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OBJECTIVES: This study examined how track cycling coaches, practitioners, and athletes: develop knowledge and practices; value performance areas; and, implement research into practice. DESIGN: Cross-sectional survey. METHODS: An online REDCap survey of track cycling coaches, practitioners, and athletes was conducted involving questions related to demographics, performance area importance, knowledge acquisition and application, research relevance, and research direction. RESULTS: A total of 159 responses were received from coaches (nâ¯=â¯55), practitioners (nâ¯=â¯29), and athletes (nâ¯=â¯75). Participants' highest track cycling competition level involvement ranged from local/regional (12.7%) to Olympic/Paralympic (39.9%). Respondents primarily develop practices by observing 'the sport' or 'others competing/working in it' (both 85.8%). Practitioners develop practices through self-guided learning (96.4%). The primary reason for practice use was prior experience (84.9%), whilst individuals were least likely to use practices resulting in marginal gains with potentially negative outcomes (27.3%). Areas of greatest perceived importance were Aerodynamics, Strength & Conditioning, and Tactics (all >96% agreed/strongly agreed). Scientific evidence for Tactics (30%) and Mental Skills (26%) was perceived to be lacking, resulting in greater reliance on personal experience (74% and 62%, respectively) to inform training decisions. The main barrier to implementing research into practice was athlete buy-in (84.3%). CONCLUSIONS: Within track cycling, informal learning was most popular amongst respondents. Greater reliance on personal experience within evidence-based practice for many performance areas aligns with limited existing research. Most respondents reported multiple barriers affecting research implementation in practice.
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This study aims to examine and describe the characteristics of potential injury situations during a men's professional international tournament quantified using the FIFA Football Language Medical Coding. A prospective study was conducted during the 64 matches of the FIFA World Cup Qatar 2022™, during which five analysts recorded potential injury situations from video analysis. "Potential injuries" were recorded when players stayed down > 5 s and/or requested medical attention. Characteristics were further recorded for variables such as opponent's action and body location. In total, 720 potential injury situations were recorded of which 139 required medical assessment. The actions which resulted in most potential injuries were running while receiving a pass (74; 10%), while passing the ball (59; 8%), and while progressing with the ball (48; 7%). Duels and ball progression led to a potential injury in 3.0% and 2.1% of all similar actions in total. Both aerial duels and ball progression led to an potential injury that required medical assessment on 0.4% of occasions. Most potential injuries involved the head (149; 21%), foot (120; 17%), or lower leg (110; 15%) with most medical assessments of the head (35; 25%), lower leg (17; 12%), and knee (15; 11%) with a median duration of 47 seconds (IQR 28-61). This study provides a detailed overview of match circumstances that may have a higher injury risk. Although some variables within the coding system need improvement to increase reliability, its use will allow a more detailed comparison of differences between high-risk player actions leading to injury and those that do not, which can improve future prevention strategies.
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Academics in sports medicine as well as other medical fields are generally expected to publish research and opinions in peer-reviewed journals. The peer-review process is intended to protect against the publication of flawed research and unsubstantiated claims. However, both financial and non-financial competing interests may result in sub-optimal results by affecting investigators, editors, peer reviewers, academic institutions, and publishers. In this article, we focus on the non-financial competing interests created in our current academic system. Because these competing interests are embedded in our current scholastic framework, the potential biases are difficult to quantify. To minimize the effect of these competing interests, we review and highlight some underlying incentives for each stakeholder and some potential solutions to mitigate their effects.
Subject(s)
Conflict of Interest , Motivation , Sports Medicine , Humans , Peer Review, Research , Periodicals as Topic , PublishingABSTRACT
AIM: Prediction intervals are a useful measure of uncertainty for meta-analyses that capture the likely effect size of a new (similar) study based on the included studies. In comparison, confidence intervals reflect the uncertainty around the point estimate but provide an incomplete summary of the underlying heterogeneity in the meta-analysis. This study aimed to estimate (i) the proportion of meta-analysis studies that report a prediction interval in sports medicine; and (ii) the proportion of studies with a discrepancy between the reported confidence interval and a calculated prediction interval. METHODS: We screened, at random, 1500 meta-analysis studies published between 2012 and 2022 in highly ranked sports medicine and medical journals. Articles that used a random effect meta-analysis model were included in the study. We randomly selected one meta-analysis from each article to extract data from, which included the number of estimates, the pooled effect, and the confidence and prediction interval. RESULTS: Of the 1500 articles screened, 866 (514 from sports medicine) used a random effect model. The probability of a prediction interval being reported in sports medicine was 1.7% (95% CI = 0.9%, 3.3%). In medicine the probability was 3.9% (95% CI = 2.4%, 6.6%). A prediction interval was able to be calculated for 220 sports medicine studies. For 60% of these studies, there was a discrepancy in study findings between the reported confidence interval and the calculated prediction interval. Prediction intervals were 3.4 times wider than confidence intervals. CONCLUSION: Very few meta-analyses report prediction intervals and hence are prone to missing the impact of between-study heterogeneity on the overall conclusions. The widespread misinterpretation of random effect meta-analyses could mean that potentially harmful treatments, or those lacking a sufficient evidence base, are being used in practice. Authors, reviewers, and editors should be aware of the importance of prediction intervals.
Subject(s)
Sports , Humans , Exercise , Probability , Uncertainty , Meta-Analysis as TopicABSTRACT
BACKGROUND: Skill acquisition science is the study of how motor skills are acquired, developed and/or learned. There is substantive evidence for general motor skill acquisition in controlled laboratory settings yet the literature on the learning of sports-related skills is typically less conclusive. OBJECTIVES: This scoping review aimed to summarise the current literature on skill acquisition intervention studies examining the learning of sports-related skills as part of a randomised controlled trial, by synthesizing and extracting the most relevant features. METHODS: Four electronic databases (PsychINFO, PubMed, SPORTDiscus and Web of Science) were searched for relevant studies. The sample characteristics of these studies were extracted, and summarised. Two systematic searches of the literature were conducted. In the first search, eighty-six studies were retained. A second search was conducted in July 2022 to include new studies and specifically focused on the inclusion of within-subject design studies, resulting in the inclusion of 35 additional studies. A third search was conducted in May 2023 to include new studies resulting in the inclusion of 10 additional studies. RESULTS: One hundred and thirty studies across 29 sports were included in the review. The vast majority of the studies in this scoping review (n = 104) examined the learning of a sport-related skill in participants with no experience. Twenty-eight percent of all retained studies (n = 35) considered only the learning of a golf skill, and all studies were practiced in a laboratory environment, examining closed motor skills (n = 130). The most common intervention categories reported were attention (n = 22), instruction and demonstration (n = 20), practice design (n = 20), and perceptual training (n = 19). Nearly half of all studies used an immediate retention test within 48 h of the cessation of practice (n = 63), and just over one quarter of studies (n = 34) reported incorporating some form of transfer test. Eighty-six percent (n = 112) reported positive findings. CONCLUSIONS: The skewed focus on golf skills across a small number of skill acquisition interventions, the inconsistent use and reporting of performance measures, practice durations and measures of learning alongside the relatively small sample sizes consisting mostly of inexperienced learners and the skewed publication of positive findings should warrant caution. More empirical studies across a broader range of sports and with more consistent methodologies are needed to develop a robust pool of literature that can support academics and practitioners interested in which skill acquisition interventions could be used to influence the learning of sports-related skills.
Subject(s)
Learning , Motor Skills , Randomized Controlled Trials as Topic , Humans , Motor Skills/physiology , Athletic Performance/physiology , SportsABSTRACT
OBJECTIVE: To investigate open science practices in research published in the top 5 sports medicine journals from May 1, 2022, and October 1, 2022. DESIGN: A meta-research systematic review. LITERATURE SEARCH: Open science practices were searched in MEDLINE. STUDY SELECTION CRITERIA: We included original scientific research published in one of the identified top 5 sports medicine journals in 2022 as ranked by Clarivate: (1) British Journal of Sports Medicine, (2) Journal of Sport and Health Science, (3) American Journal of Sports Medicine, (4) Medicine and Science in Sports and Exercise, and (5) Sports Medicine-Open. Studies were excluded if they were systematic reviews, qualitative research, gray literature, or animal or cadaver models. DATA SYNTHESIS: Open science practices were extracted in accordance with the Transparency and Openness Promotion guidelines and patient and public involvement. RESULTS: Two hundred forty-three studies were included. The median number of open science practices in each study was 2, out of a maximum of 12 (range: 0-8; interquartile range: 2). Two hundred thirty-four studies (96%, 95% confidence interval [CI]: 94%-99%) provided an author conflict-of-interest statement and 163 (67%, 95% CI: 62%-73%) reported funding. Twenty-one studies (9%, 95% CI: 5%-12%) provided open-access data. Fifty-four studies (22%, 95% CI: 17%-27%) included a data availability statement and 3 (1%, 95% CI: 0%-3%) made code available. Seventy-six studies (32%, 95% CI: 25%-37%) had transparent materials and 30 (12%, 95% CI: 8%-16%) used a reporting guideline. Twenty-eight studies (12%, 95% CI: 8%-16%) were preregistered. Six studies (3%, 95% CI: 1%-4%) published a protocol. Four studies (2%, 95% CI: 0%-3%) reported an analysis plan a priori. Seven studies (3%, 95% CI: 1%-5%) reported patient and public involvement. CONCLUSION: Open science practices in the sports medicine field are extremely limited. The least followed practices were sharing code, data, and analysis plans. J Orthop Sports Phys Ther 2023;53(12):1-13. Epub 20 October 2023. doi:10.2519/jospt.2023.12016.
Subject(s)
Exercise , Sports Medicine , Humans , ConfidentialityABSTRACT
BACKGROUND: Hyperthermia (and associated health and performance implications) can be a significant problem for athletes and teams involved in intermittent sports. Quantifying the highest thermal strain (i.e. peak core body temperature [peak Tc]) from a range of intermittent sports would enhance our understanding of the thermal requirements of sport and assist in making informed decisions about training or match-day interventions to reduce thermally induced harm and/or performance decline. OBJECTIVE: The objective of this systematic review was to synthesise and characterise the available thermal strain data collected in competition from intermittent sport athletes. METHODS: A systematic literature search was performed on Web of Science, MEDLINE, and SPORTDiscus to identify studies up to 17 April 2023. Electronic databases were searched using a text mining method to provide a partially automated and systematic search strategy retrieving terms related to core body temperature measurement and intermittent sport. Records were eligible if they included core body temperature measurement during competition, without experimental intervention that may influence thermal strain (e.g. cooling), in healthy, adult, intermittent sport athletes at any level. Due to the lack of an available tool that specifically includes potential sources of bias for physiological responses in descriptive studies, a methodological evaluation checklist was developed and used to document important methodological considerations. Data were not meta-analysed given the methodological heterogeneity between studies and therefore were presented descriptively in tabular and graphical format. RESULTS: A total of 34 studies were selected for review; 27 were observational, 5 were experimental (2 parallel group and 3 repeated measures randomised controlled trials), and 2 were quasi-experimental (1 parallel group and 1 repeated measures non-randomised controlled trial). Across all included studies, 386 participants (plus participant numbers not reported in two studies) were recruited after accounting for shared data between studies. A total of 4 studies (~ 12%) found no evidence of hyperthermia, 24 (~ 71%) found evidence of 'modest' hyperthermia (peak Tc between 38.5 and 39.5 °C), and 6 (~ 18%) found evidence of 'marked' hyperthermia (peak Tc of 39.5 °C or greater) during intermittent sports competition. CONCLUSIONS: Practitioners and coaches supporting intermittent sport athletes are justified to seek interventions aimed at mitigating the high heat strain observed in competition. More research is required to determine the most effective interventions for this population that are practically viable in intermittent sports settings (often constrained by many competing demands). Greater statistical power and homogeneity among studies are required to quantify the independent effects of wet bulb globe temperature, competition duration, sport and level of competition on peak Tc, all of which are likely to be key modulators of the thermal strain experienced by competing athletes. REGISTRATION: This systematic review was registered on the Open Science Framework ( https://osf.io/vfb4s ; https://doi.org/10.17605/OSF.IO/EZYFA , 4 January 2021).
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OBJECTIVES: Understanding how injuries occur (inciting circumstances) is useful for developing etiological hypotheses and prevention strategies. The aims of this study were 1) to evaluate the feasibility of a method combining video and Global Positioning System data to estimate the speed and acceleration of activities leading to injuries and 2) to use this method to analyse the inciting circumstances leading to non-contact injuries. DESIGN: Retrospective descriptive study. METHODS: Injury inciting circumstances from 46 elite players over three seasons were analysed from video recordings and from external load measures collected through Catapult Vector S7 Global Positioning System. RESULTS: In total 34 non-contact injuries were analysed. Sixteen out of the seventeen hamstring injuries occurred when players were running for (median and interquartile range) 16.75â¯m (8.42-26.65â¯m) and achieved a peak speed of 29.28â¯km·h-1 (26.61-31.13â¯km·h-1) which corresponded to 87.55â¯% of players' maximal speed (78.5â¯%-89.75â¯%). Of the three adductor injuries, one occurred whilst the player was decelerating without the ball, one occurred whilst the player was accelerating and controlling the ball at knee level, and one occurred whilst the player was performing an instep kick. Two quadriceps injuries occurred whilst the players were kicking either whilst walking or running. CONCLUSIONS: From the preliminary results reported in this study most hamstring injuries occurred when players ran >25â¯km·h-1 and above 80â¯% of their maximal speed. This study suggests that this novel approach can allow a detailed and standardised analysis of injury inciting circumstances.
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BACKGROUND: A comprehensive examination of the sport-specific activities and circumstances being performed at the time of injury is important to hypothesise mechanisms, develop prevention strategies and inform future investigations. Results reported in the literature are inconsistent because inciting activities are reported using different classifications. Hence the aim was to develop a standardised system for the reporting of inciting circumstances. METHODS: The system was developed using a modified Nominal Group Technique. The initial panel included 12 sports practitioners and researchers from four continents with respectively ≥ 5 years of experience working in professional football and/or conducting injury research. The process consisted of six phases: idea generation, two surveys, one online meeting and two confirmations. For answers to the closed questions, consensus was deemed achieved if ≥ 70% of respondents agreed. Open-ended answers were qualitatively analysed and then introduced in subsequent phases. RESULTS: Ten panellists completed the study. The risk of attrition bias was low. The developed system includes a comprehensive range of inciting circumstances across five domains: contact type, ball situation, physical activity, session details, contextual information. The system also distinguishes between a core set (essential reporting) and an optional set. The panel deemed all the domains to be important and easy to use both in football and in research environments. CONCLUSION: A system to classify inciting circumstances in football was developed. Given the extent of reporting inconsistency of inciting circumstances in the available literature, this can be used while further studies evaluate its reliability.
Subject(s)
Athletic Injuries , Soccer , Humans , Athletic Injuries/classification , Exercise , Reproducibility of Results , Soccer/injuriesABSTRACT
Clinical prediction models in sports medicine that utilize regression or machine learning techniques have become more widely published, used, and disseminated. However, these models are typically characterized by poor methodology and incomplete reporting, and an inadequate evaluation of performance, leading to unreliable predictions and weak clinical utility within their intended sport population. Before implementation in practice, models require a thorough evaluation. Strong replicable methods and transparency reporting allow practitioners and researchers to make independent judgments as to the model's validity, performance, clinical usefulness, and confidence it will do no harm. However, this is not reflected in the sports medicine literature. As shown in a recent systematic review of models for predicting sports injury models, most were typically characterized by poor methodology, incomplete reporting, and inadequate performance evaluation. Because of constraints imposed by data from individual teams, the development of accurate, reliable, and useful models is highly reliant on external validation. However, a barrier to collaboration is a desire to maintain a competitive advantage; a team's proprietary information is often perceived as high value, and so these 'trade secrets' are frequently guarded. These 'trade secrets' also apply to commercially available models, as developers are unwilling to share proprietary (and potentially profitable) development and validation information. In this Current Opinion, we: (1) argue that open science is essential for improving sport prediction models and (2) critically examine sport prediction models for open science practices.
Subject(s)
Athletic Injuries , Sports Medicine , Sports , Humans , Taboo , Sports Medicine/methodsABSTRACT
Various terms used in sport and exercise science, and medicine, are derived from other fields such as epidemiology, pharmacology and causal inference. Conceptual and nomological frameworks have described training load as a multidimensional construct manifested by two causally related subdimensions: external and internal training load. In this article, we explain how the concepts of training load and its subdimensions can be aligned to classifications used in occupational medicine and epidemiology, where exposure can also be differentiated into external and internal dose. The meanings of terms used in epidemiology such as exposure, external dose, internal dose and dose-response are therefore explored from a causal perspective and their underlying concepts are contextualised to the physical training process. We also explain how these concepts can assist in the validation process of training load measures. Specifically, to optimise training (i.e. within a causal context), a measure of exposure should be reflective of the mediating mechanisms of the primary outcome. Additionally, understanding the difference between intermediate and surrogate outcomes allows for the correct investigation of the effects of exposure measures and their interpretation in research and applied settings. Finally, whilst the dose-response relationship can provide evidence of the validity of a measure, conceptual and computational differentiation between causal (explanatory) and non-causal (descriptive and predictive) dose-response relationships is needed. Regardless of how sophisticated or "advanced" a training load measure (and metric) appears, in a causal context, if it cannot be connected to a plausible mediator of a relevant response (outcome), it is likely of little use in practice to support and optimise the training process.
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Sports , Humans , Exercise , CausalityABSTRACT
BACKGROUND: Being up-to-date with evidence-based knowledge of lower limb sports injuries is essential for Healthcare professionals (HCPs). PURPOSE: To assess whether HCPs possess up-to-date knowledge of lower limb sports injuries by comparing their knowledge to that of athletes. METHODS: With an expert panel, we developed an online quiz of 10 multiple-choice questions on various topics related to lower-limb sports injuries. Maximal score was 100. We used social media to invite HCPs (5 groups: Physiotherapists, Chiropractors, Medical Doctors, Trainers, and Other therapists) and athletes of all levels (amateur, semi-pro, and pro) to participate. We drafted the questions according to conclusions from the latest systematic reviews and meta-analyses. RESULTS: 1526 participants completed the study. Final quiz scores ranged from zero (n = 28, 1.8%) to 100 (n = 2, 0.1%) and were distributed normally with a mean score of 45.4 ± 20.6. None of the 6 groups' means surpassed the set threshold of 60 points. Multiple linear regressions of covariates indicated that age, gender, engagement in physical activity, learning hours per week, reading scientific journals, reading popular magazines and blogs, trainers, and other therapists' groups explained 19% of the variances (-5.914<ß < 15.082, 0.000
Subject(s)
Athletic Injuries , Physical Therapists , Sports , Humans , Athletic Injuries/diagnosis , Athletes , Lower ExtremityABSTRACT
PURPOSE: To examine the construct validity and reliability of 2 single items for fatigue and recovery in dancers. The construct validity was assessed using reference instruments: the fatigue items of the Brunel Mood Scale (BRUMS) and the Short Recovery and Stress Scale (SRSS). A secondary aim was to explore the respondent interpretation of these 2 items using a concept identification approach. METHODS: Two hundred forty-three (N = 243) dancers completed single-item fatigue and recovery (unipolar and bipolar), BRUMS, and SRSS once for construct validity. For reliability, 49 dancers completed the questionnaires twice, 1 week apart. Using a concept identification approach, 49 dancers were also asked comprehension and interpretation of fatigue and recovery. RESULTS: The fatigue item correlated with SRSS stress items (rs = .37-.51) and BRUMs fatigue items (rs = .63-.66). The recovery item was only partially confirmed in terms of construct validity, when using the SRSS recovery items as reference (rs = .39-.43). Reliability was confirmed for the single items of fatigue (κ = .77-.78) and recovery (κ = .71-.78). Main responses for the concept of fatigue were tiredness (34.7%), muscle soreness (17.3%), and energy (13.0%). Main responses for the concept of recovery were muscle soreness (43.0%), tiredness (27.9%), and fatigue (24.0%). CONCLUSION: We provide preliminary confirmation of the validity and reliability of the single item fatigue in dancers. The recovery item was only partially confirmed in terms of construct validity, when using the SRSS recovery items as reference, but did display acceptable reliability and agreement. Further research is warranted further exploring other measurement properties.
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Affect , Myalgia , Humans , Reproducibility of Results , Surveys and Questionnaires , Fatigue , PsychometricsABSTRACT
BACKGROUND: While there are a few studies on measurement properties of PROMIS short forms for pain and function in patients with knee osteoarthritis, nothing is known about the measurement properties in patients with knee arthroplasty. Therefore, this study examined the measurement properties of the German Patient-Reported Outcomes Measurement Information System (PROMIS) short forms for pain intensity (PAIN), pain interference (PI) and physical function (PF) in knee arthroplasty patients. METHODS: Short forms were collected from consecutive patients of our clinic's knee arthroplasty registry before and 12 months post-surgery. Oxford Knee Score (OKS) was the reference measure. A subsample completed the short forms twice to test reliability. Construct validity and responsiveness were assessed using scale-specific hypothesis testing. For reliability, Cronbach's alpha, intraclass correlation coefficients, and agreement using standard error of measurement (SEMagr) were used. Agreement was used to determine standardised effect sizes and smallest detectable changes (SDC90). Individual-level minimal important change (MIC) was calculated using a method of adjusted prediction. RESULTS: Of 213 eligible patients, 155 received questionnaires, 143 returned baseline questionnaires and 119, 12-month questionnaires. Correlations of short forms with OKS were large (ârâ ≥ 0.7) with slightly lower values for PAIN, and specifically for men. Cronbach's alpha values were ≥ 0.84 and intraclass correlation coefficients ≥ 0.90. SEMagr were around 3.5 for PAIN and PI and 1.7 for PF. SDC90 were around 8 for PAIN and PI and 4 for PF. Follow-up showed a relevant ceiling effect for PF. Correlations with OKS change scores of around 0.5 to 0.6 were moderate. Adjusted MICs were 7.2 for PAIN, 3.5 for PI and 5.7 for PF. CONCLUSION: Our results partly support the use of the investigated short forms for knee arthroplasty patients. The ability of PF to differentiate between patients with high perceived recovery is limited. Therefore, the advantages and disadvantages should be strongly considered within the context of the intended use.
Subject(s)
Arthroplasty, Replacement, Knee , Osteoarthritis, Knee , Male , Humans , Reproducibility of Results , Patient Reported Outcome Measures , Osteoarthritis, Knee/diagnosis , Surveys and QuestionnairesABSTRACT
This study aimed to compare the effectiveness of recreational football performed once (LOW) vs. twice (MOD) a week on cardiovascular risk factors in healthy, sedentary men. Body composition, resting blood pressure, blood lipid profile and maximal oxygen consumption (VO2max) were measured at baseline, after a 12-week control and training period, using an interrupted time-series study (study 1, n = 18: n = 8, LOW and n = 10, MOD) nested in a randomized parallel trial (study 2, n = 34: n = 18 LOW and n = 16 MOD). After the intervention in study 1, LDL-cholesterol (-12.3â mg·dL-1 [-22.7 to -2.0]) and VO2max (4.5 ml·kg-1·min-1 [1.2-7.8 ]) changed in LOW whereas differences were found in weight (-2.1â kg [-3.7 to -0.4]), BMI (-0.7â kg·m-2 [-1.2 to -0.1]), total cholesterol (-22.2â mg·dL-1 [-36.0 to -8.4]), no-HDL-cholesterol (-17.5â mg·dL-1 [-30.5 to -4.5]), LDL-cholesterol (-14.9â mg·dL-1 [-23.6 to -6.2]) and VO2max (5.7 ml·kg-1·min-1 [2.8-8.6]) in MOD. Study 2 showed no evidence of differences between groups. Our results therefore suggest positive health effects of recreational football even when performed at low frequency as it can happen in real context.Highlights Moderate and high amount of recreational football practice (i.e. 2 or 3â h a week) have been shown to be effective to improve health-related factors in both healthy and unhealthy people.Scarce data are present regarding the effect of a low frequency of recreational football practice (i.e. 1â h a week) that is often usual in a real context.Our results showed the practice of recreational football, once a week, is effective for improving some cardiovascular risk factors (maximal oxygen consumption and LDL-cholesterol) in sedentary, healthy middle-aged men.Moreover, practising recreational football once or twice a week seems to lead to similar positive health adaptations.
Subject(s)
Cardiovascular Diseases , Football , Male , Middle Aged , Humans , Football/physiology , Physical Fitness/physiology , Cardiovascular Diseases/prevention & control , Risk Factors , Oxygen Consumption/physiology , Cholesterol , Heart Disease Risk FactorsABSTRACT
BACKGROUND: A comprehensive examination of the sport-specific activities performed around the time of injury is important to hypothesise injury mechanisms, develop prevention strategies, improve management, and inform future investigations. The aim of this systematic review is to summarise the current literature describing the activities performed around the time of injury in football (soccer). METHODS: A systematic search was carried out in PubMed, Web of Science, SPORTDiscus, and OpenGrey. Studies were included if participants were football players aged > 13 years old and the activities performed at the time of injury were reported together with the total number of injuries. Risk of bias was assessed using an adapted version of checklists developed for prevalence studies. The activities reported by the studies were grouped to account for inconsistent reporting, and the proportion of each injury activity was calculated. Data were not meta-analysed due to high heterogeneity of methods and classification criteria. RESULTS: We included 64 studies reporting on 56,740 injuries in total. ACL injures were analysed by 12 studies, ankle/foot and knee injuries were analysed by five studies, thigh injuries were analysed by four studies, hip/groin injuries were analysed by three studies, and hamstring injuries were analysed by two studies. Five studies analysed more than one type of injury and 38 studies did not specify the type of injuries analysed. Running and kicking were the predominant activities leading to thigh and hamstring injuries. Changing direction and kicking were the predominant activities leading to hip and groin injuries and duels were the predominant activities leading to ankle injuries. Duels and pressing seem the predominant activities leading to ACL injuries, while results for other knee and general injuries were inconsistent. CONCLUSIONS: A qualitative summary of the activities performed at the time of injury has been reported. The results need to be interpreted carefully due to the risk of bias observed in the included studies. If we are to meaningfully progress our knowledge in this area, it is paramount that future research uses consistent methods to record and classify injuries and activities leading up to and performed at the time of injury. REGISTRATION: The protocol of this systematic review was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/U96KV ).
Subject(s)
Athletic Injuries , Soccer , Adolescent , Female , Humans , Male , Athletic Injuries/epidemiology , Knee Injuries/epidemiology , Leg Injuries/epidemiology , Lower Extremity/injuries , Soccer/injuries , Soft Tissue Injuries/epidemiologyABSTRACT
Return-to-play decision making should be based on all the advantages and disadvantages of return to play for athletes, not just the risk of injury. For competitive athletes, this includes the effect of early versus delayed return to sport on performance. In this paper, we address the questions "How can I estimate the effect of injury on the individual's performance at return to play?" and "What is the effect of delaying return to sport on the individual's performance?". To address these questions, we describe (1) some foundational concepts, design and analytical challenges related to estimating the causal effect of return to play timing on performance in the athlete, (2) additional challenges if one is interested in the effects of delaying return to play and (3) differences when the questions relate to the team's performance. Although the analytical strategies described appear complicated, coaches and athletes make these judgements informally every day without explicitly stating their assumptions. Using a formal approach should help analysts provide the most valid answers to the questions asked by athletes and coaches. In brief, the choice of a comparison group depends on the research question and requires that one consider the hypothetical performance trajectory of the athlete had they never been injured. Thus, the optimal comparison group depends on the shape of the expected trajectory and the specific research question being asked.