The effect of match congestion on hip adductor squeeze strength in youth rink hockey players

Introduction Groin injuries are common among rink hockey players. Monitoring the main risk factors can reduce the likelihood of suffering such injury. The objective of this study was to evaluate the effect of a competitive congestion period on the squeeze strength of the hip adductor muscles in a group of adolescent rink hockey players, and whether the strength reduction exceeded the injury risk threshold (>15%) for sustaining a groin injury. Materials and Methods Twenty U-16 athletes (9 females) participated in the study. Eighty-three adductor strength measurements were recorded after 10 games (2109 min of play). Function was assessed using the Sport subscale of the Hip and Groin Outcome Score (HAGOS) questionnaire. A simple linear regression model was used to analyze the accumulated time-strength relationship, and the pre-tournament and post-tournament HAGOS results were compared. Results The accumulation of games resulted in a significant strength reduction in male players' (R2= 0.27), but not in females. Eighty-five percent of the sample had their strength reduced to values at risk compared to baseline strength, but none of them stopped their activity due to discomfort in the groin region. HAGOS results were not affected by the competitive congestion (p = 0.07–0.48). Conclusion Match congestion can negatively impact adductor strength. However, there may not be a relationship between strength loss above 15% and the appearance of a groin injury. (AU)

High Prevalence of Seasonal and Current Groin Problems in Rink Hockey Players.

Groin problems are common in multidirectional sports. The aim of the present study is to assess seasonal, current, and trends for groin problems in rink hockey players, irrespective of their playing position, age, or gender. Rink hockey players from three countries [n=446 (162 female, 284 male)] were invited to participate in an online questionnaire. This form evaluated the prevalence of groin problems (time-loss and non-time-loss) for the 2022-2023 season, as well as monthly prevalence of groin problems (time-loss and non-time-loss). All groin problems were compared between playing position, gender, and age to assess between-group differences. Senior males reported the highest time-loss (25%) and non-time-loss (51%) for seasonal prevalence; while U-17 males reported the lowest in both categories of groin problems (time-loss 9%, non-time-loss 27%). No significant differences between playing position or gender were found for any of the groin problems analyzed. In-season prevalence (9-15.7%) of groin problems was significantly higher than pre-season (7.4%) prevalence (p<0.01). Seasonal prevalence of groin problems is common in rink hockey, regardless of gender, playing position, or age. Preventive efforts should be directed towards all players, regardless of their individual characteristics.

Epidemiology of injuries in elite female rink hockey players: A two season observational study.

OBJECTIVES: To record the time-loss injuries of female rink hockey players and describe the affected region, tissue, and onset of injury. DESIGN: Cross-sectional survey study. SETTING: First (Ok Liga) and Second (Plata) division clubs. PARTICIPANTS: 280 player-seasons. MAIN OUTCOME MEASURES: Incidence of overall, training, and match injuries (number of injuries per 1000 h) from two seasons. RESULTS: A total of 229 injuries occurred in 56,438 h of exposure. The overall incidence was 4 injuries per 1000 h (4/1000 h), with a significantly higher rate of injuries during matches (15.2/1000 h) compared to training sessions (2.6/1000 h) (p < 0.001). Injuries affecting the lower limb were the most common (2.3/1000 h), followed by upper limb (1.2/1000 h), and head/trunk (0.6/1000 h). The tissue with the highest incidence of injury was the muscle/tendon (1.3/1000 h), followed by the ligament (0.8/1000 h). Around one in every three injuries (31%) affected either the thigh or hip/groin (73 injuries). CONCLUSIONS: The injury incidence in elite female rink hockey is moderate and occurs mainly during match sessions. Preventative measurements should be implemented in rink hockey with a special concern for injuries affecting the thigh, and hip/groin.

Injury characteristics of young elite inline speed skaters: A one season retrospective study.

OBJECTIVES: Determining the rate of injuries related to a certain sport is accepted as the primary step toward designing, implementing and evaluating injury prevention programs. This observational and retrospective study was to examine the injuries sustained by elite young Spanish inline speed skaters during a season. METHODS: Athletes participating in the national championship (n = 80) were surveyed via an anonymous online questionnaire to screen for injury characteristics: incidence, location, and tissue affected; plus training information and demographics. RESULTS: A total of 52 injuries were recorded across 33,351 hours of exposure, which gives a rate of 1.65/1,000 h. The lower body comprised 79% of the total amount of injuries (1.3/1000 h), and the main areas affected were the thigh and foot, accounting for 25% and 19.2% of the recorded injuries, respectively. Musculotendinous injuries were the most frequent, with an incidence of 0.92/1000 h. No significant gender differences were observed for any of the variables studied. CONCLUSION: Speed skating can be considered a low injury rate sport based on our findings. The risk of sustaining an injury was independent of gender, age, and BMI.

Can the Copenhagen Adduction Exercise Prevent Groin Injuries in Soccer Players? A Critically Appraised Topic.

CLINICAL SCENARIO: Injuries that affect the groin region are among the most common in football players. To prevent this condition, studies have focused on strengthening the adductors, hip flexors, or abdominal muscles. Recent investigations have used an eccentric-biased exercise (Copenhagen Adduction Exercise [CAE]) that promotes functional and architectural adaptations in the muscle tissue, though its effect on injury risk reduction is unknown. CLINICAL QUESTION: Can the Copenhagen Adduction Exercise prevent groin injuries in soccer players? SUMMARY OF KEY FINDINGS: The literature was searched for studies investigating the potential groin injury risk reduction effect of the CAE. (1) Three studies met the inclusion criteria and were used for this appraisal; (2) one study observed a significantly lower injury rate ratio favoring the group that used the CAE program; and (3) 2 studies found similar or higher injury rates in the intervention groups, not supporting the inclusion of the CAE as a preventative tool. CLINICAL BOTTOM LINE: There is conflicting evidence that usage of the CAE is superior to not performing adductor strengthening exercises in mitigating the risk of sustaining groin injuries. Given the evidence supporting these findings, it is advisable to exercise caution when contemplating the incorporation of the CAE into training regimens aimed at preventing groin injuries. STRENGTH OF RECOMMENDATION: There is Grade B evidence to suggest that inclusion of the CAE may not be associated with reduced injury rates.

Isokinetic thigh muscles strength in semi-professional athletics: A one season prospective cohort study

Introduction: Continuous evaluations of athletes, including strength testing, can help control performance improvement or facilitate the restoration of normality after an injury. The aim of the present study was to prospectively determine the peak torque (PT), angle at which PT is achieved, and functional ratios of flexors and extensors thigh muscles during one season. Material and methods Thirty semi-professional male athletes competing in long jumping (n = 10), javelin throwing (n = 10), and sprinting (n = 10) participated. PT was evaluated in relation to limb length; the angle at which PT was achieved was obtained from the force-curve displayed in the isokinetic dynamometer; functional ratios were calculated by dividing concentric hamstring strength by eccentric quadriceps strength (flexor ratio) or vice-versa for the extensor ratio. Assessment was performed at 60º/s and 300º/s. Results Significant variations were seen for both extensor and flexor PTs at different stages of the season, with moderate to large effect sizes observed (effect size (d) = 0.49–0.93). Functional ratios and the angle at which peak torque was achieved remained stable throughout the season. Conclusions Thigh muscle strength is unstable throughout a track and field season, coaches or medical staff should consider these findings when programming training sessions or rehabilitating an athlete. (AU)

Funcionalidad y fuerza de aductores en jugadores de hockey sobrepatines de alto nivel / Adductor functionality and strength in high-level rink hockey players

Objetivo: Evaluar la fuerza de los músculos aductores y la funcionalidad en jugadores de hockey sobre patines de alto nively su relación con sufrir dolor inguinal (DI) en la temporada anterior. Material y método: Se realizó un estudio transversal donde se registraron los valores de fuerza mediante el Squeeze Test de5 segundos (5SST), y la funcionalidad de la cadera e ingle mediante el cuestionario Hip and Groin Outcome Score (HAGOS) enuna población de 11 jugadores de hockey sobre patines de alto nivel. Resultados: La prevalencia total de DI fue de 81,8% (en la anterior temporada el 54% sufrió DI), de los cuales un 18,2% llegóa detener la práctica deportiva. La fuerza media para el 5SST es de 254,68N (3,25Nm/kg) y la funcionalidad alcanzó los 90/100puntos en el cuestionario HAGOS para toda la muestra. La fuerza muscular fue similar entre jugadores que habían sufridoDI con pérdida de tiempo durante la última temporada y jugadores sanos en (p =0,261-0,948; g: 0,04-0,85). Se encontrarondiferencias significativas en las siguientes subescalas del cuestionario HAGOS: Dolor, actividades deportivas y recreacionales,y calidad de vida entre ambos grupos (p =0,005-0,042; g: 0,34-2,65; r: 0,3-0,61). Conclusión: Más de la mitad de los jugadores sufrieron DI, de los cuales un tercio llegó a detener su actividad. La funcionalidadmedida a través del HAGOS se erige como el principal indicador que mostró diferencias entre grupos. Los servicios médicosde jugadores jóvenes de hockey sobre patines deberían usar este cuestionario para poder detectar precozmente la aparicióny evitar la progresión de esta lesión.(AU)

Objective: To evaluate adductor strength and groin function in high level rink hockey players and its relationship with groinpain in the previous season. Material and method: A cross-sectional study was performed where hip/groin strength and function was assessed via 5seconds Squeeze Test and Hip and Groin Ouctome Score in 11 high level rink hockey players. Results: Overall prevalence for groin pain was 81.8% (54% of the participants suffered groin pain during the previous season),and 18.2% suffered time-loss groin pain. Mean strength in the 5SST was 254.68N (3.25Nm/Kg) and HAGOS questionnairereached 90/100 points in the whole sample. Similar adductor strength values were observed between healthy athletes andpreviously injured who suffered time-loss groin pain (P=0.261-0.948; g: 0.04-0.85). Statistically significant differences werefound for the following HAGOS subscales: Pain, function, sports and recreational activities, and quality of life between groups(P=0.005-0.042; g: 0.34-2.65; r: 0.3-0.61). Conclusion: More than a half of the participants suffered groin pain, of which one third suffered time-loss groin pain. Functionassessed via HAGOS seems to be the main proxy that discriminates between groups. Medical staff should implement thisquestionnaire to detect and avoid the progression of this injury.(AU)

Epidemiology of Rink Hockey-Related Injuries.

CONTEXT: Determining the rate of injuries related to a certain sport is accepted as the primary step toward designing, implementing, and evaluating injury prevention programs. The aim of this study was to examine the injuries sustained by semiprofessional Spanish rink hockey players and to compare data per playing position. DESIGN: Observational and retrospective. METHODS: Athletes from 21 teams were surveyed via a self-reported questionnaire to screen for incidence, injury burden, location, tissue, and onset of injuries. RESULTS: Overall, 101 time loss injuries were reported across 22,241 hours of exposure, giving rise to an incidence rate of 4.5/1000 hours. The main body regions injured were the hip/groin, shoulder, thigh, and head, accounting altogether for 47.5% of all injuries. Musculotendinous injuries were the most frequent, comprising 27.7% of all injuries. Incidence accounted for 3.1/1000 hours during training and 23/1000 hours during games (P < .001). A high number of injuries were caused by contact (46.5%). No differences were found for any of the variables analyzed between outfield players and goalkeepers. CONCLUSION: The injury incidence in rink hockey is moderate, occurring mainly due to a contact mechanism. Preventative measurements should be implemented in rink hockey with a special concern for injuries affecting the hip/groin and head.

Characterising groin pain in rink hockey: Function and five-second squeeze in Spanish players.

OBJECTIVES: To assess the relationship between history of past season groin pain and current pain during the five-second squeeze test (5SST) with groin function and adductor strength in rink hockey players. DESIGN: Cross-sectional. SETTING: First (Ok Liga), Second (Plata) and third division (Bronce) clubs. PARTICIPANTS: Sixty-eight female and 183 male hockey players. MAIN OUTCOME MEASURES: Seasonal prevalence of groin pain (time/non-time-loss). Adductor strength and pain during the 5SST. Function was evaluated with the Hip and Groin Outcome Score (HAGOS). RESULTS: Seasonal time-loss groin pain prevalence was 21%. Male players had 3.5 higher odds of having had an episode of time-loss groin pain during the previous season compared to female players. The adductor relative strength was no different between players with and without previous season groin injury (p = 0.53-0.55), while the HAGOS results differed between groups, with past season groin injury players obtaining lower values in all subscales. HAGOS scores differed between the 5SST pain intensity groups (p < 0.01). CONCLUSIONS: Male players had higher odds of having had a groin injury in the previous season compared to female players. Players with pain during 5SST and previous season groin injury reported functional deficits, while strength remains identical to their healthy counterparts.

Injury Characteristics among Young Adults during and Immediately after the COVID-19 Lockdown.

The lockdown due to the COVID-19 pandemic inherently changed people's lifestyles. Forty-eight days of isolation led to worsening physical fitness in addition to the development of other unhealthy habits. The aim of this study was to describe sport-related injuries in the active general population. Physical therapy centres and sports medicine clinics were contacted via e-mail, seeking patients who had sustained an injury during or immediately (up to two weeks) after the lockdown. Patients who agreed to participate completed an online survey that followed the International Olympic Committee Statement. The questionnaire focused on physical exercise habits, type of injury, location and tissue affected. A total of 51 females and 67 males (30.5, SD = 8.8 years) participated in the study. Eighty percent of the participants performed aerobic training sessions, while the rest dedicated their workouts to strength training. Two in every three injuries were located in the lower limbs, and 80% affected the musculoskeletal tissue. Of all the injuries recorded, 67% occurred during the first week after lockdown. The number of aerobic exercise sessions was positively correlated with lower limb injuries (χ2 = 17.12, p < 0.05). Exercise habits should be considered when planning to return to a sport after a period of confinement to avoid injury.

Concordance between Laboratory and Field Methods for the Assessment of Body Fat in Olympic Combat Athletes: Analysis of the Influence of Adiposity.

Combat sports athletes competing in the same discipline exhibit notable and substantial differences in body weight, body composition (BC) and adiposity. No studies have considered the influence of adiposity levels in the agreement between different BC assessment methods. The aim of this study was to analyze the influence of adiposity in the agreement between different methods used to estimate relative body fat (%BF) in Olympic combat sport athletes. A total of 38 male athletes were evaluated using air displacement plethysmography and dual-energy X-ray absorptiometry (DXA) as laboratory methods, and bioelectrical impedance analysis (BIA), near-infrared interactance (NIR) and anthropometry as field methods. All methods were compared to DXA. Agreement analyses were performed by means of individual intraclass correlation coefficients (ICCs) for each method compared to DXA, Bland−Altman plots and paired Student t-tests. The ICCs for the different methods compared to DXA were analyzed, considering tertiles of %BF, tertiles of body weight and type of sport. For the whole group, individual ICCs oscillated between 0.806 for BIA and 0.942 for anthropometry. BIA showed a statistically significant underestimation of %BF when compared to DXA. The agreement between every method and DXA was not affected by %BF, but it was highest in athletes at the highest %BF tertile (>13%). The ICC between NIR and DXA was poor in 72−82 kg athletes. Our results indicate that field methods are useful for routine %BF analysis, and that anthropometry is particularly appropriate, as it showed the highest accuracy irrespective of the athletes' adiposity.

Progressive resistance exercise as complementary therapy improves quality of life and body composition in anorexia nervosa: A randomized controlled trial.

BACKGROUND: and purpose: Exercise has not typically been used as an adjunct in treatment of anorexia nervosa (AN). This study aimed to examine the effects of progressive resistance exercise (PREx) on perceived quality of life (QoL) and body composition in adolescents with AN. MATERIALS AND METHODS: Forty-four adolescents diagnosed with AN were randomly allocated to either PREx or control groups after hospitalization. The PREx group completed twenty-four PREx sessions over two months including three sets of 8-10 repetitions of eight whole-body exercises at a moderate intensity. QoL and body composition were evaluated at baseline and after two months using Health Questionnaire Short-Form 36 (SF-36) and anthropometric measurements. RESULTS: At completion, forty-one participants (n = 19 PREx, and n = 22 controls) with mean age of 12.78 ± 0.88 years and mean body mass index of 18 ± 2.2 kg/m2 were analyzed. Significant group x time effects were found on SF-36 role physical (RP) scores. Significant improvements with large effect sizes (d > 0.72) were found in RP, and arm circumferences in the PREx group. Spearman association analyses between percent change in anthropometric variables and change in QoL scores showed positive associations with moderate-to-large effect sizes in the PREx group among the following variables: mid-thigh-circumference, physical functioning (PF) and general health (GH); calf-circumference relaxed and body pain; biceps skinfold and GH scores; triceps-skinfold, and role physical (RP) and vitality (VT); supraspinale-skinfold and RP and VT; mid-thigh-skinfold and calf-skinfold and VT. CONCLUSION: PREx after hospitalization enables modest positive changes in QoL associated to anthropometric changes in adolescents with AN without adverse effects on weight recovery.

Physical Fitness-Not Physical Activity Levels-Influence Quality of Life in Anorexia Nervosa.

Background: Incorporating physical activity (PA) has been a challenge for health care professionals working with anorexia nervosa (AN) patients. This has contributed to partial physical fitness (PFit) recovery that persists after weight restoration. Objective: This cross-sectional study aimed to examine the relationships between PA, sedentary behaviors, PFit, and quality of life (QoL) in a group of adolescents after hospitalization. Methods: QoL, PA, and sedentary behaviors were measured using the Health-Questionnaire Short-Form 36 (SF-36) and accelerometers, while PFit was assessed through cardiorespiratory fitness, body composition (anthropometry), and strength (six repetition maximum) tests in a total of 63 patients. Results: Light-PA (LPA), moderate-PA (MPA), moderate-to-vigorous-PA (MVPA), and relative sedentary time (%ST) did not meet the recommendations (p < 0.001). Only 22% of the patients met MVPA criteria, and ~82% exceeded %ST. SF-36 scores were lower than normative values except the physical component scale. Absolute cardiorespiratory fitness was reduced (p < 0.001) in 84% of the patients, and was positively associated to body weight, body mass index (BMI), circumferences, and muscle areas. Additional positive significant relationships were found between QoL, muscular strength, and body composition, and negative associations between vigorous-to-very vigorous PA and BMI, skinfolds, and percent body fat. Regression analyses revealed lower body strength as an explanatory factor for improved QoL (OR 1.03, 95%CI 1.00−1.07). Conclusions: PFit and QoL scores are poor after hospitalization. LPA, MPA, and MVPA do not meet recommendations. PFit management­with emphasis on improving muscular fitness­may be a valuable strategy for QoL improvement in AN after hospitalization.

Injury in CrossFit®: A Systematic Review of Epidemiology and Risk Factors.

OBJECTIVE: To review the characteristics of the injuries among CrossFit® practitioners, including prevalence and incidence, nature, location, and risk factors. METHODS: PubMed/MEDLINE, EMBASE, Web of Science, Scopus, and SPORTDiscus databases were searched from inception through August 2020, and English-language articles reporting on CrossFit®-related injuries were included. Data including sample (sex, age, and demographics) and injuries' characteristics (prevalence, incidence rate, nature, location, percentage of injuries requiring surgery and risk factors) were extracted. RESULTS: Overall, twenty-five studies involving a total of 12,079 CrossFit® practitioners met the inclusion criteria. The mean prevalence of injuries among the included studies was 35.3%, with an incidence rate varying between 0.2 and 18.9 per 1000 hours of training. The most injured areas were shoulder (26%), spine (24%), and knee (18%). Among the studies that reported the injuries requiring surgery, the mean percentage was 8.7%. Regarding the risk factors associated with injuries, older age, male sex, a greater body mass index, the existence of previous injuries, the lack of coach supervision, the experience on CrossFit® and the participation in competitions were reported by the studies. CONCLUSIONS: CrossFit® training has an injury incidence rate similar to weightlifting and powerlifting. Findings from the studies suggest that the most affected areas are shoulder, spine, and knee. The limited quality of the studies prevents us from drawing solid conclusions about injury risk factors.

Vigorous Aerobic Exercise in the Management of Parkinson Disease: A Systematic Review.

OBJECTIVE: To summarize the findings from studies examining the effects of vigorous-intensity aerobic exercise in the management of Parkinson disease. TYPE: Systematic review. LITERATURE SURVEY: PubMed/MEDLINE, EMBASE, Scopus, Web of Science, Cochrane Library, SPORTDiscus, and ScienceDirect databases were searched up to May 2020. Reference lists of the included articles were also searched for additional studies. Searches were restricted to English language. METHODOLOGY: Seven papers, including six studies, five randomized controlled trials and one controlled trial, were identified. The studies examined the effects of vigorous-intensity aerobic exercise in participants with Parkinson disease. Studies in which the minimal intensity required was ≥77% of maximum heart rate, 60% of heart rate reserve or 64% of maximal oxygen uptake met the inclusion criteria. Method appraisal showed a mean score of 5.3 in the Physiotherapy Evidence Database (PEDro) scale. SYNTHESIS: No statistically significant differences were found between vigorous-intensity aerobic exercise and moderate/low-intensity aerobic exercise for the main outcomes (disease severity and motor function). Only one study concluded a significant higher aerobic fitness in favor of the group that exercised at vigorous intensity compared to the moderate intensity group. CONCLUSIONS: Vigorous-intensity aerobic exercise has not shown statistically significant improvements in motor and nonmotor impairments in individuals with Parkinson disease as compared to moderate/low-intensity aerobic exercise. Hence, the current evidence is too limited to allow recommendations for clinical practice.

Role of nutrition in the development and prevention of age-related hearing loss: A scoping review.

Age-related hearing loss (ARHL) is a major and increasingly prevalent health problem worldwide, causing disability and social isolation in the people who present it. This impairment is caused by genetic and environmental factors. Nutritional status has been identified as a related risk associated with hearing loss (HL). This scoping review aimed to characterize the links between HL and nutritional status. PubMed, Embase, Cochrane and Scopus databases were searched up to December 2019. Studies examining the relation between nutrition and dietary habits and HL were included. After screening 3510 citations, 22 publications were selected for inclusion in the current review, all of which were published between 2010 and 2019. Diets rich in saturated fats and cholesterol have deleterious effects on hearing that could be prevented by lower consumption. Conversely, greater consumption of fruit and vegetables, and of polyunsaturated fatty acids (omega-3) and anti-oxidants in the form of vitamins A, C, and E, prevent the development of ARHL. The current literature suggests a possible association between nutritional status and hearing loss. More studies are needed to better characterize the clinical consequences of this association.