Time-loss Injuries among Female and Male Spanish Rink Hockey Players.

The present study describes the time-loss injuries among female and male athletes of the Spanish rink hockey league during the 2021/22 season.We performed a retrospective cohort study on time-loss injuries, whereby the athlete is prevented from participating in a training session or game because of the injury.A total of 463 athletes were included, with 326 (70.4%) senior male and 137 (29.6%) female. Two hundred and eighty-two time-loss injuries were recorded, the most common form being muscle injuries (112 episodes, 39.7%), especially those affecting the hip adductor muscles (52 episodes, 46.4% of muscle injuries). Most injuries were classified as mild (1-7 days of time-loss) and the median return-to-play was 9.5 days (range 1-180).Injury patterns were compared according to gender, position and moment: the results showed significant differences between senior males and females, between field players and goalkeepers, as well as between training and game, in terms of injury nature and type. The injury incidence proportion was significantly higher for field players compared to goalkeepers), and senior males had a significantly higher risk than senior females.The present study provides a starting point for studying and preventing injuries in rink hockey athletes.

Past-season, pre-season and in-season risk assessment of groin problems in male football players: a prospective full-season study.

OBJECTIVE: We assessed past-season, pre-season and in-season risk factors to investigate their association with an in-season groin problem in male amateur football players. METHODS: Past-season groin-pain information and pre-season short-lever and long-lever adductor squeeze strength were obtained at baseline, together with anthropometrics (weight, lower limb lever length) and player age. In-season hip-related and groin-related sporting function was monitored every 4 weeks using the Sports and Recreation (Sport) subscale from the Hip And Groin Outcome Score questionnaire (HAGOS (Sport)). Groin problems, including time-loss groin injuries and groin pain irrespective of time loss, were collected over a 39-week competitive in-season. We estimated relative risk (RR), and 95% credibility interval (ICr) from logistic regressions fitted in a Bayesian framework. RESULTS: Players (n=245) suffering from groin pain during the past-season had 2.4 times higher risk of experiencing a groin problem in the new season (2.40 RR; 95% ICr 1.5 to 3.7). This risk was reduced by 35% (0.65 RR; 95% ICr 0.42 to 0.99) per unit (N·m/kg) increase in the long-lever adductor squeeze test. Player age, short-lever squeeze test and the HAGOS (Sport) scores were not associated with the risk of a groin problem. CONCLUSIONS: Past-season groin pain increased the risk of a groin problem in the new in-season. This risk was reduced by higher pre-season long-lever adductor squeeze strength. Past-season groin-pain information and long-lever adductor squeeze strength can be quickly obtained during pre-season to identify players with an elevated risk of in-season groin problems. This may be key to reduce these problems in the new season.

Groin problems from pre- to in-season: a prospective study on 386 male Spanish footballers.

This study investigated the weekly prevalence of groin problems over a 3-week football pre-season, compared to a 39-week competitive in-season. We registered time-loss groin injuries, and self-reported weekly groin-pain in 17 amateur male football teams (386 players). The average weekly prevalence of groin problems (prevalence ratio (PR)) was 1.8 times higher (95% CI 1.6 to 2.0) during pre-season (21%) compared to in-season (12%). We found a higher weekly prevalence (PR 1.8; 95% CI 1.6 to 2.1) of groin problems without time loss, during the pre-season (19%) compared to the in-season (10%), but no significant difference in the weekly prevalence of groin problems with time loss (PR 1.5; 95% CI 1.0 to 2.4). Attention should be given to optimal load progression, and early implementation of preventive measures during the football pre-season to reduce the prevalence of groin problems in both pre- and in-season.

Prevalence and severity of groin problems in Spanish football: A prospective study beyond the time-loss approach.

The time-loss definition of injury is commonly adopted in epidemiological groin-injury studies in football, with a significant risk of underestimating the impact of these injuries. This study investigated the extent of groin problems, beyond the time-loss approach, over a full Spanish football season. Players from 17 amateur male teams were followed over 39 consecutive weeks. Groin-injury time loss and self-reported groin pain, irrespective of time loss, were combined to calculate the average weekly prevalence of all groin problems with or without time loss. A subscale measuring hip- and groin-related sporting function from the Copenhagen Hip and Groin Outcome Score questionnaire (HAGOS, Sport/Rec) was registered every 4 weeks. In total, 407 players participated in the study. The average (range) weekly prevalence of all groin problems was 11.7% (7.2%-20.8%); 1.3% with time loss (0.0%-3.2%) and 10.4% without time loss (6.3%-17.6%). Players with groin problems reported lower scores (mean difference) on the HAGOS, Sport/Rec subscale compared with players without (-19.5 [95% CI: -20.7 to -18.4]), while there was no difference between players reporting groin problems with and without time loss (4.0 [95% CI: -1.1 to 9.1]). The traditional time-loss measure only captured 10% of all groin problems. Hip- and groin-related sporting function was not different between players reporting groin problems with or without time loss, suggesting the reason for continuing to play is not only related to the severity of symptoms. These findings question the judicious use of the time-loss approach in overuse conditions, such as groin pain in footballers.

Methods matter: exploring the 'too much, too soon' theory, part 1: causal questions in sports injury research.

BACKGROUND: It is widely accepted that athletes sustain sports injury if they train 'too much, too soon'. However, not all athletes are built the same; some can tolerate more training than others. It is for this reason that prescribing the same training programme to all athletes to reduce injury risk is not optimal from a coaching perspective. Rather, athletes require individualised training plans. In acknowledgement of athlete diversity, it is therefore essential to ask the right causal research question in studies examining sports injury aetiology. PURPOSE: In this first part of a British Journal of Sports Medicine educational series, we present four different causal research questions related to the 'too much, too soon' theory and critically discuss their relevance to sports injury prevention. CONTENT: If it is true that there is no 'one size fits all' training programme, then we need to consider by how much training can vary depending on individual athlete characteristics. To provide an evidence-base for subgroup-specific recommendations, a stronger emphasis on the following questions is needed: (1) How much training is 'too much' before athletes with different characteristics sustain sports-related injury? and (2) Does the risk of sports injury differ among athletes with a certain characteristic (eg, high experience) compared with athletes with other characteristics (eg, low experience) depending on how much training they perform? CONCLUSION: We recommend that sports injury researchers aiming to examine the 'too much, too soon' theory should carefully consider how they, assisted by coaches, athletes and clinicians, pose their causal research question. In the light of the limitations of population-based prevention that intends to provide all athletes with the same advice, we argue that a stronger emphasis on research questions targeting subgroups of athletes is needed. In doing so, researchers may assist athletes, clinicians and coaches to understand what training advice/programme works best, for whom and under what circumstances.

Statement on methods in sport injury research from the 1st METHODS MATTER Meeting, Copenhagen, 2019.

High quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best practice methods-methods matter (greatly!). The 1st METHODS MATTER Meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research methods to discuss sports injury methods. We discussed important epidemiological and statistical topics within the field of sports injury research. With this opinion document, we provide the main take-home messages that emerged from the meeting.

Performance changes during the off-season period in football players - Effects of age and previous hamstring injury.

The aims of this study were to investigate changes in selected performance measures during an off-season period, their association, and the potential role of age and previous hamstring injury in semi-professional and amateur football players. Seventy-four male players (age: 25 ± 4 years, stature: 178.0 ± 6.6 cm, body mass: 74.9 ± 8.1 kg) were assessed at the beginning and end of the off-season summer-period for sprint, change-of-direction performance and eccentric hamstring strength. Small to medium increases in sprint times were observed at 5 (d = 0.26, p = 0.057), 10 (d = 0.42, p < 0.001) and 30 m (d = 0.64, p < 0.001). Small (d = -0.23, p = 0.033) improvements were observed for COD performance, and no changes in eccentric hamstring strength (d = 0.10, p = 0.317). The changes in the outcomes were not affected by age (p = 0.449 to 0.928) or previous hamstring injury (p = 0.109 to 0.995). The impaired sprint performance was not related to changes in eccentric hamstring strength (r = -0.21 to 0.03, p = 0.213 to 0.856), instead, changes in COD performance were associated with changes in eccentric hamstring strength (r = -0.42, p = 0.008).

Higher training workloads do not correspond to the best performances of elite basketball players.

The aim of this study was to identify the correspondence between the workload demands in training sessions and the game performance from elite basketball players, according to their specific positions. Data were collected from a professional men's basketball team competing in the Spanish Professional League and Euroleague. Players' activity during the training sessions was measured using WIMU PRO® and the game statistics were used as a measure of game performance. Cluster analysis allowed to classify the training workload and the game performance, whereas correspondence analysis allowed to explore their relationship. In essence, there was no correspondence from the higher workloads with the best performances, on the contrary, the small forwards' best performances corresponded to lower training workouts. Despite their importance, the external measures of load need to be complemented with additional (and valid) measures that can be translated to game performance.

Differences in Physical Demands between Game Quarters and Playing Positions on Professional Basketball Players during Official Competition.

The purpose of this study was to compare physical demands between game quarters and specific playing positions during official basketball competition. Thirteen professional male basketball players from the Spanish 2nd Division were monitored across all 17 regular-season home games. Physical demands were analyzed using a local positioning system (WIMU PRO™, Realtrack Systems S.L., Almería, Spain) and included peak velocity, total distance covered, high-speed running (>18 km·h-1), player load, jumps (>3G), impacts (>8G) and high-intensity accelerations (≥2 m·s-2) and decelerations (≤-2 m·s-2). A linear mixed model was used to test statistical significance (p < 0.05) between independent variables. Furthermore, standardized Cohen's effect size (ES) and respective 90% confidence intervals were also calculated. There was an overall decrease in all variables between the first and fourth quarter during competition. Specifically, total distance covered (p < 0.001; ES = -1.31) and player load (p < 0.001; ES = -1.27) showed large effects between the first and last period. Regarding differences between positions, guards presented significant increased values compared to centers (p = 0.04; ES = 0.51), whereas centers achieved significant larger results and moderate effects in comparison to guards in peak velocity (p = 0.01; ES = 0.88) and jumps (p = 0.04; ES = 0.86). In conclusion, physical demands vary between game quarters and playing positions during official competition and these differences should be considered when designing training drills to optimize game performance.

Does the economic recession influence the incidence of pertussis in a cosmopolitan European city?

BACKGROUND: In the last few years, pertussis has re-emerged worldwide. The aim of this article is to study how the incidence of the disease has evolved in Barcelona city over a 16-year period, and determine which factors are associated with the evolution of the disease. We discuss the causes of the observed changes considering different possibilities such as vaccination coverage, vaccine effectiveness, increased surveillance or the effect of the current economic recession. METHODS: We performed a cross-sectional, observational, population-based descriptive study using data for the 2000-2015 period from the notifiable diseases register maintained by Barcelona Public Health Agency. We used Poisson regression to compute adjusted odds ratios (aOR) and their corresponding 95% confidence intervals (CI). RESULTS: A total of 1791 cases were registered. The incidence of the disease increased throughout the city from 2011 onwards. While children under 1 year of age had the highest-incidence and were the most at risk (aOR = 27.18, CI:23.51-31.44), we found that the age of affected children was higher in the last years. Incidence proportion (PRR) was lower among foreign-born children than native children (PRR = 0.43 CI:0.32-0.58). In the whole-cell vaccine period (2000-2004), the percentage of cases under 1 year of age who received the vaccine was lower than in 2005-2015 when the acellular vaccine was used (p = 0.01), suggesting a lower efficacy of the acellular vaccine. However, vaccination coverage in children under 6 years remained high (~ 90%), and there were no significant year-to-year variations (p = 0.757). Moreover, there did not appear to be any significant restrictions in medical care. According to the index of disposable household income (DHI), pertussis incidence increased from 2011 onwards in all neighbourhoods and remained higher in those with lower DHI. CONCLUSIONS: The noteworthy increase in pertussis incidence does not seem to be due to the economic recession, but to other factors here described.

Incidence of Tendinopathy in Team Sports in a Multidisciplinary Sports Club Over 8 Seasons.

Tendinopathy is a critical medical condition that often hinders level of participation for professional and young athletes in many sports. The purpose of the study was to describe the incidence and severity of tendinopathy in a multi-sport club with professional and youth teams. We performed a retrospective epidemiological study. Incidence of tendinopathy in players (n = 3839; 8-38 years, professional and youth) was reviewed over 8 seasons (2008-2016) in 5 team sports: football, basketball, handball, roller hockey, and futsal. Team physicians diagnosed and classified tendinopathies according to anatomical location, sport types, playing category, sex, playing surface, lost training time, and severity (time to return to play). Injuries were coded using OSICS-10, and incidence of tendinopathies were calculated as the number of injuries per 100 players per season. The total relative frequency of tendinopathy (versus total injuries) was 22% (843/3839) over 8 seasons from 360 in youth and 483 in professional teams. The incidence of injury was the highest in professional basketball [69.9, 95%CI: (58.0-81.4)] followed by professional roller hockey [64.4, 95%CI: (47.3-85.6)], and professional futsal [36.2, 95%CI: (27.3-47.1)]. The most incidences commonly affected tendons were the patellar [11.7, 95%CI: (10.0-13.5)] and Achilles [10.3, 95%CI: (8.5-12.5)]. Tendinopathies represent a significant number of injuries in team sports and are more common in professional than youth teams, especially basketball and roller hockey. Additional studies are needed to understand associated time-loss and impact on performance, and to develop prevention strategies for high risk sports.

Sports Biostatistician: a critical member of all sports science and medicine teams for injury prevention.

Sports science and medicine need specialists to solve the challenges that arise with injury data. In the sports injury field, it is important to be able to optimise injury data to quantify injury occurrences, understand their aetiology and most importantly, prevent them. One of these specialty professions is that of Sports Biostatistician. The aim of this paper is to describe the emergent field of Sports Biostatistics and its relevance to injury prevention. A number of important issues regarding this profession and the science of sports injury prevention are highlighted. There is a clear need for more multidisciplinary teams that incorporate biostatistics, epidemiology and public health in the sports injury area.

Low External Workloads Are Related to Higher Injury Risk in Professional Male Basketball Games.

The primary purpose of this study was to identify potential risk factors for sports injuries in professional basketball. An observational retrospective cohort study involving a male professional basketball team, using game tracking data was conducted during three consecutive seasons. Thirty-three professional basketball players took part in this study. A total of 29 time-loss injuries were recorded during regular season games, accounting for 244 total missed games with a mean of 16.26 ± 15.21 per player and season. The tracking data included the following variables: minutes played, physiological load, physiological intensity, mechanical load, mechanical intensity, distance covered, walking maximal speed, maximal speed, sprinting maximal speed, maximal speed, average offensive speed, average defensive speed, level one acceleration, level two acceleration, level three acceleration, level four acceleration, level one deceleration, level two deceleration, level three deceleration, level four deceleration, player efficiency rating and usage percentage. The influence of demographic characteristics, tracking data and performance factors on the risk of injury was investigated using multivariate analysis with their incidence rate ratios (IRRs). Athletes with less or equal than 3 decelerations per game (IRR, 4.36; 95% CI, 1.78-10.6) and those running less or equal than 1.3 miles per game (lower workload) (IRR, 6.42 ; 95% CI, 2.52-16.3) had a higher risk of injury during games (p < 0.01 in both cases). Therefore, unloaded players have a higher risk of injury. Adequate management of training loads might be a relevant factor to reduce the likelihood of injury according to individual profiles.

Sports Biostatistician: a critical member of all sports science and medicine teams for injury prevention.

Sports science and medicine need specialists to solve the challenges that arise with injury data. In the sports injury field, it is important to be able to optimise injury data to quantify injury occurrences, understand their aetiology and most importantly, prevent them. One of these specialty professions is that of Sports Biostatistician. The aim of this paper is to describe the emergent field of Sports Biostatistics and its relevance to injury prevention. A number of important issues regarding this profession and the science of sports injury prevention are highlighted. There is a clear need for more multidisciplinary teams that incorporate biostatistics, epidemiology and public health in the sports injury area.

Factors associated with smoking among tuberculosis patients in Spain.

BACKGROUND: To determine the prevalence of smoking and analyze associated factors in a cohort of patients diagnosed with tuberculosis (TB) in Spain between 2006 and 2013. METHODS: Multicenter, cross-sectional, descriptive, observational study using a national database of TB patients, using logistic regression to calculate odds ratios (OR) and confidence intervals (CI). RESULTS: We analyzed 5,846 cases (62 % men, mean age 39 years, 33 % foreigners). 23.4 % were alcohol abuser, 1.3 % were injected drug users (IDU), 4.6 % were co-infected with HIV, and 7.5 % had a history of TB treatment. 6.6 % and 0.8 % showed resistance to one and multiple drugs, respectively. The predominant clinical presentation was pulmonary (71 %) with a cavitary radiological pattern in 32.8 % of cases. 82 % of cases were confirmed microbiologically, and 54 % were smear-positive microscopy. 2,300 (39.3 %) patients were smokers. The following factors were associated with smoking: male sex (OR = 2.26;CI:1.97;2.60), Spanish origin (OR = 2.79;CI:2.40-3.24), alcoholism (OR = 2.85;CI:2.46;3.31), IDU (OR = 2.78;CI:1.48;5.52), homelessness (OR = 1.99;CI:1.14-3.57), pulmonary TB (OR = 1.61;CI:1.16;2.24), cavitary radiological pattern (OR = 1.99;CI:1.43;2.79) and a smear-positive microscopy at the time of diagnosis (OR = 1.39;CI:1.14;1.17). CONCLUSIONS: The prevalence of smoking among TB patients is high. Smokers with TB have a distinct sociodemographic, clinical, radiological and microbiological profile to non-smokers.

Factors associated with unreported tuberculosis cases in Spanish hospitals.

BACKGROUND: Under-reporting of tuberculosis (TB) cases complicates disease control, hinders contact tracing and alters the accuracy of epidemiological data, including disease burden. The objective of the present study is to evaluate the proportion of unreported TB cases in Spanish healthcare facilities and to identify the associated factors. METHODS: A multi-center retrospective study design was employed. The study included TB cases diagnosed in 16 facilities during 2011-2012. These cases were compared to those reported to the corresponding public health departments. Demographic, microbiological and clinical data were analyzed to determine the factors associated with unreported cases. Associated factors were analyzed on a bivariate level using the x(2) test and on a multivariate level using a logistic regression. Odds ratios (OR) and 95 % confidence intervals (CI) were calculated. RESULTS: Of the 592 TB cases included in the study, 85 (14.4 %) were not reported. The percentage of unreported cases per healthcare center ranged from 0-45.2 %. The following variables were associated to under-reporting at a multivariate level: smear-negative TB (OR = 1.87; CI:1.07-3.28), extrapulmonary disease (OR = 2.07; CI:1.05-4.09) and retired patients (OR = 3.04; CI:1.29-7.18). A nurse case manager was present in all of the centers with 100 % reporting. The percentage of reported cases among the smear-positive cases was 9.4 % and 19.4 % (p = 0.001) among the rest of the study population. Smear-positive TB was no associated to under-reporting. CONCLUSIONS: It is important that TB Control Programs encourage thorough case reporting to improve disease control, contact tracing and accuracy of epidemiological data. The help from a TB nurse case manager could improve the rate of under-reporting.

Quantifying Hitting Load in Racket Sports: A Scoping Review of Key Technologies.

PURPOSE: This scoping review aims to identify the primary racket and arm-mounted technologies based on inertial measurement units that enable the quantification of hitting load in racket sports. METHODS: A comprehensive search of several databases (PubMed, SPORTDiscus, Web of Science, and IEEE Xplore) and Google search engines was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews guidelines. Included records primarily focused on monitoring hitting load in racket sports using commercialized racket or arm-mounted inertial sensors through noncompetitive and competitive racket-sports players. RESULTS: A total of 484 records were identified, and 19 finally met the inclusion criteria. The largest number of systems found were compatible with tennis (n = 11), followed by badminton (n = 4), table tennis (n = 2), padel (n = 1), and squash (n = 1). Four sensor locations were identified: grip-attached (n = 8), grip-embedded (n = 6), wrist (n = 3), and dampener sensors (n = 2). Among the tennis sensors, only 4 out of the 11 (36.4%) demonstrated excellent reliability (>.85) in monitoring the number of shots hit either during analytic drills or during simulated matches. None of the other racket-sports sensors have undergone successful, reliable validation for hitting-volume quantification. CONCLUSIONS: Despite recent advancements in this field, the quantification of hitting volume in racket sports remains a challenge, with only a limited number of tennis devices demonstrating reliable results. Thus, further progress in technology and research is essential to develop comprehensive solutions that adequately address these specific requirements.