Prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of German first and lower leagues.

BACKGROUND: While several studies on mental health of elite athletes were published in recent years, few compared the prevalence with the general population and none included field hockey players. AIMS: To analyze the prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of different skill levels and to compare it to the general population. METHODS: Male and female hockey players from different leagues were asked to answer questions on player characteristics, the Centre of Epidemiologic Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7). RESULTS: One hundred and eighty-seven players (incl. 54 first and 28 second league players) participated in the study (response rate 97.4%). More than a third (n = 64; 35.0%) reported to be affected by an injury/health complaint, but 157 (86.3%) were able to train and play without limitations. The CES-D score indicated depression symptoms in more female (n = 15; 18.3%) than male (n = 5; 4.8%) players (χ2=8.8; p < 0.01). No male and one female player had symptoms of generalized anxiety disorder. Players who played 60 or more matches in the previous 12 months had on average significantly higher depression (t = 2.3; p < 0.05) and generalized anxiety scores (t = 4.2; p < 0.001) than players who played fewer matches. The prevalence of depression and of generalized anxiety symptoms was similar to or lower than in the general population. Although 20 (10.7%) players had depression symptoms, only 4 (2.2%) received psychological counseling or psychotherapy. CONCLUSION: It is recommended to provide routine screening of mental health problems and low-threshold access to adequate treatment for elite athletes.

The Interval Between Matches Significantly Influences Injury Risk in Field Hockey.

Fixture congestion increases injury risk in football, but how it impacts other sports is unclear. The aim of this study was to identify associations between match density and injury incidence in field hockey players. Injury data from a prospective cohort study of professional and youth players was analysed in two ways. Inter-match intervals were clustered into<2424-hours, 3-7-days, and 13 + days, and injury rate ratios (IRR) were calculated to identify differences between clusters in match injuries. Separately, a Lasso-penalised Poisson regression model was used to determine the association between match load across the previous 24-hours, 3-days, 7-days and 14-days, and match and training injuries. Injury rates in matches within 24-hours of the previous match were mostly significantly higher when compared to matches after 3-7-days (IRRs: 3.78; 6.77, P = 0.003; 0.005). While a higher match exposure in the preceding 24-hour and 3-day periods was associated with higher combined match and training injury rates (ß̂ = 0.0001; 0.0018), a higher match exposure in the previous 7-and 14-day periods was associated with a reduced injury rate (ß̂ = -0.0001; -0.0005). Due to the increased injury risk in matches 3-days and especially 24-hours following the previous fixture, match distribution should be cautiously planned.

Epidemiology of injuries in outdoor and indoor hockey players over one season: a prospective cohort study.

OBJECTIVES: To determine the incidence and characteristics of hockey ('field hockey') injuries over the course of one outdoor and indoor season. Comparisons of female versus male players, outdoor versus indoor season and match versus practice were performed. METHODS: Female and male teams of the first, second, third, regional and youth divisions were recruited among a local hockey association in Northern Germany, and followed over an indoor and an outdoor season. Exposure times and location, type, severity and cause of injuries during practice and matches were documented by the coaches or medical staff and collected weekly. Prevalence and incidence rates were calculated. RESULTS: Of the 232 players (mean±SD age 20.7±4.7 years, 68.1% male, 31.9% first division), 84 players (36.2%) suffered 108 new injuries during the season. The overall incidence rate was 3.7 injuries per 1000 player hours (95% CI 3.0 to 4.4). The injury incidence was lower in practice (2.7 per 1000 player practice hours, 95% CI 2.0 to 3.3) than in matches (9.7 per 1000 player match hours, 95% CI 6.8 to 12.7), and was similar for female and male players as well as during the outdoor and the indoor season. Most injuries affected the lower limb (thigh, knee and ankle) and occurred without contact (58.3%). Severe injuries (n=34; 31.5%) were predominantly located at the knee and hand/finger. CONCLUSION: Hockey players have a high prevalence and incidence of injuries, especially at the lower limb.

Game Exposure, Player Characteristics, and Neuromuscular Performance Influence Injury Risk in Professional and Youth Field Hockey Players.

BACKGROUND: Identifying factors that contribute to the occurrence of injury is an important step in designing training programs to minimize the risk of injury. However, despite high injury rates, variables contributing to injury in field hockey players remain relatively unexplored. PURPOSE: To identify factors that may predict injury in professional and youth field hockey players. STUDY DESIGN: Cohort study; Level of evidence, 2. METHOD: Professional and youth hockey players completed preseason neuromuscular performance testing and were monitored for injuries, training, and game exposure throughout the subsequent 12-month indoor and outdoor hockey season. Least absolute shrinkage and selection operator analysis was conducted to identify injury risk factors. Receiver operating characteristic curves were then calculated to determine the individual predictive accuracy of the identified variables. RESULTS: A total of 83 players (mean ± SD age, 20.7 ± 4.9 years; 34.9% female) with complete performance, injury, and exposure data were included for data analysis. Almost half of players (44.6%) sustained a time-loss injury during the season, and 73% of these injuries occurred in the lower limb. Playing more games and having an older age, asymmetrical and poor dynamic postural control, and better explosive performance were identified as jointly influencing the risk of injury. When considered individually, number of games played throughout the season was the most accurate predictor of injury risk (area under the curve [AUC] = 0.74; P < .001), while asymmetrical and poor dynamic postural control (AUCs = 0.61-0.65; P = .01-.04) and better explosive athletic performance (AUCs = 0.65-0.67; P < .01) were identified as moderate individual predictors of sustaining a general or lower limb injury. CONCLUSION: A number of modifiable factors were individually and jointly associated with an increased injury risk in field hockey players, providing initial evidence for the design of targeted and sport-specific training programs to mitigate the risk of injury.

General perceptual-cognitive abilities: Age and position in soccer.

Various studies suggest the importance of sport-specific cognitive and perceptual abilities in soccer. However, the role of general perceptual-cognitive abilities and the relation of age respective to position have not been clarified for soccer in detail. Therefore, it was the objective of the present study to determine the relation of age and position to general perceptual-cognitive abilities. 178 highly talented male soccer players (mean age 16.2, age range 10 to 33 years) were involved. The participants performed computer-based sustained attention and anticipation (using Vienna Test System) tests. 139 subjects (mean age 16.6) took part in visual and acoustic reaction tests (using Talent Diagnostic System). The soccer players, subdivided into age and position groups, were recruited from a youth academy of a professional soccer club and played at the highest and 2nd highest national soccer competition for their age. Group differences were tested using analysis of variance. Correlations were analyzed for age and abilities. Significant correlations and group differences were found for age and sustained attention tasks. Significant differences for position groups were observed with regard to acoustic reaction time (ART). Further, we found statistical tendencies for group differences regarding the visual reaction time (VRT), indicating that midfielders outperform defenders and strikers in simple reaction tasks. Improved skills in sustained attention tasks resulted for defenders, who worked faster and more precisely in figural tasks. Regarding general anticipation tasks differences were not found. No group differences were found in basic anticipation tasks. Our study indicates that additional research is needed to further clarify the development of general perceptual-cognitive abilities and position-specific differences in the above abilities of highly talented soccer players.

Effectiveness of 2 Osteopathic Treatment Approaches on Pain, Pressure-Pain Threshold, and Disease Severity in Patients with Fibromyalgia: A Randomized Controlled Trial.

OBJECTIVE: To assess the effectiveness of osteopathic intervention (OI) and general osteopathic treatment (GOT) in individuals with fibromyalgia syndrome (FMS). METHODS: The trial was designed as a randomized controlled trial with 2 osteopathic interventions and 1 untreated control group. The patients in the two osteopathic groups received 10 osteopathic treatments (OI or GOT) within a time period of 12 weeks. The control group did not receive any osteopathic treatment. The primary outcome was the average pain intensity (API) assessed by visual analog scale (VAS). Secondary outcomes were the pressure-pain threshold rated by means of a tender point score, and disease severity, assessed by the Fibromyalgia Impact Questionnaire (FIQ). RESULTS: 50 patients were randomized. The primary outcome parameter API decreased from 7.2 to 4.7 in the OI group, from 6.3 to 4.3 in the GOT group, and increased slightly in the control group from 6.2 to 6.6. There were significant differences for the change in API between the OI group and the control group (VAS: 2.9, 95% confidence interval (CI) = 1.12-4.52), and between the GOT group and the control group (VAS: 2.4, 95% CI = 0.65-4.11), but no significant differences between the OI group and the GOT group. There were no significant differences for the secondary outcome parameters between the groups. CONCLUSION: A series of osteopathic treatments might be beneficial for patients suffering from FMS.

Perceptions of football players regarding injury risk factors and prevention strategies.

Current approaches regarding injury prevention focus on the transfer of evidence into daily practice. One promising approach is to influence attitudes and beliefs of players. The objective of this study was to record player's perceptions on injury prevention. A survey was performed among players of one German high-level football (soccer) club. 139 professional and youth players between age 13 and 35 years completed a standardized questionnaire (response rate = 98%). It included categories with (1) history of lower extremity injuries, (2) perceptions regarding risk factors and (3) regularly used prevention strategies. The majority of players (84.2%) had a previous injury. 47.5% of respondents believe that contact with other players is a risk factor, followed by fatigue (38.1%) and environmental factors (25.9%). The relevance of previous injuries as a risk factor is differently perceived between injured (25%) and uninjured players (0.0%). Nearly all players (91.5%) perform stretching to prevent injuries, followed by neuromuscular warm up exercises (54.0%). Taping is used by 40.2% of previously injured players and 13.6% of players without a history of injuries. In conclusion, the perception of risk factors and performed preventive strategies are inconsistent with scientific evidence. Future transfer strategies should incorporate the players beliefs and attitudes.