mechanism and is thought to activate the hamstrings through maximal eccentric contractions. The purpose of this study was to compare the effects of sprint training and the NHE on eccentric hamstring strength and sprint performance. METHODS. Twenty-eight participants (mean +/- SD age=16.21 +/- 1.34 years; height=1.75m +/- 0.10m; body mass=68.5kg +/- 12.1kg) completed an eccentric hamstring strength assessment and 40m sprint to assess acceleration and maximum speed. Participants were randomly allocated to either a NHE training or sprint training group. Two sessions per week for four-weeks of training was performed with baseline testing procedures repeated in the week following the intervention. Perceptions of soreness were recorded following the warm-up in each training session. RESULTS. Both the NHE (effect size=0.39, P<0.05) and sprint training (effect size=0.29, P<0.05) groups displayed significant gains in eccentric hamstring strength. The NHE group reported trivial improvements in sprint performance, whilst the sprint training group experienced a moderate improvement, specifically in maximum speed (ES=0.83 Moderate). Sprint training also produced greater perceptions of soreness than the NHE following a four-week training intervention, specifically before the start of the last session (P<0.05). CONCLUSIONS. These findings indicate that sprint training had a beneficial effect for both eccentric hamstring strength and sprint performance, whilst also producing greater soreness than the NHE following the final training session. It was concluded that a four-week block of maximum speed training may have both an injury prevention and performance enhancement benefit.
A 12-month prospective cohort study of symptoms of common mental disorders among professional rugby players
- Gouttebarge, Vincent, Hopley, Philip, Kerkhoffs, Gino, Verhagen, Evert, Viljoen, Wayne, Wylleman, Paul, Lambert, Mike
- Authors: Gouttebarge, Vincent , Hopley, Philip , Kerkhoffs, Gino , Verhagen, Evert , Viljoen, Wayne , Wylleman, Paul , Lambert, Mike
- Date: 2018
- Type: Text , Journal article
- Relation: European Journal of Sport Science Vol. 18, no. 7 (2018), p. 1004-1012
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- Description: The primary aims were to determine the 12-month incidence (and comorbidity) of symptoms of common mental disorders (CMD) among male professional rugby players and to explore their association with potential stressors. A secondary aim was to explore the view of male professional rugby players about the consequences of symptoms of CMD and related medical support/needs. An observational prospective cohort study with three measurements over a 12-month period was conducted among male professional rugby players from several countries. Symptoms of CMD (distress, anxiety/depression, sleep disturbance, eating disorders and adverse alcohol use) and stressors (adverse life events, rugby career dissatisfaction) were assessed through validated questionnaires. A total of 595 players (mean age of 26 years; mean career duration of 6 years) were enrolled, of which 333 completed the follow-up period. The incidence of symptoms of CMD were: 11% for distress, 28% for anxiety/depression, 12% for sleep disturbance, 11% for eating disorders and 22% for adverse alcohol use (13% for two simultaneous symptoms of CMD). Professional rugby players reporting recent adverse life events or career dissatisfaction were more likely to report symptoms of CMD but statistically significant associations were not found. Around 95% of the participants stated that symptoms of CMD can negatively influence rugby performances, while 46% mentioned that specific support measures for players were not available in professional rugby. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve not only awareness and psychological resilience of rugby players but also their rugby performance and quality-of-life. © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Gouttebarge, Vincent , Hopley, Philip , Kerkhoffs, Gino , Verhagen, Evert , Viljoen, Wayne , Wylleman, Paul , Lambert, Mike
- Date: 2018
- Type: Text , Journal article
- Relation: European Journal of Sport Science Vol. 18, no. 7 (2018), p. 1004-1012
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- Description: The primary aims were to determine the 12-month incidence (and comorbidity) of symptoms of common mental disorders (CMD) among male professional rugby players and to explore their association with potential stressors. A secondary aim was to explore the view of male professional rugby players about the consequences of symptoms of CMD and related medical support/needs. An observational prospective cohort study with three measurements over a 12-month period was conducted among male professional rugby players from several countries. Symptoms of CMD (distress, anxiety/depression, sleep disturbance, eating disorders and adverse alcohol use) and stressors (adverse life events, rugby career dissatisfaction) were assessed through validated questionnaires. A total of 595 players (mean age of 26 years; mean career duration of 6 years) were enrolled, of which 333 completed the follow-up period. The incidence of symptoms of CMD were: 11% for distress, 28% for anxiety/depression, 12% for sleep disturbance, 11% for eating disorders and 22% for adverse alcohol use (13% for two simultaneous symptoms of CMD). Professional rugby players reporting recent adverse life events or career dissatisfaction were more likely to report symptoms of CMD but statistically significant associations were not found. Around 95% of the participants stated that symptoms of CMD can negatively influence rugby performances, while 46% mentioned that specific support measures for players were not available in professional rugby. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve not only awareness and psychological resilience of rugby players but also their rugby performance and quality-of-life. © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Injuries in field hockey players : A systematic review
- Barboza, Saulo, Joseph, Corey, Nauta, Joske, van Mechelen, Willem, Verhagen, Evert
- Authors: Barboza, Saulo , Joseph, Corey , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 48, no. 4 (2018), p. 849-866
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- Description: Background: To commence injury prevention efforts, it is necessary to understand the magnitude of the injury problem. No systematic reviews have yet investigated the extent of injuries in field hockey, despite the popularity of the sport worldwide. Objective: Our objective was to describe the rate and severity of injuries in field hockey and investigate their characteristics. Methods: We conducted electronic searches in PubMed, Embase, SPORTDiscus, and CINAHL. Prospective cohort studies were included if they were published in English in a peer-reviewed journal and observed all possible injuries sustained by field hockey players during the period of the study. Results: The risk of bias score of the 22 studies included ranged from three to nine of a possible ten. In total, 12 studies (55%) reported injuries normalized by field hockey exposure. Injury rates ranged from 0.1 injuries (in school-aged players) to 90.9 injuries (in Africa Cup of Nations) per 1000 player-hours and from one injury (in high-school women) to 70 injuries (in under-21 age women) per 1000 player-sessions. Studies used different classifications for injury severity, but—within studies—injuries were included mostly in the less severe category. The lower limbs were most affected, and contusions/hematomas and abrasions were common types of injury. Contact injuries are common, but non-contact injuries are also a cause for concern. Conclusions: Considerable heterogeneity meant it was not possible to draw conclusive findings on the extent of the rate and severity of injuries. Establishing the extent of sports injury is considered the first step towards prevention, so there is a need for a consensus on injury surveillance in field hockey. © 2018, The Author(s).
- Authors: Barboza, Saulo , Joseph, Corey , Nauta, Joske , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 48, no. 4 (2018), p. 849-866
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- Description: Background: To commence injury prevention efforts, it is necessary to understand the magnitude of the injury problem. No systematic reviews have yet investigated the extent of injuries in field hockey, despite the popularity of the sport worldwide. Objective: Our objective was to describe the rate and severity of injuries in field hockey and investigate their characteristics. Methods: We conducted electronic searches in PubMed, Embase, SPORTDiscus, and CINAHL. Prospective cohort studies were included if they were published in English in a peer-reviewed journal and observed all possible injuries sustained by field hockey players during the period of the study. Results: The risk of bias score of the 22 studies included ranged from three to nine of a possible ten. In total, 12 studies (55%) reported injuries normalized by field hockey exposure. Injury rates ranged from 0.1 injuries (in school-aged players) to 90.9 injuries (in Africa Cup of Nations) per 1000 player-hours and from one injury (in high-school women) to 70 injuries (in under-21 age women) per 1000 player-sessions. Studies used different classifications for injury severity, but—within studies—injuries were included mostly in the less severe category. The lower limbs were most affected, and contusions/hematomas and abrasions were common types of injury. Contact injuries are common, but non-contact injuries are also a cause for concern. Conclusions: Considerable heterogeneity meant it was not possible to draw conclusive findings on the extent of the rate and severity of injuries. Establishing the extent of sports injury is considered the first step towards prevention, so there is a need for a consensus on injury surveillance in field hockey. © 2018, The Author(s).
A prospective cohort study on symptoms of common mental disorders among Dutch elite athletes
- Gouttebarge, Vincent, Jonkers, Ruud, Moen, Maarten, Verhagen, Evert, Wylleman, Paul, Kerkhoffs, Gino
- Authors: Gouttebarge, Vincent , Jonkers, Ruud , Moen, Maarten , Verhagen, Evert , Wylleman, Paul , Kerkhoffs, Gino
- Date: 2017
- Type: Text , Journal article
- Relation: Physician and Sportsmedicine Vol. 45, no. 4 (2017), p. 426-432
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- Description: Objective: Scientific knowledge about symptoms of common mental disorders in elite sports is scarce. Consequently, the objectives of the study were to (i) establish the 12-month incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, adverse alcohol use, eating disorders) among Dutch elite athletes and (ii) explore their potential association with several stressors (being injured, recent life events, career dissatisfaction).Methods: A prospective cohort study with a 12-month follow-up period was conducted. The study used validated questionnaires to assess symptoms of common mental disorders (thus not clinically diagnosed) as well as several stressors; an electronic questionnaire was set up and repeatedly distributed.Results: A total of 203 elite athletes gave their written informed consent to participate in the study, from which 143 completed the 12-month follow-up period (follow-up rate of 70%). Incidence of symptoms of CMD ranged from 6% for adverse alcohol use to 57% for symptoms of anxiety/depression. Over the follow-up period, around 17% of the participants reported two simultaneous symptoms of CMD, and around 19% reported three simultaneous symptoms of CMD. Inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant.Conclusions: Substantial 12-month incidence rates of symptoms of CMD (self-reported and not clinically diagnosed) were found among Dutch elite athletes (especially for anxiety/depression), appearing similar to the ones found among athletes from other sports disciplines and the Dutch general population. Also, inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve awareness and psychological resilience of athletes, which would likely improve their performance and quality-of-life.
- Authors: Gouttebarge, Vincent , Jonkers, Ruud , Moen, Maarten , Verhagen, Evert , Wylleman, Paul , Kerkhoffs, Gino
- Date: 2017
- Type: Text , Journal article
- Relation: Physician and Sportsmedicine Vol. 45, no. 4 (2017), p. 426-432
- Full Text:
- Reviewed:
- Description: Objective: Scientific knowledge about symptoms of common mental disorders in elite sports is scarce. Consequently, the objectives of the study were to (i) establish the 12-month incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, adverse alcohol use, eating disorders) among Dutch elite athletes and (ii) explore their potential association with several stressors (being injured, recent life events, career dissatisfaction).Methods: A prospective cohort study with a 12-month follow-up period was conducted. The study used validated questionnaires to assess symptoms of common mental disorders (thus not clinically diagnosed) as well as several stressors; an electronic questionnaire was set up and repeatedly distributed.Results: A total of 203 elite athletes gave their written informed consent to participate in the study, from which 143 completed the 12-month follow-up period (follow-up rate of 70%). Incidence of symptoms of CMD ranged from 6% for adverse alcohol use to 57% for symptoms of anxiety/depression. Over the follow-up period, around 17% of the participants reported two simultaneous symptoms of CMD, and around 19% reported three simultaneous symptoms of CMD. Inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant.Conclusions: Substantial 12-month incidence rates of symptoms of CMD (self-reported and not clinically diagnosed) were found among Dutch elite athletes (especially for anxiety/depression), appearing similar to the ones found among athletes from other sports disciplines and the Dutch general population. Also, inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve awareness and psychological resilience of athletes, which would likely improve their performance and quality-of-life.
Health and economic burden of running-related injuries in Dutch trailrunners : A prospective cohort study
- Hespanhol Junior, Luiz, van Mechelen, Willem, Verhagen, Evert
- Authors: Hespanhol Junior, Luiz , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 47, no. 2 (2017), p. 367-377
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- Description: Background: Trailrunning is becoming very popular. However, the risk and burden of running-related injuries (RRI) in trailrunning is not well established. Objective: To investigate the prevalence, injury rate, severity, nature, and economic burden of RRIs in Dutch trailrunners. Methods: This prospective cohort study included 228 trailrunners aged 18 years or over (range 23–67), and was conducted between October 2013 and December 2014. After completing the baseline questionnaire, the Oslo Sports Trauma Research Center Questionnaire on Health Problems was administered every 2 weeks to collect data on RRIs. Participants who reported RRIs were asked about healthcare utilization (direct costs) and absenteeism from paid work (indirect costs). RRI was defined as disorders of the musculoskeletal system or concussions experienced or sustained during participation in running. Results: The mean prevalence of RRIs measured over time was 22.4 % [95 % confidence interval (CI) 20.9–24.0], and the injury rate was 10.7 RRIs per 1000 h of running (95 % CI 9.4–12.1). The prevalence was higher for overuse (17.7 %; 95 % CI 15.9–19.5) than for acute (4.1 %; 95 % CI 3.3–5.0) RRIs. Also, the injury rate was higher for overuse (8.1; 95 % CI 6.9–9.3) than for acute (2.7; 95 % CI 2.0–3.4) RRIs. The median of the severity score was 35.0 [25–75 %, interquartile range (IQR) 22.0–55.7], and the median of the duration of RRIs was 2.0 weeks (IQR 2.0–6.0) during the study. The total economic burden of RRIs was estimated at €172.22 (95 % CI 117.10–271.74) per RRI, and €1849.49 (95 % CI 1180.62–3058.91) per 1000 h of running. An RRI was estimated to have a direct cost of €60.92 (95 % CI 45.11–94.90) and an indirect cost of €111.30 (95 % CI 61.02–192.75). Conclusions: The health and economic burden of RRIs presented in this study are significant for trailrunners and for society. Therefore, efforts should be made in order to prevent RRIs in trailrunners. © 2016, The Author(s).
- Authors: Hespanhol Junior, Luiz , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 47, no. 2 (2017), p. 367-377
- Full Text:
- Reviewed:
- Description: Background: Trailrunning is becoming very popular. However, the risk and burden of running-related injuries (RRI) in trailrunning is not well established. Objective: To investigate the prevalence, injury rate, severity, nature, and economic burden of RRIs in Dutch trailrunners. Methods: This prospective cohort study included 228 trailrunners aged 18 years or over (range 23–67), and was conducted between October 2013 and December 2014. After completing the baseline questionnaire, the Oslo Sports Trauma Research Center Questionnaire on Health Problems was administered every 2 weeks to collect data on RRIs. Participants who reported RRIs were asked about healthcare utilization (direct costs) and absenteeism from paid work (indirect costs). RRI was defined as disorders of the musculoskeletal system or concussions experienced or sustained during participation in running. Results: The mean prevalence of RRIs measured over time was 22.4 % [95 % confidence interval (CI) 20.9–24.0], and the injury rate was 10.7 RRIs per 1000 h of running (95 % CI 9.4–12.1). The prevalence was higher for overuse (17.7 %; 95 % CI 15.9–19.5) than for acute (4.1 %; 95 % CI 3.3–5.0) RRIs. Also, the injury rate was higher for overuse (8.1; 95 % CI 6.9–9.3) than for acute (2.7; 95 % CI 2.0–3.4) RRIs. The median of the severity score was 35.0 [25–75 %, interquartile range (IQR) 22.0–55.7], and the median of the duration of RRIs was 2.0 weeks (IQR 2.0–6.0) during the study. The total economic burden of RRIs was estimated at €172.22 (95 % CI 117.10–271.74) per RRI, and €1849.49 (95 % CI 1180.62–3058.91) per 1000 h of running. An RRI was estimated to have a direct cost of €60.92 (95 % CI 45.11–94.90) and an indirect cost of €111.30 (95 % CI 61.02–192.75). Conclusions: The health and economic burden of RRIs presented in this study are significant for trailrunners and for society. Therefore, efforts should be made in order to prevent RRIs in trailrunners. © 2016, The Author(s).
Incidence, aetiology and prevention of musculoskeletal injuries in volleyball : A systematic review of the literature
- Kilic, O., Maas, Mario, Verhagen, Evert, Zwerver, Johannes, Gouttebarge, Vincent
- Authors: Kilic, O. , Maas, Mario , Verhagen, Evert , Zwerver, Johannes , Gouttebarge, Vincent
- Date: 2017
- Type: Text , Journal article , Review
- Relation: European Journal of Sport Science Vol. 17, no. 6 (2017), p. 765-793
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- Description: Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies. © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Kilic, O. , Maas, Mario , Verhagen, Evert , Zwerver, Johannes , Gouttebarge, Vincent
- Date: 2017
- Type: Text , Journal article , Review
- Relation: European Journal of Sport Science Vol. 17, no. 6 (2017), p. 765-793
- Full Text:
- Reviewed:
- Description: Currently, there is no overview of the incidence and (volleyball-specific) risk factors of musculoskeletal injuries among volleyball players, nor any insight into the effect of preventive measures on the incidence of injuries in volleyball. This study aimed to review systematically the scientific evidence on the incidence, prevalence, aetiology and preventive measures of volleyball injuries. To this end, a highly sensitive search strategy was built based on two groups of keywords (and their synonyms). Two electronic databases were searched, namely Medline (biomedical literature) via Pubmed, and SPORTDiscus (sports and sports medicine literature) via EBSCOhost. The results showed that ankle, knee and shoulder injuries are the most common injuries sustained while playing volleyball. Results are presented separately for acute and overuse injuries, as well as for contact and non-contact injuries. Measures to prevent musculoskeletal injuries, anterior knee injuries and ankle injuries were identified in the scientific literature. These preventive measures were found to have a significant effect on decreasing the occurrence of volleyball injuries (for instance on ankle injuries with a reduction from 0.9 to 0.5 injuries per 1000 player hours). Our systematic review showed that musculoskeletal injuries are common among volleyball players, while effective preventive measures remain scarce. Further epidemiological studies should focus on other specific injuries besides knee and ankle injuries, and should also report their prevalence and not only the incidence. Additionally, high-quality studies on the aetiology and prevention of shoulder injuries are lacking and should be a focus of future studies. © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Intervention strategies used in sport injury prevention studies : A systematic review identifying studies applying the Haddon matrix
- Vriend, Ingrid, Gouttebarge, Vincent, Finch, Caroline, van Mechelen, Willem, Verhagen, Evert
- Authors: Vriend, Ingrid , Gouttebarge, Vincent , Finch, Caroline , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 47, no. 10 (2017), p. 2027-2043
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- Description: Background: Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Objective: Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Methods: Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. Results: A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the ‘pre-event’ phase (n = 73) and the use of equipment to avoid injury in the ‘event phase’ (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Conclusions: Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention. © 2017, The Author(s).
- Authors: Vriend, Ingrid , Gouttebarge, Vincent , Finch, Caroline , van Mechelen, Willem , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 47, no. 10 (2017), p. 2027-2043
- Full Text:
- Reviewed:
- Description: Background: Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. Objective: Our aim was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps. Methods: Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include a control group/condition, prospective data collection, and a quantitative injury outcome measure. Results: A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes. Studies predominantly evaluated the preventive effect of various training programmes targeted at the ‘pre-event’ phase (n = 73) and the use of equipment to avoid injury in the ‘event phase’ (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5). Conclusions: Valuable insight into the extent of the evidence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention. © 2017, The Author(s).
Compliance with sport injury prevention interventions in randomised controlled trials : A systematic review
- van Reijen, Miriam, Vriend, Ingrid, van Mechelen, Willem, Finch, Caroline, Verhagen, Evert
- Authors: van Reijen, Miriam , Vriend, Ingrid , van Mechelen, Willem , Finch, Caroline , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 46, no. 8 (2016), p. 1125-1139
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- Reviewed:
- Description: Introduction Sport injury prevention studies vary in the way compliance with an intervention is defined, measured and adjusted for. Objective The objective of this systematic review was to assess the extent to which sport injury prevention randomised controlled trials (RCTs) have defined, measured and adjusted results for compliance with an injury prevention intervention. Methods An electronic search was performed in MEDLINE, PubMed, the Cochrane Center of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database) and SPORTDiscus. English RCTs, quasi-RCTs and cluster-RCTs were considered eligible. Trials that involved physically active individuals or examined the effects of an intervention aimed at the prevention of sport-or physical activity-related injuries were included. Results Of the total of 100 studies included, 71.6 % mentioned compliance or a related term, 68.8 % provided details on compliance measurement and 51.4 % provided compliance data. Only 19.3 % analysed the effect of compliance rates on study outcomes. While studies used heterogeneous methods, pooled effects could not be presented. Conclusions Studies that account for compliance demonstrated that compliance significant affects study outcomes. The way compliance is dealt with in preventions studies is subject to a large degree of heterogeneity. Valid and reliable tools to measure and report compliance are needed and should be matched to a uniform definition of compliance.
- Authors: van Reijen, Miriam , Vriend, Ingrid , van Mechelen, Willem , Finch, Caroline , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 46, no. 8 (2016), p. 1125-1139
- Full Text:
- Reviewed:
- Description: Introduction Sport injury prevention studies vary in the way compliance with an intervention is defined, measured and adjusted for. Objective The objective of this systematic review was to assess the extent to which sport injury prevention randomised controlled trials (RCTs) have defined, measured and adjusted results for compliance with an injury prevention intervention. Methods An electronic search was performed in MEDLINE, PubMed, the Cochrane Center of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database) and SPORTDiscus. English RCTs, quasi-RCTs and cluster-RCTs were considered eligible. Trials that involved physically active individuals or examined the effects of an intervention aimed at the prevention of sport-or physical activity-related injuries were included. Results Of the total of 100 studies included, 71.6 % mentioned compliance or a related term, 68.8 % provided details on compliance measurement and 51.4 % provided compliance data. Only 19.3 % analysed the effect of compliance rates on study outcomes. While studies used heterogeneous methods, pooled effects could not be presented. Conclusions Studies that account for compliance demonstrated that compliance significant affects study outcomes. The way compliance is dealt with in preventions studies is subject to a large degree of heterogeneity. Valid and reliable tools to measure and report compliance are needed and should be matched to a uniform definition of compliance.
Reporting multiple individual injuries in studies of team ball sports : A systematic review of current practice
- Fortington, Lauren, van der Worp, Henk, van den Akker-Scheek, Inge, Finch, Caroline
- Authors: Fortington, Lauren , van der Worp, Henk , van den Akker-Scheek, Inge , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 47, no. 6 (2016), p. 1103-1122
- Full Text:
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- Description: BACKGROUND: To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. OBJECTIVE: The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and reported in prospective, long-term, injury studies in team ball sports. DATA SOURCES: A systematic search of three online databases for articles published before 2016. STUDY SELECTION: Publications were included if (1) they collected prospective data on musculoskeletal injuries in individual participants; (2) the study duration was >1 consecutive calendar year/season; and (3) individuals were the unit of analysis. DATA EXTRACTION: Key study features were summarised, including definitions of injury, how multiple individual injuries were reported and results relating to multiple injuries. RESULTS: Of the 71 publications included, half did not specifically indicate multiple individual injuries; those that did were largely limited to reporting recurrent injuries. Eight studies reported the number/proportion of athletes with more than one injury, and 11 studies presented the mean/number of injuries per athlete. CONCLUSIONS: Despite it being relatively common to collect data on individuals across more than one season, the reporting of multiple injuries within individuals is much more limited. Ultimately, better addressing of multiple injuries will improve the accuracy of injury incidence studies and enable more precise targeting and monitoring of the effectiveness of preventive interventions.
- Authors: Fortington, Lauren , van der Worp, Henk , van den Akker-Scheek, Inge , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 47, no. 6 (2016), p. 1103-1122
- Full Text:
- Reviewed:
- Description: BACKGROUND: To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. OBJECTIVE: The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and reported in prospective, long-term, injury studies in team ball sports. DATA SOURCES: A systematic search of three online databases for articles published before 2016. STUDY SELECTION: Publications were included if (1) they collected prospective data on musculoskeletal injuries in individual participants; (2) the study duration was >1 consecutive calendar year/season; and (3) individuals were the unit of analysis. DATA EXTRACTION: Key study features were summarised, including definitions of injury, how multiple individual injuries were reported and results relating to multiple injuries. RESULTS: Of the 71 publications included, half did not specifically indicate multiple individual injuries; those that did were largely limited to reporting recurrent injuries. Eight studies reported the number/proportion of athletes with more than one injury, and 11 studies presented the mean/number of injuries per athlete. CONCLUSIONS: Despite it being relatively common to collect data on individuals across more than one season, the reporting of multiple injuries within individuals is much more limited. Ultimately, better addressing of multiple injuries will improve the accuracy of injury incidence studies and enable more precise targeting and monitoring of the effectiveness of preventive interventions.
Sport injuries sustained by athletes with disability : A systematic review
- Weiler, Richard, van Mechelen, Willem, Fuller, Colin, Verhagen, Evert
- Authors: Weiler, Richard , van Mechelen, Willem , Fuller, Colin , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 46, no. 8 (2016), p. 1141-1153
- Full Text:
- Reviewed:
- Description: Background Fifteen percent of the world's population live with disability, and many of these individuals choose to play sport. There are barriers to sport participation for athletes with disability and sports injury can greatly impact on daily life, which makes sports injury prevention additionally important. Objective The purpose of this review is to systematically review the definitions, methodologies and injury rates in disability sport, which should assist future identification of risk factors and development of injury prevention strategies. A secondary aim is to highlight the most pressing issues for improvement of the quality of injury epidemiology research for disability sport. Methods A search of NICE, AMED, British Nursing Index, CINAHL, EMBASE and Medline was conducted to identify all publications up to 16 June 2015. Of 489 potentially relevant articles and reference searching, a total of 15 studies were included. Wide study sample heterogeneity prevented data pooling and meta-analysis. Results Results demonstrated an evolving field of epidemiology, but with wide differences in sports injury definition and with studies focused on short competitions. Background data were generally sparse; there was minimal exposure analysis, and no analysis of injury severity, all of which made comparison of injury risk and injury severity difficult. Conclusion There is an urgent need for consensus on sports injury definition and methodology in disability sports. The quality of studies is variable, with inconsistent sports injury definitions, methodologies and injury rates, which prevents comparison, conclusions and development of injury prevention strategies. The authors highlight the most pressing issues for improvement of the quality in injury epidemiology research for disability sport.
- Authors: Weiler, Richard , van Mechelen, Willem , Fuller, Colin , Verhagen, Evert
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 46, no. 8 (2016), p. 1141-1153
- Full Text:
- Reviewed:
- Description: Background Fifteen percent of the world's population live with disability, and many of these individuals choose to play sport. There are barriers to sport participation for athletes with disability and sports injury can greatly impact on daily life, which makes sports injury prevention additionally important. Objective The purpose of this review is to systematically review the definitions, methodologies and injury rates in disability sport, which should assist future identification of risk factors and development of injury prevention strategies. A secondary aim is to highlight the most pressing issues for improvement of the quality of injury epidemiology research for disability sport. Methods A search of NICE, AMED, British Nursing Index, CINAHL, EMBASE and Medline was conducted to identify all publications up to 16 June 2015. Of 489 potentially relevant articles and reference searching, a total of 15 studies were included. Wide study sample heterogeneity prevented data pooling and meta-analysis. Results Results demonstrated an evolving field of epidemiology, but with wide differences in sports injury definition and with studies focused on short competitions. Background data were generally sparse; there was minimal exposure analysis, and no analysis of injury severity, all of which made comparison of injury risk and injury severity difficult. Conclusion There is an urgent need for consensus on sports injury definition and methodology in disability sports. The quality of studies is variable, with inconsistent sports injury definitions, methodologies and injury rates, which prevents comparison, conclusions and development of injury prevention strategies. The authors highlight the most pressing issues for improvement of the quality in injury epidemiology research for disability sport.
Telomere length maintenance and cardio-metabolic disease prevention through exercise training
- Denham, Joshua, O'Brien, Brendan, Charchar, Fadi
- Authors: Denham, Joshua , O'Brien, Brendan , Charchar, Fadi
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 46, no. 9 (2016), p. 1213-1237
- Relation: http://purl.org/au-research/grants/nhmrc/1009490
- Full Text:
- Reviewed:
- Description: Telomeres are tandem repeat DNA sequences located at distal ends of chromosomes that protect against genomic DNA degradation and chromosomal instability. Excessive telomere shortening leads to cellular senescence and for this reason telomere length is a marker of biological age. Abnormally short telomeres may culminate in the manifestation of a number of cardio-metabolic diseases. Age-related cardio-metabolic diseases attributable to an inactive lifestyle, such as obesity, type 2 diabetes mellitus and cardiovascular disease, are associated with short leukocyte telomeres. Exercise training prevents and manages the symptoms of many cardio-metabolic diseases whilst concurrently maintaining telomere length. The positive relationship between exercise training, physical fitness and telomere length raises the possibility of a mediating role of telomeres in chronic disease prevention via exercise. Further elucidation of the underpinning molecular mechanisms of how exercise maintains telomere length should provide crucial information on how physical activity can be best structured to combat the chronic disease epidemic and improve the human health span. Here, we synthesise and discuss the current evidence on the impact of physical activity and cardiorespiratory fitness on telomere dynamics. We provide the molecular mechanisms with a known role in exercise-induced telomere length maintenance and highlight unexplored, alternative pathways ripe for future investigations.
- Authors: Denham, Joshua , O'Brien, Brendan , Charchar, Fadi
- Date: 2016
- Type: Text , Journal article , Review
- Relation: Sports Medicine Vol. 46, no. 9 (2016), p. 1213-1237
- Relation: http://purl.org/au-research/grants/nhmrc/1009490
- Full Text:
- Reviewed:
- Description: Telomeres are tandem repeat DNA sequences located at distal ends of chromosomes that protect against genomic DNA degradation and chromosomal instability. Excessive telomere shortening leads to cellular senescence and for this reason telomere length is a marker of biological age. Abnormally short telomeres may culminate in the manifestation of a number of cardio-metabolic diseases. Age-related cardio-metabolic diseases attributable to an inactive lifestyle, such as obesity, type 2 diabetes mellitus and cardiovascular disease, are associated with short leukocyte telomeres. Exercise training prevents and manages the symptoms of many cardio-metabolic diseases whilst concurrently maintaining telomere length. The positive relationship between exercise training, physical fitness and telomere length raises the possibility of a mediating role of telomeres in chronic disease prevention via exercise. Further elucidation of the underpinning molecular mechanisms of how exercise maintains telomere length should provide crucial information on how physical activity can be best structured to combat the chronic disease epidemic and improve the human health span. Here, we synthesise and discuss the current evidence on the impact of physical activity and cardiorespiratory fitness on telomere dynamics. We provide the molecular mechanisms with a known role in exercise-induced telomere length maintenance and highlight unexplored, alternative pathways ripe for future investigations.
Could targeted exercise programmes prevent lower limb injury in community Australian football?
- Andrew, Nadine, Gabbe, Belinda, Cook, Jill, Lloyd, David, Donnelly, Cyril, Nash, Clare, Finch, Caroline
- Authors: Andrew, Nadine , Gabbe, Belinda , Cook, Jill , Lloyd, David , Donnelly, Cyril , Nash, Clare , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 43, no. 8 (2013), p. 751-763
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. Objective: The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. Methods: The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Results: Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most (n = 27 [57 %]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. Conclusions: Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football. © 2013 Springer International Publishing Switzerland. Funded by the NHMRC.
- Description: 2003011215
- Authors: Andrew, Nadine , Gabbe, Belinda , Cook, Jill , Lloyd, David , Donnelly, Cyril , Nash, Clare , Finch, Caroline
- Date: 2013
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 43, no. 8 (2013), p. 751-763
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565907
- Full Text:
- Reviewed:
- Description: Background: Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. Objective: The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. Methods: The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. Results: Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most (n = 27 [57 %]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. Conclusions: Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football. © 2013 Springer International Publishing Switzerland. Funded by the NHMRC.
- Description: 2003011215
Combining epidemiology and biomechanics in sports injury prevention research : A new approach for selecting suitable controls
- Finch, Caroline, Ullah, Shahid, McIntosh, Andrew
- Authors: Finch, Caroline , Ullah, Shahid , McIntosh, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 41, no. 1 (2011), p. 59-72
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Several important methodological issues need to be considered when designing sports injury case-control studies. Major design goals for case-control studies include the accounting for prior injury risk exposure, and optimal definitions of both cases and suitable controls are needed to ensure this. This article reviews methodological aspects of published sports injury case-control studies, particularly with regard to the selection of controls. It argues for a new approach towards selecting controls for case-control studies that draws on an interface between epidemiological and biomechanical concepts. A review was conducted to identify sport injury case-control studies published in the peer-review literature during 1985-2008. Overall, 32 articles were identified, of which the majority related to upper or lower extremity injuries. Matching considerations were used for control selection in 16 studies. Specific mention of application of biomechanical principles in the selection of appropriate controls was absent from all studies, including those purporting to evaluate the benefits of personal protective equipment to protect against impact injury. This is a problem because it could lead to biased conclusions, as cases and controls are not fully comparable in terms of similar biomechanical impact profiles relating to the injury incident, such as site of the impact on the body. The strength of the conclusions drawn from case-control studies, and the extent to which results can be generalized, is directly influenced by the definition and recruitment of cases and appropriate controls. Future studies should consider the interface between epidemiological and biomechanical concepts when choosing appropriate controls to ensure that proper adjustment of prior exposure to injury risk is made. To provide necessary guidance for the optimal selection of controls in case-control studies of interventions to prevent sports-related impact injury, this review outlines a new case-control selection strategy that reflects the importance of biomechanical considerations, which ensures that controls are selected based on the presence of the same global injury mechanism as the cases. To summarize, the general biomechanical principles that should apply to the selection of controls in future case-control studies are as follows: (i) each control must have been exposed to the same global injury mechanism as the case, (e.g. head impact, fall onto outstretched arm); and (ii) intrinsic (individual) factors (e.g. age, sex, skill level) that might modify the person's response to the relevant biomechanical loads are adjusted when either selecting the controls or are in the analysis phase. The same considerations for control selection apply to other study designs such as matched cohort studies or case-crossover studies. © 2011 Adis Data Information BV. All rights reserved.
- Authors: Finch, Caroline , Ullah, Shahid , McIntosh, Andrew
- Date: 2011
- Type: Text , Journal article
- Relation: Sports Medicine Vol. 41, no. 1 (2011), p. 59-72
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Several important methodological issues need to be considered when designing sports injury case-control studies. Major design goals for case-control studies include the accounting for prior injury risk exposure, and optimal definitions of both cases and suitable controls are needed to ensure this. This article reviews methodological aspects of published sports injury case-control studies, particularly with regard to the selection of controls. It argues for a new approach towards selecting controls for case-control studies that draws on an interface between epidemiological and biomechanical concepts. A review was conducted to identify sport injury case-control studies published in the peer-review literature during 1985-2008. Overall, 32 articles were identified, of which the majority related to upper or lower extremity injuries. Matching considerations were used for control selection in 16 studies. Specific mention of application of biomechanical principles in the selection of appropriate controls was absent from all studies, including those purporting to evaluate the benefits of personal protective equipment to protect against impact injury. This is a problem because it could lead to biased conclusions, as cases and controls are not fully comparable in terms of similar biomechanical impact profiles relating to the injury incident, such as site of the impact on the body. The strength of the conclusions drawn from case-control studies, and the extent to which results can be generalized, is directly influenced by the definition and recruitment of cases and appropriate controls. Future studies should consider the interface between epidemiological and biomechanical concepts when choosing appropriate controls to ensure that proper adjustment of prior exposure to injury risk is made. To provide necessary guidance for the optimal selection of controls in case-control studies of interventions to prevent sports-related impact injury, this review outlines a new case-control selection strategy that reflects the importance of biomechanical considerations, which ensures that controls are selected based on the presence of the same global injury mechanism as the cases. To summarize, the general biomechanical principles that should apply to the selection of controls in future case-control studies are as follows: (i) each control must have been exposed to the same global injury mechanism as the case, (e.g. head impact, fall onto outstretched arm); and (ii) intrinsic (individual) factors (e.g. age, sex, skill level) that might modify the person's response to the relevant biomechanical loads are adjusted when either selecting the controls or are in the analysis phase. The same considerations for control selection apply to other study designs such as matched cohort studies or case-crossover studies. © 2011 Adis Data Information BV. All rights reserved.
Instrumentation and motivations for organised cycling: : The development of the cyclist motivation instrument (CMI)
- Brown, Trent, O'Connor, Justen, Barkatsas, Anastasios
- Authors: Brown, Trent , O'Connor, Justen , Barkatsas, Anastasios
- Date: 2009
- Type: Text , Journal article
- Relation: Journal of Sports Science and Medicine, vol. 8, no. 2, Asist Group, p. 211-218
- Full Text:
- Description: ‘Serious leisure’ cycling has developed as a reinterpretation of the traditional form of the sport. This short term, informal, unstructured and unconventional conceptualisation represents a challenge to participant numbers in the mainstream sport. The purpose of this study was twofold: (i) to ascertain the cultural, subcultural and ecological factors of participation in this new conceptualised form enabling clubs, associations and governments to a deeper understanding about participants practices and (ii) as an ongoing validation to previous qualitative work (see O’Connor and Brown, 2005). This study reports on the development and psychometric properties (principal components analysis, confirmatory factor analysis) of the Cyclists’ Motivation Instrument. Four hundred and twenty two cyclists (371 males, 51 females) who were registered members of the state competitive cycling body completed a fifty-one item instrument. Five factors were identified: social, embodiment, self-presentation, exploring environments and physical health outcomes and these accounted for 47.2% of the variance. Factor alpha coefficients ranged from .63 to .88, overall scale reliability was .92, suggesting moderate to high reliability for each of the factors and the overall scale.
- Authors: Brown, Trent , O'Connor, Justen , Barkatsas, Anastasios
- Date: 2009
- Type: Text , Journal article
- Relation: Journal of Sports Science and Medicine, vol. 8, no. 2, Asist Group, p. 211-218
- Full Text:
- Description: ‘Serious leisure’ cycling has developed as a reinterpretation of the traditional form of the sport. This short term, informal, unstructured and unconventional conceptualisation represents a challenge to participant numbers in the mainstream sport. The purpose of this study was twofold: (i) to ascertain the cultural, subcultural and ecological factors of participation in this new conceptualised form enabling clubs, associations and governments to a deeper understanding about participants practices and (ii) as an ongoing validation to previous qualitative work (see O’Connor and Brown, 2005). This study reports on the development and psychometric properties (principal components analysis, confirmatory factor analysis) of the Cyclists’ Motivation Instrument. Four hundred and twenty two cyclists (371 males, 51 females) who were registered members of the state competitive cycling body completed a fifty-one item instrument. Five factors were identified: social, embodiment, self-presentation, exploring environments and physical health outcomes and these accounted for 47.2% of the variance. Factor alpha coefficients ranged from .63 to .88, overall scale reliability was .92, suggesting moderate to high reliability for each of the factors and the overall scale.
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