A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 2: an analysis by movement patterns.

The objectives of this network meta-analysis were: (a) to estimate and compare the pooled effects of some injury prevention programs (IPPs) whose exercise-based components were categorized using a movement pattern-specific taxonomy on reducing overall and some specific body regions (lower extremity, thigh, knee, and ankle) injury incidences in youth team sport athletes and (b) to explore the individual effects of these components on the injury incidence rates (IIRs) previously mentioned. Searches were performed in PubMed, Web of Science, SPORTDiscus, and Cochrane Library. Eligible criteria were: exercise-based interventions comprised of exercises involving athletic motor skill competencies and evaluated against a control group, overall IIRs were reported, and youth (≤19 years old) team sport players. For the current analysis, a taxonomy based on movement patterns was employed for exercise component identification (upper body pushing and pulling; lower body concentric and eccentric; core; mechanics; acceleration; and lower body stability). Pooled effects were calculated by frequentist random effects pairwise and network meta-analyses. Nineteen studies were included. Most of the IPPs exhibit risk reduction when compared to their control groups on overall, lower extremity, and ankle injuries. Interventions comprised of lower body concentric and eccentric, core, mechanics, and lower body stability exercises were the most effective measures for reducing these injuries. None of the IPPs demonstrated to be effective for reducing thigh injuries, and contradictory results were found for knee injuries. Individual analysis at component level revealed that the lower body (bilateral and unilateral, concentric, and eccentric) component was the only one associated with a significant reduction on overall injuries. Indirect evidence suggests that interventions incorporating lower body concentric and eccentric, core, mechanics, and lower body stability exercises might be the most effective for reducing overall, lower extremity, and ankle injuries in youth team sports.

The categorization of exercise components based on the movement patterns might, a priori, be considered a criterion more closely associated with the injury phenomenon.Lower body concentric and eccentric, core, mechanics, and lower body stability exercises should be incorporated to any training program aimed at minimizing the risk of injury in youth.The ineffectiveness of interventions on the reduction of thigh injuries reveals the need for reconsideration of injury prevention strategies.

Acute pre- and post-competitive soccer match-play changes in neuromuscular factors, physical performance, and muscle response in youth male players.

There is a paucity of literature analyzing the impact of fatigue from actual competitive soccer match-play on measures of neuromuscular function and muscle damage markers in youth players. Aims The main purpose was to analyze the acute pre- and post-competitive soccer match-play changes in measures of landing mechanics, stretch-shortening cycle capability, physical performance, muscle damage, and match intensity. A secondary purpose was to explore whether the players' maturity status and chronological age were associated with post-soccer match-play responses. Methods Thirty-two male youth outfield soccer players from two chronological competition age groups (U14 and U16) were assessed pre-and post-competitive soccer match-play for 2D dynamic knee valgus at landing (DKV), leg stiffness, reactive strength index, 20 m sprint time, CMJ-Abalakov jump height, creatine kinase and urea activity and visual analogue scale for muscle soreness (VAS). Players' maturity status was also estimated using a previously validated regression equation. Results There were statistically significant (p < 0.05) post-competitive soccer match-play impairments in all measures of stretch-shortening cycle capability and muscle damage markers assessed irrespective of the age group. Likewise, significant post-match play alterations in landing mechanics (DKV of the dominant leg) and physical performance (sprint time and jump height) scores were documented for the U14 players. Significant interactions between maturity and landing mechanics and VAS responses to competitive soccer match-play were also found whereby more mature players demonstrated larger post-match changes. Conclusion The findings of this study suggest the existence of a negative influence of competitive match-play on neuromuscular function and muscle damage in youth soccer.

Development of novel calibration model(s) to predict whole-body density in professional football players.

INTRODUCTION: Questions continue to be raised about the validity that is in existence to estimate Db, in professional male footballer players. METHODS: Phase 1: n = 28 anthropometric variables were used on n = 206 footballers, using regression analyses to determine standard error of estimate and R2. A cut-off correlation coefficient set at r = 0.950 and 90% R2. Phase 2: all variables (z-scores, x- = 0.0, SD = ±1.0) to help reduce heteroscedasticity, ß, r, t, significance of t and P-values were calculated. Phase 3: a forced stepwise-backwards regression analysis approach with nine predictors which met the acceptance criteria (r = 0.950, R2 = 90% and ß weights) was used to develop a 'best fit' and a 'practical' calibration model. Phase 4: cross-validation of the two newly developed calibration method using LoA. RESULTS: The 'best fit' model SEM (0.115 g ml-1), the highest R2 (6.6%) (P ≤ 0.005), whereas the 'practical' calibration model SEM (0.115 g ml-1), R2 (4.7%) (P ≤ 0.005) with r values = 0.271 and 0.596 and R2 (%) coefficients = 0.3526 for the 'best fit' and 'practical' calibration models, respectively (P = 0.01). CONCLUSIONS: The two calibration models supported an ecologically and statistically valid contribution and can provide sound judgements about professional footballers' body composition.

The Association Between Chronological Age and Maturity Status on Lower Body Clinical Measurements and Asymmetries in Elite Youth Tennis Players.

BACKGROUND: Tennis is one of the most popular sports among youths. At elite levels, a notable increase in injury incidence and a temporary decline in performance may occur when children progress through puberty. However, limited research has explored maturity-associated variations in clinical measurements suggested as predictors of injury and tennis performance in elite youth players. Therefore, the main purpose of this study was to analyze the association between chronological age and maturity status on several measures of neuromuscular capability and physical performance as well as bilateral (interlimb) asymmetries in elite youth tennis players. HYPOTHESIS: Youth tennis players around peak height velocity (PHV) will show higher growth-related impairments or deficits in measures of neuromuscular capability and physical performance than their less (pre-PHV) and more (post-PHV) mature counterparts irrespective of sex. LEVEL OF EVIDENCE: Level 4. METHODS: A total of 68 male (age, 13.7 ± 1.1 years; height, 162.4 ± 9.4 cm; body mass, 51.4 ± 10.3 kg [Mean values ± SD]) and 60 female (age, 13.6 ± 1.1 years; height, 162.8 ± 7.2 cm; body mass, 52.7 ± 7.5 kg [Mean values ± SD]) elite youth tennis players from 2 different age groups (under 13 [U13] and under 15 [U15]) and maturity status (pre-PHV, around PHV, and post-PHV), were tested during national training camps. Tests included the Y Balance Test, isometric hip abduction and adduction strength, hip ranges of motion (ROMs), and countermovement jump (CMJ) height. Bayesian analysis was used to establish any significant between-group differences. RESULTS: Only dynamic balance (in boys; Bayesian factor [BF10] = 88.2) and jump height (in both boys and girls; BF10 >100) were significatively associated with chronological age, whereby the U15 group showed lower Y Balance Test reach distances (-6%; standardized effect size δ = 0.62) but higher CMJ height scores (+18%; δ = 0.73) than the U13 group. Although boys jump higher (+11%; δ = 0.62) and were stronger in isometric hip adduction strength (+14%; δ = 0.92) than girls, the latter had greater hip internal ROM values (+15%; δ = 0.75). Furthermore, relevant maturity-associated effects (BF10 = 34.6) were solely observed for the CMJ test in boys, with the most mature players demonstrating higher jump height scores (+12%; δ = 0.93). Finally, a significant percentage (>25%) of tennis players, independent of sex, demonstrated bilateral asymmetries in hip ROM, hip strength, and jump height values. CONCLUSION: The findings of this study show that in U13 and U15 male and female tennis players, there were neither positive nor negative maturity-associated variations in the clinical measurements analyzed (with the exception of jump height in male players). The high proportion of tennis players showing bilateral asymmetries in dynamic balance, hip ROM, and strength and jump performance highlight the need of future studies to analyze these factors in relation to unilateral tennis-specific adaptations in the musculoskeletal and sensorimotor systems. CLINICAL RELEVANCE: These results may help to better understand how different clinical measurements are associated with the process of growth and maturation in elite youth tennis players and may aid in the design of specific training interventions during these stages of development.

Effects of Age and Maturation on Lower Extremity Range of Motion in Male Youth Soccer Players.

ABSTRACT: Robles-Palazón, FJ, Ayala, F, Cejudo, A, De Ste Croix, M, Sainz de Baranda, P, and Santonja, F. Effects of age and maturation on lower extremity range of motion in male youth soccer players. J Strength Cond Res 36(5): 1417-1425, 2022-Restricted joint range of motion (ROM) has been considered as a primary risk factor for some sport-related injuries. Consequently, preparticipation assessment of lower extremity joints ROM could help identify youth soccer players at high risk of injury and to aid in the design of tailored age and maturational specific training interventions. The purpose of this study was to analyze and compare the influence of chronological age and maturational stage on several lower extremity ROM measures, as well as to describe the lower extremity ROM profile using a comprehensive approach in youth soccer players. A total of 286 male youth soccer players' ROM were assessed including passive hip (extension [PHE], adduction with hip flexed 90° [PHADHF90°], flexion with knee flexed [PHFKF] and extended [PHFKE], abduction with hip neutral [PHABD] and flexed 90° [PHABDHF90°], external [PHER] and internal [PHIR] rotation), knee (flexion [PKF]) and ankle (dorsiflexion with knee flexed [ADFKF] and extended [ADFKE]) ROMs. Between-group differences were analyzed using a one-way analysis of variance (ANOVA) and magnitude-based decisions. The results only report statistically significant (p < 0.05; d > 0.5) and clinically relevant differences (>8°) for the PKF ROM between U12 vs. U19, and Pre-PHV vs. Post-PHV groups. Furthermore, approximately 40, 35, and 20% of players displayed restrictions in their PHFKE, PKF, and ADFKF ROM values, respectively. These findings emphasize the necessity of prescribing (across all age groups and periods of growth and maturation) compensatory measures in daily soccer training, and these exercises should be equally applied to both limbs with the aim of improving PHFKE, PKF and ADFKF ROM values.

The Deceleration Deficit: A Novel Field-Based Method to Quantify Deceleration During Change of Direction Performance.

ABSTRACT: Clarke, R, Read, PJ, De Ste Croix, MBA, and Hughes, JD. The deceleration deficit: a novel field-based method to quantify deceleration during change of direction performance. J Strength Cond Res 36(9): 2434-2439, 2022-The study investigated the relationship between linear and change of direction (COD) speed performance components and the individual differences between deceleration deficit (DD) and COD deficit (CODD). Thirty-six subjects (mean ± SD : age = 20.3 ± 2.9 years; stature = 175.2 ± 7.7 cm; and body mass = 78.0 ± 16.7 kg) completed 3 trials of a 505 test in both turning directions (dominant [D]; nondominant [ND]) and 3 15-m linear sprints. Deceleration deficit was calculated by the 15-m approach in the 505 test, minus the athlete's linear 15-m sprint time. To compare individuals CODD and DD, z-scores were calculated, and moderate worthwhile changes (MWCs) were identified between these deficit z-scores. Significant correlations were identified between linear sprints and 505 time (D: r = 0.71, 0.74; P < 0.01. ND: r = 0.76, 0.75; P < 0.01) for 10-m and 15-m sprint. respectively, and between 505 performance and CODD (D: r = 0.74; P < 0.01. ND: r = 0.77; P < 0.01) and DD (D: r = 0.41, P < 0.05. ND: r = 0.44, P < 0.01). Deceleration deficit was significantly related to CODD (D: r = 0.59; P < 0.01. ND: r = 0.62; P < 0.01); however, 78% of subjects demonstrated differences between these deficit measures greater than an MWC. In conclusion, linear speed has the strongest significant relationship with 505 performance. Deceleration deficit could provide a more isolated construct than CODD which may be related to an athlete's deceleration capabilities.

Epidemiology of injuries in male and female youth football players: A systematic review and meta-analysis.

BACKGROUND: To conduct a systematic review and meta-analysis of epidemiological data of injuries in male and female youth football players. METHODS: Searches were performed in MEDLINE/PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases. Studies were considered if they reported injury incidence rate in male and female youth (≤19 years old) football players. Two reviewers (FJRP and ALV) extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale. The Grading of Recommendations Assessment, Development, and Evaluation approach determined the quality of evidence. Studies were combined using a Poisson random effects regression model. RESULTS: Forty-three studies were included. The overall incidence rate was 5.70 injuries/1000 h in males and 6.77 injuries/1000 h in females. Match injury incidence (14.43 injuries/1000 h in males and 14.97 injuries/1000 h in females) was significantly higher than training injury incidence (2.77 injuries/1000 h in males and 2.62 injuries/1000 h in females). The lower extremity had the highest incidence rate in both sexes. The most common type of injury was muscle/tendon for males and joint/ligament for females. Minimal injuries were the most common in both sexes. The incidence rate of injuries increased with advances in chronological age in males. Elite male players presented higher match injury incidence than sub-elite players. In females, there was a paucity of data for comparison across age groups and levels of play. CONCLUSION: The high injury incidence rates and sex differences identified for the most common location and type of injury reinforce the need for implementing different targeted injury-risk mitigation strategies in male and female youth football players.

Injury Profile in Professional Handball Players During 4 Consecutive Seasons According to Playing Positions: A Longitudinal Study.

BACKGROUND: The injury profile of each playing position in handball is a key factor in being able to improve the injury risk management process. Therefore, the aim of this study was to longitudinally analyze the differences in professional handball players' injury profile according to their playing position (ie, goalkeeper, back, wing, and line). HYPOTHESIS: Injury incidence and burden would be higher in back players compared with the other playing positions, while ligament and knee would be the most common injury type and location. STUDY DESIGN: Prospective cohort design. LEVEL OF EVIDENCE: Level 4. METHODS: Sixty-eight male handball players belonging to the same professional team participated in this study over 4 consecutive seasons. Injury incidence and injury burden were recorded as well as the severity, type, and location following the International Olympic Committee consensus statement. RESULTS: Although nonsignificant differences in injury incidence were found according to playing position (rate ratios [RRs] from 0.43 to 2.47; P > 0.05), back players reported the highest burden (60.65 absence days/1000 h; RR from 0.12 to 7.75;P < 0.05), with wing players showing a greater burden (54.29 absence days/1000 h; RR from 0.09 to 4.91; P < 0.05) in comparison with goalkeepers (12.19 absence days/1000 h) and line players (13.10 absence days/1000 h). Muscle/tendon injuries and sprains presented higher incidence and burden than other type of injuries, and a greater incidence and burden was reported for knee injuries in all playing positions. CONCLUSION: The highest injury incidence and injury burden is in back players in professional handball. CLINICAL RELEVANCE: This study provides comprehensive information on the injury profile of professional handball players, which can be useful for strength and conditioning coaches when developing specific injury risk management programs.

Comprehensive Lower Extremities Joints Range of Motion Profile in Futsal Players.

The purposes of this study were to describe the lower extremities joints range of motion (ROM) profile using a comprehensive approach in futsal players and to examine potential player position (goalkeepers vs. outfield players), competitive level (first [top] division vs. second division), number of playing years, sex (males vs. females), and bilateral (dominant limb vs. non-dominant limb) differences. A total of 72 male and 67 female elite futsal players from 11 clubs were measured of passive hip (flexion with knee flexed [HF KF ] and extended [HF KE ], extension [HE], abduction [HA], external [HER], and internal [HIR] rotation), knee (flexion [KF]) and ankle (dorsiflexion with knee flexed [ADF KF ] and extended [ADF KE ]) ROMs. Bayesian inferences exploring differences between player position, competitive level, sex and limb were made. A Bayesian correlation analysis was conducted to explore the influence of playing years on joints ROMs. The results showed no significant player position or competitive level related differences in any average ROM score. However, statistically significant sex-related differences were documented whereby female players reported higher hip and knee joints ROM average values than their male counterparts. Especially relevant were the proportions of males (72%) and players from teams engaged in the second division (61%) displaying limited HF KE ROMs. Likewise, around 35% of all players showed restricted ADF KF ROMs. In addition, approximately 21, 18, 22, and 25% of the futsal players were identified as having bilateral asymmetries (≥8°) for HA, HIR, HER, and KF ROMs, respectively. Finally, Bayesian correlation analysis did not report any significant association between years of playing futsal and ROM measures (all r values < 0.34). The implications that these restricted HF KE and ADF KF ROMs and bilateral asymmetries in hip (abduction, internal and external rotation) and knee (flexion) ROMs caused by the practice of futsal may have on physical performance and injury risk warrant future research.

Physiological Characteristics of Female Soccer Players and Health and Performance Considerations: A Narrative Review.

Female soccer has seen a substantial rise in participation, as well as increased financial support from governing bodies over the last decade. Thus, there is an onus on researchers and medical departments to develop a better understanding of the physical characteristics and demands, and the health and performance needs of female soccer players. In this review, we discuss the current research, as well as the knowledge gaps, of six major topics: physical demands, talent identification, body composition, injury risk and prevention, health and nutrition. Data on female talent identification are scarce, and future studies need to elucidate the influence of relative age and maturation selection across age groups. Regarding the physical demands, more research is needed on the pattern of high-intensity sprinting during matches and the contribution of soccer-specific movements. Injuries are not uncommon in female soccer players, but targeting intrinsically modifiable factors with injury prevention programmes can reduce injury rates. The anthropometric and physical characteristics of female players are heterogeneous and setting specific targets should be discouraged in youth and sub-elite players. Menstrual cycle phase may influence performance and injury risk; however, there are few studies in soccer players. Nutrition plays a critical role in health and performance and ensuring adequate energy intake remains a priority. Despite recent progress, there is considerably less research in female than male soccer players. Many gaps in our understanding of how best to develop and manage the health and performance of female soccer players remain.

The Influence of Age and Maturation on Trajectories of Stretch-Shortening Cycle Capability in Male Youth Team Sports.

PURPOSE: To examine the influence of growth and maturation in the trajectory of stretch-shortening cycle capability. METHOD: Using a mixed-longitudinal design, absolute and relative leg stiffness and reactive strength index (RSI) were measured 3 times over a 3-year period in 44 youth team-sport players. Maturation was determined as maturity offset and included within the Bayesian inference analysis as a covariate alongside chronological age. RESULTS: Irrespective of age and maturation, there was no change in absolute leg stiffness, however relative leg stiffness decreased over time. Maturation and age reduced this decline, but the decline remained significant (Bayesian factor [10] = 5097, model averaged R2 = .61). The RSI increased over time and more so in older more mature youth players (Bayesian factor [10] = 9.29e8, model averaged R2 = .657). CONCLUSION: In youth players who are at/post peak height velocity, relative leg stiffness appears to decline, which could have an impact on both performance and injury risk. However, RSI increases during this period, and these data reinforce that leg stiffness and RSI reflect different components of stretch-shortening cycle capability. Practitioners should consider these differences when planning training to maximize stretch-shortening cycle capability during growth and maturation in athletes on the developmental performance pathway.

Reliability of five trunk flexion and extension endurance field-based tests in high school-aged adolescents: ISQUIOS programme.

This study aimed to explore the inter-session reliability of the measures obtained from 2 trunk extension (Biering-Sorensen and Dynamic Extensor Endurance (DEE) tests) and 3 trunk flexion (Ito, Side Bridge and Bench Trunk Curl-Up (BTC) tests) endurance field-based tests in adolescents. A total of 208 (males, n = 100; females, n = 108) adolescents performed all the field-based tests on 2 separate testing sessions, 7-days apart. The inter-session reliability scores were explored through relative reliability, inter-session differences and precision of measurements. Most of the trunk endurance measures demonstrated acceptable relative reliability (the intraclass correlation coefficients (ICC) ranged from 0.75 to 0.94). However, significant inter-session differences were identified for measures from the DEE and BTC tests. Likewise, the precision of the measurement of each field-based test was poor (the the standard error of measurement expressed as a percentage of the mean score (CVTE) ranged from 11.3 to 24.4%) with the minimal detectable change (MDC95) revealing that changes higher than 42% for trunk extension endurance tests and 31.4% for trunk flexion endurance tests after an intervention are required to indicate a significant change above measurement error. Therefore, the findings from this study indicate that only the BTC test demonstrates acceptable inter-session reliability (ICC > 0.9, CVTE ~ 10%, MDC95 ~ 30%) to monitor the changes in trunk endurance scores that may be expected in adolescents after performing an intervention programme.

The most demanding scenarios of 5-on-5 modified scrimmage situations in elite basketball.

BACKGROUND: The most demanding scenarios and physical demands of elite basketball 5-on-5 scrimmages are unknown to trainers, although recent advances in microtechnology allows the gaps in this research to be filled. The purpose of this study was to describe and compare the physical demands, through the most demanding scenarios and traditional average measures, of two different 5-on-5 scrimmage situations executed during training sessions in elite male basketball players. METHODS: Physical demand measures (i.e., total distance covered, high-speed running distance, number of high-intensity accelerations actions, number of high-intensity decelerations actions) were collected from 12 players from the Spanish first Division using a Local Positioning System. Measures were compared via a Bayesian inference analysis, considering playing in half-court (HALF) and half-court and transition (HTRAN) conditions for the 5-on-5 scrimmage. RESULTS: This study showed that, irrespective of the approach used to quantify the physical demands (traditional [average measures per minute] and novel rolling average time epoch [most demanding scenarios]), during the HALF condition players covered less and performed a lower number of high-intensity accelerations and decelerations than in HTRAN (Bayesian factor >10 and standardized effect size >0.6). Furthermore, players' physical demands during 5-on-5 scrimmage situations, independently of the court size, were underestimated consistently by the traditional approach. CONCLUSIONS: Quantifying players' physical demands through the rolling approach may provide a more accurate measure of the most intense periods of activity. Based on the physical demands described, HTRAN may be used to help train players to perform optimally during the most physically-stressful scenarios of match-play whereas HALF may be more suitable to be included in warm-ups, recovery sessions and sessions immediately before a match.

A Field-Based Approach to Determine Soft Tissue Injury Risk in Elite Futsal Using Novel Machine Learning Techniques.

Lower extremity non-contact soft tissue (LE-ST) injuries are prevalent in elite futsal. The purpose of this study was to develop robust screening models based on pre-season measures obtained from questionnaires and field-based tests to prospectively predict LE-ST injuries after having applied a range of supervised Machine Learning techniques. One hundred and thirty-nine elite futsal players underwent a pre-season screening evaluation that included individual characteristics; measures related to sleep quality, athlete burnout, psychological characteristics related to sport performance and self-reported perception of chronic ankle instability. A number of neuromuscular performance measures obtained through three field-based tests [isometric hip strength, dynamic postural control (Y-Balance) and lower extremity joints range of motion (ROM-Sport battery)] were also recorded. Injury incidence was monitored over one competitive season. There were 25 LE-ST injuries. Only those groups of measures from two of the field-based tests (ROM-Sport battery and Y-Balance), as independent data sets, were able to build robust models [area under the receiver operating characteristic curve (AUC) score ≥0.7] to identify elite futsal players at risk of sustaining a LE-ST injury. Unlike the measures obtained from the five questionnaires selected, the neuromuscular performance measures did build robust prediction models (AUC score ≥0.7). The inclusion in the same data set of the measures recorded from all the questionnaires and field-based tests did not result in models with significantly higher performance scores. The model generated by the UnderBagging technique with a cost-sensitive SMO as the base classifier and using only four ROM measures reported the best prediction performance scores (AUC = 0.767, true positive rate = 65.9% and true negative rate = 62%). The models developed might help coaches, physical trainers and medical practitioners in the decision-making process for injury prevention in futsal.

Injury Profile in Women's Football: A Systematic Review and Meta-Analysis.

BACKGROUND: Football is the most popular sport among women; however, little is known about the injury profile in this population. This information would help design tailored injury risk mitigation strategies that may make football safer for women. OBJECTIVE: The aim of this study was to perform a systematic review and meta-analysis of epidemiological data of injuries in women´s football. METHODS: A systematic review following PRISMA guidelines was performed up to January 2020 in PubMed, Web of Science, Sportdiscus and the Cochrane Library databases. Twenty-two studies reporting the incidence of injuries in women football were analysed. Two reviewers independently extracted data (intraclass correlation coefficient [ICC] for inter-reviewer reliability = 0.87) and assessed study quality using the STROBE statement, GRADE approach, Newcastle Ottawa Scale and Downs and Black assessment tools. Studies were combined in pooled analyses (injury incidence and injury proportion) using a Poisson random effects regression model. RESULTS: The overall incidence of injuries in female football players was 6.1 injuries/1000 h of exposure. Match injury incidence (19.2 injuries/1000 h of exposure) was almost six times higher than training injury incidence rate (3.5 injuries/1000 h of exposure). Lower extremity injuries had the highest incidence rates (4.8 injuries/1000 h of exposure). The most common types of injuries were muscle/tendon (1.8 injuries/1000 h of exposure) and joint (non-bone) and ligament (1.5 injuries/1000 h of exposure), which were frequently associated with traumatic incidents. Slight/minimal injuries (1-3 days of time loss) were the most common. The incidence rate of injuries during matches in the top five world ranking leagues was higher than the rest of the leagues (19.3 vs 10.7 injuries/1000 h of exposure, respectively). The weighted injury proportion was 1.1 (95% confidence interval = 0.6-1.7) whereby on average players sustained more than one injury per season. CONCLUSIONS: Female football players are exposed to a substantial risk of sustaining injuries, especially during matches that require the highest level of performance. To markedly reduce overall injury burden, efforts should focus on introducing and evaluating preventative measures that target match specific dynamics to make football players more capable of responding to the challenges that they have to deal with during match play. REGISTRATION: This systematic review was registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42019118152).

Monitoring Practices of Training Load and Biological Maturity in UK Soccer Academies.

PURPOSE: Overuse injury risk increases during periods of accelerated growth, which can subsequently impact development in academy soccer, suggesting a need to quantify training exposure. Nonprescriptive development scheme legislation could lead to inconsistent approaches to monitoring maturity and training load. Therefore, this study aimed to communicate current practices of UK soccer academies toward biological maturity and training load. METHODS: Forty-nine respondents completed an online survey representing support staff from male Premier League academies (n = 38) and female Regional Talent Clubs (n = 11). The survey included 16 questions covering maturity and training-load monitoring. Questions were multiple-choice or unipolar scaled (agreement 0-100) with a magnitude-based decision approach used for interpretation. RESULTS: Injury prevention was deemed highest importance for maturity (83.0 [5.3], mean [SD]) and training-load monitoring (80.0 [2.8]). There were large differences in methods adopted for maturity estimation and moderate differences for training-load monitoring between academies. Predictions of maturity were deemed comparatively low in importance for bio-banded (biological classification) training (61.0 [3.3]) and low for bio-banded competition (56.0 [1.8]) across academies. Few respondents reported maturity (42%) and training load (16%) to parent/guardians, and only 9% of medical staff were routinely provided this data. CONCLUSIONS: Although consistencies between academies exist, disparities in monitoring approaches are likely reflective of environment-specific resource and logistical constraints. Designating consistent and qualified responsibility to staff will help promote fidelity, feedback, and transparency to advise stakeholders of maturity-load relationships. Practitioners should consider biological categorization to manage load prescription to promote maturity-appropriate dose-responses and to help reduce the risk of noncontact injury.

Epidemiology of injuries in elite male and female futsal: a systematic review and meta-analysis.

The main purpose of this study was to conduct a systematic review and meta-analysis quantifying the incidence of injuries in futsal players. A systematic search was conducted using MEDLINE, PubMed, Web of Science and Scopus databases and subsequently, six studies (14 cohorts) were selected. Separate meta-analyses for male and female players were conducted using a Poisson random-effect regression model approach. The overall and match incidence rates in elite male futsal players were 6.8 (95% CI = 0.0-15.2) and 44.9 (95% CI = 17.2-72.6) injuries/1000 hours of exposure. Pooled training injury rate in male players was not calculated due to the lack of studies reporting training injuries in this cohort. For females, an overall, training and match incidence rates of 5.3 (95% CI = 3.5-7), 5.1 (95% CI = 2.7-7.6) and 10.3 (95% CI = 0.6-20.1) injuries/1000 hours of exposure were reported. In males, match incidence rate in International tournaments was 8.5 times higher than in national leagues (77.2 [95% CI = 60.0-94.5] vs 9.1 [95% CI = 0.0-19.3] for international tournaments and national leagues, respectively). Elite male and female futsal players are exposed to a substantial risk of sustaining injuries, especially during matches.

Longitudinal differences in the injury profile of professional male handball players according to competitive-level.

The aim was to analyse the differences in professional handball players` injury profile according to the team`s competitive-level (i.e., First division vs. Second division). Fifty-three professional male handball players participated in this study during four consecutive seasons in the same team (2015-16 and 2016-17 for the First division league and 2017-18 and 2018-19 for the Second division league). No significant differences in overall incidence were observed between groups (3.69 vs 4.19 injuries/1000 h, RR = 0.88, 95% CI 0.64-1.22, P = 0.44), although significantly greater injury incidence during training sessions was observed in the Second division group (3.06 vs 1.61 injuries/1000 h, RR = 0.52, 95% CI 0.34-0.81, P = 0.01), while greater injury incidence during matches was reported in the First division group (84.03 vs 49.88 injuries/1000 h, RR = 1.68, 95% CI 1.00-2.83, P = 0.05). The second division group presented the greatest injury burden attending to overall, training and match exposure, as well as in most locations and injury types. Given the between groups differences found in the injury profile of handball player, it is suggested to implement specific preventive strategies attending to the characteristics of each level-group.

The moderating impact of maturation on acute neuromuscular and psycho-physiological responses to simulated soccer activity in academy soccer players.

AbstractResource constraints complicate load monitoring practices in some academies, which is problematic based on load-injury associations surrounding periods of rapid non-linear growth. Limited research has explored relationships between maturation and perceived psycho-physiological response to activity and associated neuromuscular performance changes. This study aimed to quantify neuromuscular and psycho-physiological responses to standardised activity and analyse whether dose-responses were moderated by maturation. Fifty-seven male soccer players (age: 14.1 ± 0.9 years; stature: 165 ± 10 cm; body mass, 57 ± 9 kg; percentage of predicted adult height 92.7 ± 5%) from two Elite Player Performance Plan (EPPP) academies completed the youth soccer-specific aerobic fitness test (Y-SAFT60). Countermovement jump (CMJ), reactive strength index (RSI), absolute (ABS) and relative leg stiffness (REL) were measured pre-post the Y-SAFT60 with playerload (PL), heart rate (HR), total distance (TDist) and differential ratings of perceived exertion (dRPE) used as markers of load and intensity. A moderation model was employed to analyse interactions of maturation as a continuous variable. Analysis indicated no significant interaction (p <0.05) between maturation and neuromuscular performance but RPE-Technical demonstrated significant interactions (p = 0.01). Slope analysis indicated four variables (PL, RSI, ABS and REL) that demonstrated significance at various stages of maturation, most notably aligning with peak height velocity (∼87-96% PAH). Tentatively, we propose that maturational developments in the neuromuscular system offer some mechanistic explanation to the varied dose-responses observed. It is therefore important that maturation is habitually considered within prescription of training programmes and that further empirical studies are completed to determine maturity specific dose-responses.