scholarly journals Timing return-to-competition: a prospective registration of 45 different types of severe injuries in Germany’s highest football league

Author(s):  
Werner Krutsch ◽  
Clemens Memmel ◽  
Volker Alt ◽  
Volker Krutsch ◽  
Tobias Tröß ◽  
...  

Abstract Introduction Many professional football players sustain at least one severe injury over the course of their career. Because detailed epidemiological data on different severe injuries in professional football have been missing so far, this study describes the frequency and return-to-competition (RTC) periods of different types of severe football injuries. Material and methods This epidemiological investigation is a prospective standardised injury analysis based on national media longitudinal registration. Injuries were classified according to the consensus statement by Fuller et al. (2006). The analysis includes injuries sustained by players of the first German football league during the seasons 2014–2015 to 2017–2018. Level of evidence: II. Results Overall, 660 severe injuries were registered during the four seasons (mean 165 per season; 9.2 per season per team; incidence in 1000 h: 0.77). The body region most frequently affected by severe injury was the knee (30.0%; 49.5 injuries per season/SD 13.2) followed by the thigh (26.4%; 43.5 injuries/SD 4.2) and the ankle (16.7%; 27.5 injuries/SD 5.0). The distribution of injuries over the course of a season showed a trend for ACL ruptures to mainly occur at the beginning of a season (45.8%), overuse syndromes such as achillodynia (40.9%) and irritation of the knee (44.4%) during the winter months and severe muscle and ankle injuries at the end of a season. ACL ruptures showed the longest RTC durations (median 222 days). Conclusion This study presents detailed epidemiological data on severe injuries in professional football. The body region most frequently affected by severe injuries was the knee. Several types of severe injuries showed a seasonal injury pattern. The appropriate timing of RTC after an injury is one of the most important and complex decisions to be made. This study provides information on the typical time loss due to specific severe football injuries, which may serve as a guideline.

2019 ◽  
Vol 25 (3) ◽  
pp. 245-251
Author(s):  
Luciana Duarte Pimenta ◽  
Danilo Alexandre Massini ◽  
Daniel dos Santos ◽  
Camila Midori Takemoto Vasconcelos ◽  
Astor Reis Simionato ◽  
...  

ABSTRACT Although muscle strength, lean mass and bone mineral content/density (BMC/BMD) are consistently reported as major outcomes of resistance training (RT), there is still no agreement on the RT regimen that is capable of achieving this result in men and women of different ages. This study describes the effects of RT on muscle strength, lean mass and bone mineralization, highlighting the relationships between them and analyzing the effectiveness of the RT protocol. Information searches were conducted in open access online academic libraries, using the BMC/BMD indices combined with muscle strength, body composition, and resistance exercises. The results showed changes in BMC/BMD in 72% of the studies published in the last decade. Among these, 77% recommended loads ≥ 80% 1-RM, 61% involved older individuals (> 60 years) and 61% had planning protocols of between 3 and 5 months (~12-20 weeks). The results also highlight muscle strength as a promising index of variations in BMC/BMD, with a moderate to high level of association (r2>0.5), which are specific for men and women in relation to the body region with best responsiveness. Among the studies published in last decade, about 61% had protocols involving only RT, and of these, 82% observed combined changes in BMC/BMD, body composition and muscle strength. This review therefore concludes that RT is important for improving muscle strength, increasing lean mass (whole-body and regional) and preventing risk factors that could impair the mineral integrity of the bone tissue, in individuals of all ages and sexes. Level of Evidence I; Systematic review of Level I RCTs (and study results were homogenous).


2021 ◽  
Vol 27 (2) ◽  
pp. 218-224
Author(s):  
Alex Castro ◽  
Márcio Fagundes Goethel ◽  
Edgar Ramos Vieira ◽  
Pedro Vieira Sarmet Moreira ◽  
Antônio Francisco de Almeida Neto ◽  
...  

ABSTRACT Introduction: The use of ankle braces reduces the risk of ankle injuries in basketball players. However, the mechanisms of injury protection provided by the ankle braces in the basketball game are still unknown. Objectives: To analyze the effects of wearing a lace-up ankle brace, and to conduct an exercise protocol that simulated the intensity of the basketball game on ground reaction force (GRF) during basketball-specific vertical jumps. Methods: Eleven male younger basketball players aged under 18 completed 48 vertical jumps, with and without ankle braces, during an exercise protocol composed of four 10-minute periods, simulating the activity profile and intensity of the basketball game as well as the typical intervals between periods. Mediolateral (variables: the greatest medial and lateral peaks) and vertical (variables: vertical peak, impulse peak, impulse at 50 ms of landing, loading rate and jump height) GRF were measured during takeoff and landing for all the jumps performed in the exercise protocol. Results: The use of the ankle brace reduced mediolateral GRF in all periods of the exercise protocol during takeoff and landing ( P < 0.05), without affecting the vertical GRF ( P > 0.05). Mediolateral and vertical GRF (takeoff mediolateral vertical peaks, landing mediolateral peaks, landing impulse peak, takeoff and landing loading rate) increased significantly during four subsequent 10-minute periods ( P < 0.05). However, for mediolateral GRF, the increase overtime was higher without braces. Conclusions: The use of the ankle brace reduced the mediolateral GRF on the lower limb, while there was a progressive increase in the external load applied to the body during the vertical jumps in the subsequent periods of the exercise protocol performed at the same intensity of the basketball game. Level of evidence I; Randomized clinical trial .


Author(s):  
A.M. Satarkulova

The assessment and dynamic control over students’ status is a very important task. It allows timely detection of prenosological status prior to pathology and health maintenance in students. The objective of the paper is to assess the adaptive abilities of the body, to analyze changes in heart rate variability indicators in students with various types of autonomic regulation, to identify prenosological status and precursory pathological symptoms. Materials and Methods. The study enrolled 302 students from India, aged 21.54±1.43. Programming complex «Psychophysiologist» was used to register the main HRV parameters within 5 minutes. Health status was evaluated according to the index of functional changes and the scale of functional states. Results. N.I. Shlyk (2009) distinguished two groups of students with different types of autonomic regulation: type 1 (53 %) with moderate and type 2 (5 %) with marked characteristics of central regulation profile, type 3 (35 %) with moderate and type 4 (7 %) with marked characteristics of autonomous regulation profile. Main parameters of HRV and adaptation potential were defined for each student.All the parameters characterized functional and health status. Conclusions. It was shown that 82 % of trial subjects (type 1), 53 % (type 2), 94 % (type 3) and 95 % (type 4) demonstrated satisfactory adaptation and their physiological processes were at an optimal level. 18 % of students (type 1) demonstrated reduced adaptive abilities of the body. Moreover, they were under moderate stress. 47 % of subjects (type 2) were also under a significant stress, which was proven by excessively high SI, low SDNN and TP, and an increased index of functional changes. 5 % of students (type 4) revealed dysfunctional characteristics in the heart rhythm, peculiar to pathology. Keywords: foreign students, heart rate variability, types of autonomic regulation, adaptation potential, functional status. Оценка состояния студентов и динамический контроль за ним является важной задачей, поскольку позволяет своевременно выявлять у студентов донозологические состояния, предшествующие патологии, и способствовать сохранению здоровья. Цель. Оценка адаптивных возможностей организма, анализ изменений показателей вариабельности сердечного ритма у студентов с различными типами вегетативной регуляции, выявление донозологических состояний и ранних признаков патологии. Материалы и методы. В исследовании участвовало 302 студента в возрасте 21,54+1,43 года из Индии. Регистрировались основные параметры ВСР в течение 5 мин с использованием программно-аппаратного комплекса «Психофизиолог». Состояние и уровень здоровья оценивались по индексу функциональных изменений и шкале функциональных состояний. Результаты. По способу, предложенному Н.И. Шлык, выделены группы студентов с различными типами вегетативной регуляции: I (53 %) и II типы (5 %) – с умеренным и выраженным преобладанием центрального контура регуляции соответственно, III (35 %) и IV типы (7 %) – с умеренным и выраженным преобладанием автономного контура регуляции соответственно. У каждого из студентов определены основные параметры ВСР и адаптационного потенциала, характеризующие функциональное состояние и уровень здоровья. Выводы. Показано, что для 82 % обследуемых с I типом, 53 % со II типом, 94 % c III типом и 95 % с IV типом регуляции характерно состояние удовлетворительной адаптации, физиологические процессы сохраняются на оптимальном уровне. В группе студентов I типа у 18 % студентов адаптивные возможности организма снижены, выявлено состояние умеренного напряжения. У 47 % обследуемых II типа также зафиксировано состояние резко выраженного напряжения, индикатором которого является чрезмерно высокое значение SI, низкие величины SDNN и ТP, повышенное значение индекса функциональных изменений. В группе студентов с IV типом у 5 % учащихсяв регуляции ритма сердца выявлены дисфункциональные признаки, характерные для патологии. Ключевые слова: иностранные студенты, вариабельность сердечного ритма, типы вегетативной регуляции, адаптационный потенциал, функциональное состояние.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Jessica B. Farley ◽  
Lily M. Barrett ◽  
Justin W. L. Keogh ◽  
Carl T. Woods ◽  
Nikki Milne

Abstract Background Understanding the relationships between physical fitness characteristics and sports injury may assist with the development of injury minimisation programs. The purpose of this systematic review was to investigate the association between physical fitness attributes and sports injury in female, team ball sport players. Methods Four scientific databases (MEDLINE, EMBASE, SPORTDiscus, Scopus) and reference lists of relevant research were searched for eligible studies up to September 2, 2019. Full-text articles examining the relationship between physical fitness and sports injury in female, team ball sport players were included. A modified Downs and Black checklist was used to assess methodological quality. Data synthesis determined summary conclusions based on the number of significant relationships divided by the total relationships investigated and reported as a percentage. Level of certainty was identified for summary conclusions based on level of evidence. Sub-analyses regarding competition level, age, and single injury types were also conducted. Results A total of 44 studies were included. Data synthesis revealed no associations (low to moderate certainty) between body composition (1/9; 11%), flexibility (18–20%), and balance (2/8; 25%) and ‘any injury’ classification. No associations (mostly of moderate certainty) were found between flexibility (0–27%), muscular strength (0–27%), and body composition (14–33%) and various body region injury classifications, whereas mixed summary conclusions were shown for balance (0-48%). Many associations between physical fitness and sports injury were deemed ‘unknown’ or with an insufficient level of certainty. Sub-analyses revealed no association between strength and noncontact ACL injuries (0/5; 0%) or ankle sprains (0/12; 0%), and between flexibility and ankle sprains (1/5; 20%); however, insufficient certainty of these results exists. Clear associations were concluded between balance and lower body injuries in female, non-elite (10/16; 63%) and junior (9/12; 75%) team ball sport players, with moderate and insufficient certainty of these results, respectively. Conclusion Limited evidence is available to demonstrate relationships between physical fitness and sports injury in female, team ball sport players. High-quality evidence investigating the multifactorial nature of sports injury, including the interactions physical fitness qualities have with other injury determinants, is needed to better understand the role of physical fitness in minimising sports injuries in female, team ball sport players. Trial Registration CRD42017077374 (PROSPERO on September 14, 2017).


2021 ◽  
pp. 194173812110036
Author(s):  
Jonathan K. Ochoa ◽  
Christopher E. Gross ◽  
Robert B. Anderson ◽  
Andrew R. Hsu

Context: Injections are commonly used by health care practitioners to treat foot and ankle injuries in athletes despite ongoing questions regarding efficacy and safety. Evidence Acquisition: An extensive literature review was performed through MEDLINE, Google Scholar, and EBSCOhost from database inception to 2021. Keywords searched were injections, athletes, sports, foot and ankle, corticosteroids, platelet-rich plasma, and placental tissue. Search results included articles written in the English language and encompassed reviews, case series, empirical studies, and basic science articles. Study Design: Clinical review. Level of Evidence: Level 4. Results: Corticosteroids, platelet-rich plasma/autologous blood, anesthetic, and placental tissue injections are commonly used in the treatment of foot and ankle injuries. Primary indications for injections in athletes include plantar fasciitis, Achilles tendinosis, isolated syndesmotic injury, and ankle impingement with varying clinical results. Conclusions: Despite promising results from limited case series and comparative studies, the data for safety and efficacy of injections for foot and ankle injuries in athletes remain inconclusive.


2021 ◽  
pp. 194173812110129
Author(s):  
Kevin K. Chen ◽  
Jimmy J. Chan ◽  
William Ranson ◽  
Nicholas Debellis ◽  
Hsin-Hui Huang ◽  
...  

Background: Extensor mechanism injuries involving the quadriceps tendon, patella, or patellar tendon can be a devastating setback for athletes. Despite the potential severity and relative frequency with which these injuries occur, large-scale epidemiological data on collegiate-level athletes are lacking. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: Knee extensor mechanism injuries across 16 sports among National Collegiate Athletic Association (NCAA) men and women during the 2004-2005 to 2013-2014 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Extensor mechanism injuries per 100,000 athlete-exposures (AEs), operative rate, annual injury and reinjury rates, in-season status (pre-/regular/postseason), and time lost were compiled and calculated. Results: A total of 11,778,265 AEs were identified and included in the study. Overall, 1,748 extensor mechanism injuries were identified, with an injury rate (IR) of 14.84 (per 100,000 AEs). N = 114 (6.5%) injuries were classified as severe injuries with a relatively higher median time loss (44 days) and operative risk (18.42%). Male athletes had higher risk of season-ending injuries in both all (3.20% vs 0.89%, P < 0.01) and severe (41.54% vs 16.33%, P < 0.01) extensor mechanism injuries. Similarly, contact injuries were more frequently season-ending injuries (4.44% vs 1.69%, P = 0.01). Women’s soccer (IR = 2.59), women’s field hockey (IR = 2.15), and women’s cross country (IR = 2.14) were the sports with the highest rate of severe extensor mechanism injuries. Conclusion: Extensor mechanism injuries in collegiate athletes represent a significant set of injuries both in terms of volume and potentially to their athletic careers. Male athletes and contact injuries appear to have a greater risk of severe injuries. Injuries defined as severe had a higher risk of operative intervention and greater amount of missed playing time. Clinical Relevance: Knowledge of the epidemiology of extensor mechanism injuries may help clinicians guide their athlete patients in sports-related injury prevention and management.


2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0011
Author(s):  
Katie Kim ◽  
Michael Saper

Background: Gymnastics exposes the body to many different types of stressors ranging from repetitive motion, high impact loading, extreme weight bearing, and hyperextension. These stressors predispose the spine and upper and lower extremities to injury. In fact, among female sports, gymnastics has the highest rate of injury each year. Purpose: The purpose of this study was to systematically review the literature on location and types of orthopedic injuries in adolescent (≤20 years) gymnasts. Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL) and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting orthopedic injuries in adolescent and young adult gymnasts. All aspects of injuries were extracted and analyzed including location, type and rates of orthopedic injuries. Results: Screening yielded 22 eligible studies with a total of 427,225 patients. Twenty of 22 studies reported upper extremity injuries of which four specifically focused on wrist injuries. Eight studies reported lower extremity injuries. Nine studies reported back/spinal injuries. Seven studies investigated each body location of injury; one study reported the upper extremity as the most common location for injury and six studies reported the lower extremity as the most common location for injury. Of those seven studies, five (23%) reported sprains and strains as the most common injury. One study reported fractures as the most common injury. Conclusion: There is considerable variation in reported injury location. Some studies focused specifically on the spine/back or wrist. The type of gymnastics each patient participated in was also different, contributing to which area of the body was more heavily stressed, or lacking. Current literature lacks data to fully provide evidence regarding which body region is more frequently injured and the type of injury sustained.


2021 ◽  
Vol 7 ◽  
pp. 205951312098032
Author(s):  
Chenyu Huang ◽  
Rei Ogawa

Introduction: Keloids are pathological scars that are notorious for their chronic and relentless invasion into adjacent healthy skin, with commonly seen post-therapeutic recurrence after monotherapies. Methods: An English literature review on keloid pathophysiology was performed by searching the PubMed, Embase and Web of Science databases, to find out the up-to-date relevant articles. The level of evidence was evaluated based on the included studies with the highest level of evidence first. Results: Keloid morphology, signs, symptoms and the histopathological changes that occur in the local cells and extracellular matrix components are described. The theories on the pathophysiology of keloidogenesis that have been proposed to date are also covered; these include endocrinological, nutritional, vascular, and autoimmunological factors. In addition, we describe the local mechanical forces (and the mechanosignalling pathways by which these forces shape keloid cell activities) that promote keloid formation and determine the direction of invasion of keloids and the body sites that are prone to them. Conclusion: A better understanding of this pathological entity, particularly its mechanobiology, will aid the development of new diagnostic and therapeutic strategies for use in the clinic to prevent, reduce or even reverse the growth of this pathological scar. Lay Summary Keloids are skin scars that are famous for their chronic invasion into healthy skin, with commonly seen recurrence after surgeries. Cells such as lymphocytes, macrophages, mast cells and endothelial cells are involved in keloid growth. Particularly, endocrinological, nutritional, vascular, autoimmunological and mechanical factors actively take part in keloid progression.


Sensors ◽  
2021 ◽  
Vol 21 (8) ◽  
pp. 2780
Author(s):  
Zahra Rahemtulla ◽  
Theodore Hughes-Riley ◽  
Tilak Dias

Overexposure to hand transmitted vibrations (HTVs) from prolonged use of vibrating power tools can result in severe injuries. By monitoring the exposure of a worker to HTVs, overexposure, and injury, can be mitigated. An ideal HTV-monitoring system would measure vibration were it enters the body, which for many power tools will be the palm and fingers, however this is difficult to achieve using conventional transducers as they will affect the comfort of the user and subsequently alter the way that the tool is held. By embedding a transducer within the core of a textile yarn, that can be used to produce a glove, vibration can be monitored close to where it enters the body without compromising the comfort of the user. This work presents a vibration-sensing electronic yarn that was created by embedding a commercially available accelerometer within the structure of a yarn. These yarns were subsequently used to produce a vibration-sensing glove. The purpose of this study is to characterize the response of the embedded accelerometer over a range of relevant frequencies and vibration amplitudes at each stage of the electronic yarn’s manufacture to understand how the yarn structure influences the sensors response. The vibration-sensing electronic yarn was subsequently incorporated into a fabric sample and characterized. Finally, four vibration-sensing electronic yarns were used to produce a vibration-sensing glove that is capable of monitoring vibration at the palm and index finger.


1968 ◽  
Vol 48 (2) ◽  
pp. 427-434
Author(s):  
A. E. BRAFIELD

1. The oxygen consumption of the echiuroid Bonellia viridis has been investigated by means of a continuous-flow polarographic respirometer. 2. The general rate of oxygen consumption per unit dry weight is similar to that characteristic of polychaetes, and declines exponentially with increasing body size. 3. The rate of oxygen consumption rises in the light and falls again if darkness is restored. 4. The oxygen consumption of the isolated proboscis plus that of the isolated body region corresponds closely to that of the entire animal. 5. The oxygen consumption per unit dry weight of the proboscis is considerably higher than that of the body region. 6. The oxygen consumption of an isolated body region increases in the presence of light, but that of an isolated proboscis does not. 7. These findings are discussed in relation to the biology of the animal, observed muscular activity, and the occurrence of the pigment bonellin.


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