Effects of Acute Physical Fatigue on Gaze Behavior in Expert Badminton Players.

Perceptual cognitive skills in real game settings, under conditions of fatigue, such as the ability to gather relevant visual information, are key factors in achieving motor goals in sports. The objectives were to evaluate the effects of acute physical fatigue on gaze behavior during a badminton game (Study 1) and in an unfavorable force ratio situation (Study 2). Six international-level badminton players played two sets and unfavorable force ratio situations while wearing eye-tracking glasses before and after a fatiguing task. During the set, fatiguing physical exercise led to fewer fixations per exchange and more fixations on one area of interest. During unfavorable force ratio situations, fatiguing physical exercise led to shorter fixation durations per exchange, shorter fixation durations on two areas of interest, and longer fixation durations on one area of interest. The results showed that gaze behaviors were adapted in acute physical fatigue conditions to maintain performance.

Reliability of Accuracy and Precision Tests for Elite Para Table Tennis Players.

The primary purpose of this study was to adapt selected accuracy and precision tests in table tennis to the specific skills of elite table tennis players with impairment. The study included a sample of 23 Para table tennis players with an average age of 31.8 ± 12.22 years (including 30.4% females) who belonged to the senior Polish Para table tennis team. A battery of six tests evaluating stroke accuracy and serve precision was assessed. The analysis of the reliability of these tests confirmed the legitimacy of using this battery of accuracy and precision tests to assess the skills of Para table tennis players in all three integrated sport classes: players in wheelchairs, in a standing position, and with intellectual impairment. Analysis of the data obtained from the tests could provide coaches with relevant information regarding elite Para table tennis players' level of performance and examine selected accuracy and precision elements of their individual technique.

From The Ground Up: Expert Perceptions of Lower Limb Activity Monitoring in Tennis.

Understanding on-court movement in tennis allows for enhanced preparation strategies to improve player readiness and performance. Here, we explore expert physical preparation coaches' perceptions of elite training strategies for preparation and performance in tennis, with special reference to lower limb activity. Thirteen world renowned tennis strength and conditioning coaches were interviewed in a semi-structured method that explored four key topic areas of physical preparation for tennis: i) the physical demands; ii) load monitoring practice; iii) the direction of ground reaction forces application during match-play; and iv) the application of strength and conditioning for tennis. Three higher-order themes emerged from these discussions: i) off-court training for tennis should be specific to the demands of the sport, ii) the mechanical understanding of tennis lags our physiological approach, and iii) our understanding of the lower limb's contribution to tennis performance is limited. These findings provide valuable insights into the importance of improving our knowledge relevant to the mechanical demands of tennis movement, whilst highlighting important practical considerations from leading tennis conditioning experts.

A Query Language for Exploratory Analysis of Video-Based Tracking Data in Padel Matches.

Recent advances in sensor technologies, in particular video-based human detection, object tracking and pose estimation, have opened new possibilities for the automatic or semi-automatic per-frame annotation of sport videos. In the case of racket sports such as tennis and padel, state-of-the-art deep learning methods allow the robust detection and tracking of the players from a single video, which can be combined with ball tracking and shot recognition techniques to obtain a precise description of the play state at every frame. These data, which might include the court-space position of the players, their speeds, accelerations, shots and ball trajectories, can be exported in tabular format for further analysis. Unfortunately, the limitations of traditional table-based methods for analyzing such sport data are twofold. On the one hand, these methods cannot represent complex spatio-temporal queries in a compact, readable way, usable by sport analysts. On the other hand, traditional data visualization tools often fail to convey all the information available in the video (such as the precise body motion before, during and after the execution of a shot) and resulting plots only show a small portion of the available data. In this paper we address these two limitations by focusing on the analysis of video-based tracking data of padel matches. In particular, we propose a domain-specific query language to facilitate coaches and sport analysts to write queries in a very compact form. Additionally, we enrich the data visualization plots by linking each data item to a specific segment of the video so that analysts have full access to all the details related to the query. We demonstrate the flexibility of our system by collecting and converting into readable queries multiple tips and hypotheses on padel strategies extracted from the literature.

Effects of isoinertial or machine-based strength training on performance in tennis players.

The objective of this study was to analyze the effects of two 8-week neuromuscular training (NMT) interventions on selected physical indicators in young tennis players. Twenty-four junior male tennis players were assigned to a machine-based (MG) (n = 8), flywheel (FG) (n = 8) or a control training group (CG) (n = 8). Tests at baseline, week 4 and 8 included: countermovement jump (CMJ); speed (S; 5, 10, 15 m); agility (right [AR] and left [AL]); serve velocity (SV) and medicine ball throws (MBT; overhead [O], forehand [FH], backhand [BH]). MG and FG attained large positive effects at week 4 in CMJ, S 10 m; AR, AL and MBT FH only in FG. Regarding inter- to post-test, MG achieved large positive effects in MBT O, FH and both groups in BH. Large negative effects appeared for FG in S 5 and 10 m and AR and AL. Both NMT interventions led to positive effects from baseline to week 4 measures in CMJ, S 5 m, 10 m and agility and at week 8 in MBT. Conducting the same NMT for a longer period of time did not lead to the same improvements and other negative effects in FG appeared. Results indicate that performing these interventions with little exercise variability or load management, especially after technical-tactical sessions, could interpose further beneficial outcomes and initial gains could be impaired.

Recreational beach tennis reduces 24-h blood pressure in adults with hypertension: a randomized crossover trial.

PURPOSE: To evaluate the effect of a beach tennis session on 24-h ambulatory blood pressure in adults with hypertension. METHODS: In this randomized crossover trial, 24 participants (12 men and 12 women) randomly performed two experimental sessions: a beach tennis session and a non-exercise control session. The beach tennis session started with a standardized 5-min warm-up consisting of basic techniques, followed by three 12-min beach tennis matches with 2-min intervals between them. Heart rate was continuously recorded and rating of perceived exertion was assessed in the middle and at the end of each set during the beach tennis session. Enjoyment was also assessed after the beach tennis session. The control session was performed in seated rest. Both experimental sessions lasted 45 min. Ambulatory blood pressure was measured continuously for 24 h after sessions. RESULTS: Systolic blood pressure (24-h: 6 mmHg, P = 0.008; daytime: 6 mmHg, P = 0.031; nighttime: 6 mmHg, P = 0.042) and diastolic blood pressure (24-h: 3 mmHg, P = 0.021; daytime: 3 mmHg, P = 0.036; nighttime: 4 mmHg, P = 0.076) decreased after beach tennis when compared with control. The participants presented a reserve heart rate of 59-68%, and a rating of perceived exertion score of 3.4-4.7 using Borg's CR10 Scale. The enjoyment scores after beach tennis session were higher than 90%. CONCLUSION: A single session of recreational beach tennis reduces 24-h ambulatory blood pressure in adults with hypertension. Additionally, the participants can achieve a high physiological stress but perceive less effort during the practice. TRIAL REGISTRATION: Date: April 10, 2019; identifier number NCT03909308 (Clinicaltrials.gov).

Evaluation of Open-Source and Pre-Trained Deep Convolutional Neural Networks Suitable for Player Detection and Motion Analysis in Squash.

In sport science, athlete tracking and motion analysis are essential for monitoring and optimizing training programs, with the goal of increasing success in competition and preventing injury. At present, contact-free, camera-based, multi-athlete detection and tracking have become a reality, mainly due to the advances in machine learning regarding computer vision and, specifically, advances in artificial convolutional neural networks (CNN), used for human pose estimation (HPE-CNN) in image sequences. Sport science in general, as well as coaches and athletes in particular, would greatly benefit from HPE-CNN-based tracking, but the sheer amount of HPE-CNNs available, as well as their complexity, pose a hurdle to the adoption of this new technology. It is unclear how many HPE-CNNs which are available at present are ready to use in out-of-the-box inference to squash, to what extent they allow motion analysis and if detections can easily be used to provide insight to coaches and athletes. Therefore, we conducted a systematic investigation of more than 250 HPE-CNNs. After applying our selection criteria of open-source, pre-trained, state-of-the-art and ready-to-use, five variants of three HPE-CNNs remained, and were evaluated in the context of motion analysis for the racket sport of squash. Specifically, we are interested in detecting player's feet in videos from a single camera and investigated the detection accuracy of all HPE-CNNs. To that end, we created a ground-truth dataset from publicly available squash videos by developing our own annotation tool and manually labeling frames and events. We present heatmaps, which depict the court floor using a color scale and highlight areas according to the relative time for which a player occupied that location during matchplay. These are used to provide insight into detections. Finally, we created a decision flow chart to help sport scientists, coaches and athletes to decide which HPE-CNN is best for player detection and tracking in a given application scenario.

Estimating Player Positions from Padel High-Angle Videos: Accuracy Comparison of Recent Computer Vision Methods.

The estimation of player positions is key for performance analysis in sport. In this paper, we focus on image-based, single-angle, player position estimation in padel. Unlike tennis, the primary camera view in professional padel videos follows a de facto standard, consisting of a high-angle shot at about 7.6 m above the court floor. This camera angle reduces the occlusion impact of the mesh that stands over the glass walls, and offers a convenient view for judging the depth of the ball and the player positions and poses. We evaluate and compare the accuracy of state-of-the-art computer vision methods on a large set of images from both amateur videos and publicly available videos from the major international padel circuit. The methods we analyze include object detection, image segmentation and pose estimation techniques, all of them based on deep convolutional neural networks. We report accuracy and average precision with respect to manually-annotated video frames. The best results are obtained by top-down pose estimation methods, which offer a detection rate of 99.8% and a RMSE below 5 and 12 cm for horizontal/vertical court-space coordinates (deviations from predicted and ground-truth player positions). These results demonstrate the suitability of pose estimation methods based on deep convolutional neural networks for estimating player positions from single-angle padel videos. Immediate applications of this work include the player and team analysis of the large collection of publicly available videos from international circuits, as well as an inexpensive method to get player positional data in amateur padel clubs.

Entropy of Badminton Strike Positions.

The aim of the current study was twofold: (i) to investigate the distribution of the strike positions of badminton players while quantifying the corresponding standard entropy and using an alternative metric (spatial entropy) related to winning and losing points and random positions; and (ii) to evaluate the standard entropy of the receiving positions. With the datasets of 259 badminton matches, we focused on the positions of players' strokes and the outcome of each point. First, we identified those regions of the court from which hits were most likely to be struck. Second, we computed the standard entropy of stroke positions, and then the spatial entropy, which also considers the order and clustering of the hitting locations in a two-dimensional Euclidean space. Both entropy quantifiers revealed high uncertainty in the striking position; however, specific court locations (i.e., the four corners) are preferred over the rest. When the outcome of each point was taken into account, we observed that the hitting patterns with lower entropy were associated with higher probabilities of winning points. On the contrary, players striking from more random positions were more prone to losing the points.

Acute effects of dynamic versus foam rolling warm-up strategies on physical performance in elite tennis players.

To date, there is a lack of information about the optimal conditions of the warm-up to lead to a better performance in elite tennis players. The aim of this study was to compare the effects of two different warm-up protocols (dynamic vs. self-myofascial release with foam rolling) on neuromuscular variables associated with physical determinants of tennis performance. Using a crossover randomised experimental design, eleven professional men tennis players (20.6 ± 3.5 years) performed either a dynamic warm-up (DWU) or a self-myofascial release with foam rolling (SMFR) protocol. DWU consisted of 8 min of dynamic exercises at increasing intensity and SMFR consisted of 8 min of rolling on each lower extremity unilaterally. Just before (baseline) and after completing warm-up protocols, players performed a countermovement jump (CMJ), the 5-0-5 agility test, a 10-m sprint test and the Straight Leg Raise and Thomas tests to assess range of motion. Compared to baseline, the DWU was more effective to reduce the time in the 5-0-5 test than SMFR (-2.23 vs. 0.44%, respectively, p = 0.042, ηp2 = 0.19). However, both warm-up protocols similarly affected CMJ (2.32 vs. 0.61%, p = 0.373, ηp2 = 0.04) and 10-m sprint time changes (-1.26 vs. 1.03%, p = 0.124, ηp2 = 0.11). Changes in range of motion tests were also similar with both protocols (p = 0.448-1.000, ηp2 = 0.00-0.02). Overall, both DWU and SMFR were effective to prepare well-trained tennis players for highly demanding neuromuscular actions. However, DWU offered a better preparation for performing change of direction and sprint actions, and hence, in high-performance tennis players, the warm-up should include dynamic exercises.

Heart rate and pulmonary oxygen uptake response in professional badminton players: comparison between on-court game simulation and laboratory exercise testing.

PURPOSE: Badminton is characterized by bouts of high intensity interspersed by short recovery periods. Aerobic assessment via indirect calorimetry is impractical on court because of the encumbrance of portable metabolic devices. When the relationship between heart rate (HR) and pulmonary oxygen uptake [Formula: see text] [Formula: see text] is linear, HR monitoring can provide an indirect estimation of metabolic demands on court. However, owing to the intermittent nature of badminton, the [Formula: see text] relationship will differ from that obtained in the laboratory, making its use on court questionable. The aims of this study were to (i) assess cardiorespiratory and metabolic responses during on-court badminton rally simulations at different intensities and (ii) compare [Formula: see text] relationships obtained from laboratory and on-court measurements. METHODS: The study sample was seven professional badminton players (age 16.9 ± 2.1 years; body mass 62.8 ± 9.2 kg; stature 1.71 ± 0.09 m). [Formula: see text] HR, and other respiratory and metabolic parameters were assessed in the laboratory with an incremental intermittent Astrand-type test (IIAT) and on court during rally simulations at three different intensities. RESULTS: Cardiorespiratory parameters measured during the rallies reached 95% of maximal IIAT values. The [Formula: see text] slope and intercept differed in the on-court and the IIAT conditions (P = 0.012 and P = 0.008, respectively). CONCLUSIONS: The difference in [Formula: see text] regression lines between the IIAT and the on-court condition indicates that HR monitoring may not provide accurate data on the aerobic demands of specific on-court badminton tasks. HR monitoring should be preceded by an indirect calorimetry test on court to assess aerobic demands more precisely.

A kinematic comparison between long-line and cross-court top spin forehand in competitive table tennis players.

The aim of the present study was to compare the biomechanical characteristics of the table tennis top spin shot when played cross-court (CC) or long-line (LL) in competitive table tennis players. Seven national level players respectively completed 10 long-line and 10 cross-court top spin shots responding to a standard ball machine. A stereophotogrammetric system was used to track body segments while executing the motion. Significantly more flexed right knee and elbow angles were measured at the moment of maximum velocity of the racket (MMV) in LL. In addition, significantly greater angles between the feet and the table and between the shoulders and the table at the MMV, indicated more pronounced rotation angles of the lower upper and upper-body in LL compared to CC with respect to the table. A higher inclination of the racket at the MMV was found in LL. The elbow flexion and the racket inclination may be associated to the direction of the shot. The present findings show that kinematic differences exist between the LL and the CC topspin forehand in competitive table tennis players. Coaches should be aware of these differences to adopt the optimal teaching strategies and to reproduce proper joint angles during training.

Glenohumeral internal rotation deficit in table tennis players.

Table tennis requires rapid and extreme movements that may result in shoulder adaptations, such as glenohumeral internal rotation deficit, which is a risk factor for several injuries. This study compared range of motion of internal and external rotation and total rotation motion of glenohumeral joint between dominant and non-dominant shoulders of table tennis players. This is a cross-sectional observational study. Twenty healthy male table tennis players that were enrolled in an official table tennis league took part in this study (mean age: 22.9 ± 12.9 years, time of sports practice: 6.2 ± 7.12 years). Measurements of passive glenohumeral external rotation and internal rotation were taken with the individuals in the supine and sidelying positions. Total rotation motion was calculated by summing external and internal rotations. The dominant side showed decreased internal rotation when compared to non-dominant side in both supine (mean difference: 14.9°, p = 0.02) and sidelying positions (mean difference: 16.3°, p = 0.01). No significant difference (p > 0.05) was found for external rotation and total rotation motion between dominant and non-dominant shoulders. The findings indicate that table tennis players exhibit glenohumeral internal rotation deficit of dominant shoulder.

Mental fatigue alters the speed and the accuracy of the ball in table tennis.

This study aimed at evaluating the effects of mental and muscle fatigue on table tennis performance. Mental fatigue (MF) was induced by completion of 90 minutes of the AX-CPT; muscle fatigue was induced by completion of an eccentric exercise performed with the elbow flexors (biceps fatigue, BF) or the knee extensors (quadriceps fatigue, QF). The control condition consisted of watching a movie. Stroke parameters (speed and accuracy of the ball), as well as feelings of fatigue and force production capacity of the elbow flexors (BF, MF and control conditions) and knee extensors (QF condition), were assessed pre and post fatigue protocols. Feelings of fatigue increased post fatigue protocols. Force production capacity decreased only in the BF and QF conditions. BF and MF induced a decrease in accuracy. This decrease in accuracy was associated with an increased ball speed in the BF condition, and a decreased ball speed in the MF condition. QF had a negligible effect on stroke performance. Our results suggest that both mental fatigue, and muscle fatigue, significantly impair table tennis performance and therefore coaches should take into account both the physical and mental state of table tennis players to optimize performance.

Table tennis match analysis: a review.

In table tennis, many different approaches to scientific founded match analysis have been developed since the first ones in the 1960s. The aim of this paper is to give a review on some of the most acknowledged methods of match analysis in table tennis. The first chapter presents a historical overview of match analysis from all over the world. The second part reviews different approaches to match analysis in more detail, using the performance analysis classification of theoretical and practical performance analysis. The review includes the most actual theoretical performance analysis techniques in table tennis: performance indices, simulative approaches, momentum analysis, footwork analysis, and finally an approach which uses top expert knowledge for a comprehensive technical-tactical analysis. In the section of practical performance analysis, the paper presents two "best practice" examples describing performance analysis procedures of the two most successful countries of the last Olympics: China and Japan. The paper ends with a summary on the impact of the different approaches and gives an outlook on promising new developments.

The Relative Age Effect and Physical Fitness Characteristics in German Male Tennis Players.

The aims of the study were to test: 1) whether the relative age effect (RAE) was prevalent in young (U12-U18) German male tennis players; 2) the potential influence of age and/or skill level on RAE and 3) whether maturity, anthropometric and fitness measures vary according to birth date distribution in elite youth tennis players. For the present study the following male populations were analysed: Overall German population (n = 3.216.811), all players affiliated to the German Tennis Federation (DTB) (n = 120.851), players with DTB official ranking (n = 7165), regional (n = 381) and national (n = 57) squads (11-17 years old), as well as the top 50 German senior players were analyzed. RAEs were more prevalent at higher competitive levels with more players born in the first quarter of the year compared with the reference population for ranked (29.6%), regional (38.1%) and national (42.1%) players. No systematic differences were found in any of the maturity, anthropometric and fitness characteristics of the regional squad players born across different quarters. RAEs are present in the DTB competitive system and it was more pronounced at higher competitive levels. Compared with early born, late born players who were selected into elite squads did not differ in maturation, anthropometric and fitness characteristics. Key pointsRAEsexist in the selection of youth tennis players in Germany, a greater percentage of players analyzed was born in the 1st quarter compared to all licensed tennis players in the country, and more pronounced with an increased competition level in youth players.Players born later in the selection year and still selected in elite squads were likely to be similar across a range of physical fitness attributes compared with those born earlier in the year.The selection process should be reevaluated and changed to reduce the impact of RAEs on tennis players.

The Effects of Neuromuscular Training on Sand Versus Hard Surfaces on Physical Fitness in Young Male Tennis Players.

PURPOSE: To examine the effects of a neuromuscular training program combining plyometric exercises with acceleration, deceleration, and change-of-direction drills conducted on sand or hard surfaces on the fitness qualities of young male tennis players. METHODS: Thirty-one young male players were allocated to a training group performing 12 training sessions on sand or hard surfaces, during a 6-week period. Tests included linear sprint (10-m acceleration with 5-m split times), change of direction (modified 5-0-5 test), vertical jumps (countermovement jump and the 10/5 repeated-jump test), isometric hip abduction and adduction strength, and dynamic balance (Y-balance test). Perceived training loads and muscle soreness were assessed during the intervention. RESULTS: Both training strategies were similarly effective in improving the analyzed fitness components. Group × time interaction effects were noticed, with countermovement jump (P = .032), repeated-jump test (P = .029), and reactive strength index (P = .008) favoring hard surfaces and 5-m sprint (P = .009), dynamic balance (P < .05), adduction strength (P < .05), and abduction strength (P < .001) indices favoring sand. Furthermore, the sand group promoted greater perceived training loads and muscle soreness (P < .05) than the hard group across the intervention period. CONCLUSION: Neuromuscular training strategies characterized by a relatively low volume (∼35 min), conducted on sand or hard surfaces, promoted similar improvements in the fitness qualities of young tennis players, with selected surface-interaction effects. Training on sand can cause transiently higher training loads and persistently higher muscle soreness, suggesting the need for an adequate familiarization period.

Sequential Mapping of Game Patterns in Men and Women Professional Padel Players.

PURPOSE: This study analyzed the sequences of actions in professional men and women padel players to identify common game patterns. METHODS: The sample comprised 17,557 stroke-by-stroke actions (N = 1640 rallies) of the championship World Padel Tour. Multistep Markov chains were used to calculate the conditional probabilities of occurrence of actions during the rally. RESULTS: Results revealed that men's and women's padel is mainly defined by 36 patterns constituting 55% and 63% of all actions in the game, respectively, with the 10 most common sequences accounting for 42% to 45% of the game. There were recurrent technical-tactical actions with specific offensive and defensive functions that were constantly reiterated during the rallies. In men, the use of smash, volley, bandeja, direct, back wall, back-wall lobs, and direct lobs followed a foreseeable pattern up to 8 lags, whereas women described predictable interactions for volley, bandeja, direct, lobs, and direct lobs up to 5 lags and for smash and back wall up to 4 lags. CONCLUSIONS: The ability of padel players to recall these patterns and enhance their anticipation skills may potentially improve their performance. These findings contribute to a better knowledge of professional padel game dynamics while providing coaches and players with useful information to optimize training and decision-making strategies.

Does mental fatigue affect performance in racket sports? A systematic review.

Mental fatigue impairs performance across several sports domains. However, a systematic review on its effects on racket sports performance has been lacking due to the previous scarcity of studies. This review aims to provide a comprehensive review the effects of mental fatigue on racket players' performance, with a discussion of the underlying mechanisms. A thorough search was conducted across five databases, including Web of Science, PubMed, SCOPUS, SPORTDiscus (via EBSCOhost), and the Psychological and Behavioral Science Collection (via EBSCOhost). The PICOS framework established the inclusion criteria: (1) healthy racket sports players; (2) induction of mental fatigue in both field and laboratory settings; (3) comparison of mental fatigue interventions with a control group (e.g., watching a movie or reading a magazine); (4) assessment of performance outcomes, including physical performance, skilled performance, and perceptual-cognitive performance; and (5) randomized controlled trials (RCTs), non-randomized controlled trials (non-RCTs), and non-randomized non-controlled trials. Mental fatigue manipulation, subjective evaluation, and (neuro)physiological markers were synthesized to support the successful induction of mental fatigue. Performance was categorized into tennis, table tennis, badminton, and padel based on the characteristics of specific racket sports domains. Secondary outcomes, such as the rate perception of effort (RPE) and motivation, were synthesized to explain the mechanisms based on the prominent theory of the Psychobiological model of endurance performance. Six studies revealed that mental fatigue impacts stroke performance in table tennis, affecting speed, accuracy, faults, and only second-serve accuracy in tennis. The response time of psychomotor performance increased in table tennis, padel, and badminton. Meanwhile, mental fatigue increased the RPE and remained unchanged in heart rate, blood glucose, and lactate, consistent with the Psychobiological model of endurance performance. Additionally, attention is suggested as a significant underlying psychobiological factor.

A Systematic Review on the Effectiveness of Eyewear in Reducing the Incidence and Severity of Eye Injuries in Racket Sports.

PURPOSE: To assess what eyewear (if any) reduces eye injury incidence and severity in squash, racketball, tennis and badminton. DESIGN: Systematic review following the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) and the 'implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science' (PERSiST) guidelines. METHODS: PubMed, SportDiscus and Web of Science were searched on 22nd February 2023. All study types except reviews were eligible. Studies had to report the type of eyewear worn (if any) with a form of eye injury incidence and severity. RESULTS: 364 papers were initially retrieved and after the screening process 29 remained. A subgroup analysis was carried out on studies that had a sample size of five or above, were not only looking at a particular type of eye injury and that had sufficient data to allow the percentage of eye injuries that occurred when no eyewear was worn to be calculated. From this analysis, the median percentage of eye injuries that occurred when no eyewear was worn was found to be 93%. Some of these injuries were serious and required complex treatment. Prescription lenses, contact lenses and industrial eyewear made some injuries more severe. In squash and racketball, lensless eye guards were ineffective as the ball could deform on impact, still making contact with the eye. Only eyewear compliant with updated ASTM (or similar) standards was associated with no eye injuries and so provided adequate protection in all four sports. CONCLUSIONS: Although this systematic review only summarizes evidence on injuries requiring hospital treatment, it is recommended that national governing bodies and key decision makers within squash, racketball, tennis and badminton examine the evidence presented and consider extending existing rules or implementing new recommendations and policies on protective eyewear use to reduce eye injury incidence and severity in their sport.