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Investigating the Effect of Return-to-Play Timing After Injury on Performance: Does the Analysis Answer the Research Objective?
Shrier, Ian; Stokes, Tyrel; Wang, Chinchin; Trejovargas, Jorge; Impellizzeri, Franco M; Steele, Russell J.
Affiliation
  • Shrier I; Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, McGill University, 3755 Cote Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada. ian.shrier@mcgill.ca.
  • Stokes T; Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada.
  • Wang C; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
  • Trejovargas J; Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada.
  • Impellizzeri FM; Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
  • Steele RJ; Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada.
Sports Med ; 53(5): 949-958, 2023 05.
Article in En | MEDLINE | ID: mdl-36378413
ABSTRACT
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.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Athletic Injuries / Sports / Sports Medicine Limits: Humans Language: En Journal: Sports Med Journal subject: MEDICINA ESPORTIVA Year: 2023 Document type: Article Affiliation country:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Athletic Injuries / Sports / Sports Medicine Limits: Humans Language: En Journal: Sports Med Journal subject: MEDICINA ESPORTIVA Year: 2023 Document type: Article Affiliation country: